The Portal of Geriatrics Online Education

Boston University School of Medicine

Is this a Reynold's grantee: 
Yes

Teaching Transitions of Care to Residents Using A Post-Hospitalization Patient Visit

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
2
Abstract: 

With the goal of learning key components to a good hospital discharge of an older patient, residents at Boston Medical Center participated in a structured teaching exercise adapted from University of Rochester's Hospital to Home program in which they made a home or nursing home visit to see a patient whom they cared for during the hospital admission. This exercise effectively enhances the medical resident's self reported ability to assess and implement post-discharge care for complex older patients. Specifically residents expressed an increased awareness of the need to tailor post-discharge plans to a patient's health literacy level, functional status and psychosocial factors. This exercise is a promising intervention for teaching transitions of care.

Educational objectives: 
  1. Identify the discharge summary as a vital communication tool in the handoff between hospital and post-hospital care teams.
  2. Explain the role of community agencies and services, such as Community Home Health Agencies (CHHA), in providing post-hospital care.
  3. Perform medication reconciliation in order to lessen medication errors at the time of transition.
  4. Identify the psychosocial factors that impact a patient's implementation of his/her discharge plan.
Additional information/Special implementation requirements or guidelines: 

BU Internal Medicine residents who participate in the Geriatrics Ambulatory Rotation are required to complete a post-hospitalization visit on a patient that they cared for (rounding, admission, or discharge) on the inpatient geriatrics service during their weekend coverage duties. This visit may happen in either the home or the nursing home setting. While accompanied by a geriatrician, residents will conduct a brief interview of the patient and his/her family to assess their perspective of the discharge. They will also perform medication reconciliation while in the patient's home or at the nursing home. After the visit, they will critically review the discharge summary to determine if the discharge plan was appropriate for the patient. They will then reflect on ways the discharge plan could have been altered to better fit the patient's needs. The geriatrics attending will evaluate the resident's performance on the post-hospital visit by evaluating skills that correlate with the core competences.

Date posted: 
Mon, 02/11/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 02/11/2013
Contact Person/Corresponding Author:



Suggested Citation:
Teaching Transitions of Care to Residents Using A Post-Hospitalization Patient Visit. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/1148

Spirituality & End of Life OSCE

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

The purpose of this OSCE is for the trainee to acknowledge, address, and work with patient spirituality as it impacts health care decisions. Spirituality and religious beliefs are commonly raised by patients and families and are frequently accessed to assist them in making difficult decisions in their health care.

Educational objectives: 

Upon completion fellows will demonstrate:

  1. Ability to obtain a focused patient history
  2. Ability to discuss patient's spirituality and its impact on health care decisions
Additional information/Special implementation requirements or guidelines: 

Standardized patients need to be familiarized with the case and use of the history content checklist. Use of an exam room and faculty observation room is also necessary.

Date posted: 
Tue, 10/19/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 10/19/2010
Contact Person/Corresponding Author:



Suggested Citation:
Spirituality & End of Life OSCE. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/1148

Delirium in Older Patients: An Online Case-Based Curriculum

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

An interactive, multimedia online curriculum that teaches delirium. Using the virtual patient Mrs. Casimira Rivera, important teaching points are illustrated. Learners complete two modules that focus on the diagnosis, evaluation, and management of delirium. Prior to starting each individual module, learners watch video clips and read mock charts describing the patient’s complaints. The modules consist of didactic teaching PowerPoint slides alternating with multiple-choice questions designed to reinforce key concepts. Answers given to these questions are not graded. Copyright 2006, Trustees of Boston University

Educational objectives: 

<p>
At the end of the online curriculum, the learner will be able to:</p>

<ul>
<li>
Make a diagnosis of delirium · Identify predisposing and precipitating risk factors of delirium</li>
<li>
Recognize delirium in its hypoactive presentation as well as its agitated, hyperactive presentation</li>
<li>
Choose evaluation that is needed to better refine the differential diagnosis of delirium, including additional history, physical exam and lab testing</li>
<li>
Develop treatment and management approaches to delirium in the hospitalized older patient</li>
</ul>

Additional information/Special implementation requirements or guidelines: 

Intended Audience:

  • Fourth year medical students who are completing a required Geriatrics rotation.
  • Also appropriate for third year medical students during their third year Medicine clerkship.

Instructor Responsibility: Course instructors or rotation directors should be available to learners for questions regarding the content of this online curriculum.

Required Resources:

  1. RealPlayer, to view the videos
  2. PowerPoint

Procedures for Implementation:

  1. To use the curriculum, you will need to have a program called RealPlayer installed on your computer. Download it for FREE by visiting this website: www.real.com.
  2. Visit our website: http://www.bu.edu/geriatrics/casimiracase/
  3. Learner instructions and links to video clips, mock charts, and PowerPoint Modules A and B are located on this website.
  4. Learners should complete all components of Modules A and B.
  5. If instructors choose to grade completion of the modules as a clerkship exercise, BU has a 10-question quiz consisting of multiple choice and true-false items.

At BU, we require students to complete modules A and B by the end of the first week of their required fourth year geriatrics clerkship. On the last day of week 1, students are administered this paper quiz in a proctored setting. To receive a passing grade for the exercise, students must answer 7 out of 10 questions correctly (i.e. at least 70% correct). We give students an unlimited opportunity to retake this quiz (and redo the online curriculum) if they do not pass it on the initial attempt. If you would like a copy of the quiz, please contact Dr. Serena Chao at serena.chao@bmc.org

Relationship to Other Educational Materials: This tool was designed to be a stand-alone curriculum in delirium. However, clerkship directors may use it as an adjunctive teaching resource. For example, it may be used as a supplement to existing delirium lectures or as a preparatory tool for small group case discussions.

Assessment of Learners: After learners complete the online curriculum, instructors may choose to administer a 10-question quiz consisting of multiple choice and true/false questions. Please see item 5 in “Procedures for Implementation”.

Publications from, presentations from, and/or citations to this product: 

Chao S, Brett B, Wiecha J, Norton L, Doyle J, Ackerman K, Cao X, Levine SA. Comparison of Online Curriculum to Lecture Format in Teaching Delirium to 4th-Year Medical Students. J Am Geriatr Soc 2007; 55:S182 (accepted for poster presentation, Presidential Poster Session, 2007 American Geriatrics Society Annual Scientific Meeting, Seattle, Washington).

Date posted: 
Wed, 06/03/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 06/01/2012
Contact Person/Corresponding Author:



Suggested Citation:
Delirium in Older Patients: An Online Case-Based Curriculum. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1148

Physician's Guide to Nursing Home Phone Call Coverage

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This is intended to be a guide to physicians covering the nursing home on weekends and evenings with suggested responses to common calls.

Educational objectives: 

Act as a quick reference for covering physicians

Additional information/Special implementation requirements or guidelines: 

This was originally designed for a specific institution. It can be used as a template to help develop a guide that fits a particular situation.

Date posted: 
Mon, 06/08/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/19/2009
Contact Person/Corresponding Author:



Suggested Citation:
Physician's Guide to Nursing Home Phone Call Coverage. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1148
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