The Portal of Geriatrics Online Education

Otolaryngology

Elder Care - A Resource for Interprofessional Providers: Hearing Loss

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

Hearing Loss is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 

After reading this issue of Elder Care, you should be able to…

  1. Identify the most common cause of hearing loss in older adults
  2. State whether or not most people who could benefit from a hearing aid have one
  3. Identify relative advantages and disadvantages of methods of screening for hearing loss
Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as:

  1. Content is not changed,
  2. No one is charged a fee to use or read the publication,
  3. Authors and their affiliated institutions are noted without change, and
  4. The reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatrics Workforce Enhancement Program”. 
Publications from, presentations from, and/or citations to this product: 

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.

Date posted: 
Fri, 06/30/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 03/01/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care - A Resource for Interprofessional Providers: Hearing Loss. POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/218

Elder Care A Resource for Interprofessional Providers: Age-Related Vestibular Disorders: Implications for Older Adult Patients

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

Age-Related Vestibular Disorders: Implications for Older Adult Patients is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 

After reading this issue of Elder Care, you should be able to…

  1. Name the most common vestibular disorder in older adults.
  2. State the symptoms of the most common vestibular disorders in older adults
  3. Order an appropriate test to determine the side (left or right) of a vestibular lesion
Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as:

  1. Content is not changed,
  2. No one is charged a fee to use or read the publication,
  3. Authors and their affiliated institutions are noted without change, and
  4. The reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatrics Workforce Enhancement Program”. 
Publications from, presentations from, and/or citations to this product: 

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.       

Date posted: 
Wed, 06/14/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 06/14/2017
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Age-Related Vestibular Disorders: Implications for Older Adult Patients. POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/218

Goals of Care Conversation Curriculum (GOCCC) Training

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

We developed a 3-part curriculum for teaching the basics of communication about goals of care (GOC) in older persons targeted towards medical students, residents, fellows, and faculty. There are 3 modules: 

1. Communicating Serious News - identifies strategies for effective communication and especially communicating serious news to patients or family members and improving our ability to transmit this news in an empathic and effective manner.

2. Goals of Care Discussion -focuses on the essential components of a GOC discussion; initiation, understanding the patient and family perspective, surrogate decision making, and concluding remarks clarifying and summarizing key discussion points and areas of understanding.

3. Managing conflict with patients and families - focuses on how to address frustrated and perhaps angry patients or family members who sometimes don’t feel that they are being listened to.  As providers, we are often put in this situation with few resources or skills to help guide us on how to deal with the patient’s and family’s emotions as well as our own. 

Each module contains a didactic lecture (45-60 minutes), examples of faculty role play (10-15 minutes), and instructions for participant role play activities. Each module is focused around a clinical case scenario done in dyads (30 minutes), and a sample evaluation form. Each module is best done in 2-hour sessions and in small groups (10-20 participants) but can be modified for 1-hour sessions. The content is applicable to a range of learners although the participant role play will likely be more meaningful for the more advanced learners.

Educational objectives: 

At the end of Module 1: Discussing Serious News, students, residents, and faculty will be able to:        

a.      Use curiosity and good listening skills to understand patient coping styles

b.      Describe empathic and effective approaches to discussing serious news

c.       Identify strategies for discussing prognosis

At the end of Module 2: Basic GOC, students, residents, and faculty will be able to:

a.       Be comfortable and effective in talking with patients and families about goals of care for patients with serious life-threatening, or chronic conditions

b.      Describe goals of care discussions as an essential component of the practice of medicine accepted within the mainstream of legal, moral, and ethical principles

c.       Articulate the complexity and subtleties of surrogate decision-making,  and the concept of substituted judgment

d.      Practice the key components of goals of care discussions in a simulation as a means of gaining competence and confidence in conducting GOC conversations

At the end of Module 3: Managing Conflict, students, residents, and faculty will be able to:

a.       Manage conflict in an effective and empathic manner to de-escalate anger and frustration experienced by patients and families during serious illness

b.      Recognize that in life-threatening situations, anger is a common response

c.       Describe communication techniques for diffusing anger

d.      Apply recommended skills to manage conflict and guide patients, families, and other clinicians through difficult decisions

Date posted: 
Mon, 06/20/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 08/08/2019
Contact Person/Corresponding Author:



Suggested Citation:
Goals of Care Conversation Curriculum (GOCCC) Training. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/218

Geriatric Fast Facts Quizzes

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
0
Abstract: 

Geriatric Fast Facts (GFFs) [www.geriatricfastfacts.com] is a mobile enabled website which contains 1-2 page concise, peer-reviewed evidence-based educational summaries on key geriatrics topics to increase medical knowledge.

GFF Quizzes are quick, online assessment tools paired with GFF content, to be used by learners at the point of care to assess knowledge of geriatric content aligned with ACGME Milestones.  Design elements include quiz content searchable by topic, links to corresponding GFFs, MCQ/ short answer question formats and ability to include images. Learners enter brief demographic information to start (institution, email of self and up to 1 other) allowing annotated score results, displayed immediately after quiz completion, to be sent to themselves and one other individual (faculty, program director). These quick quizzes, available on hand held mobile devices at the point of care, linked to GFF content provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Educational objectives: 

The Geriatric Fast Fact (GFF) quizzes, available on hand held mobile devices at the point of care, linked to GFF content will provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Additional information/Special implementation requirements or guidelines: 

The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed and accessed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app".

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

Quick Quizzes:  Geriatrics Right in Your Hand & at the Point of Care.  Denson K, Simpson D, Padua K, and the GET Collaboratives at the Medical College of Wisconsin & Aurora Health Care, American Geriatrics Society Annual Meeting, Baltimore, MD, 05/2015

Date posted: 
Thu, 10/08/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/08/2015
Product Viewing Instructions: 
The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app"
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Fast Facts Quizzes. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/218

Interprofessional Collaborator Mini-Course

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

Physicians (and other health professionals) are often expected to participate with teams of health professionals; however, postgraduate training infrequently includes interprofessional (IP) or team training.  Thus, this curriculum was developed to teach and demonstrate the knowledge, skills and attitudes which lead to successful IP collaboration.  While created for an audience of in-training physicians, it may be used with other health professional audiences.

During a four-week geriatrics rotation, medicine interns complete a fifty-minute, in-person, multimedia lecture to introduce the IP collaborator concept and the Canadian and American IP competency frameworks. The IP pocket card is demonstrated and interns complete a guided, team-meeting video observation exercise. Using a SurveyMonkey, narrative reporting tool, interns analyze team competencies that they observe or initiate during geriatrics team meetings during the rotation. They report on two interactions. They complete a closing SurveyMonkey questionnaire and have an in-person debriefing.

Educational objectives: 

Given opportunity to work with interprofessional teams for patient care on the Geriatrics Block Rotation:

  • Learner will recognize interprofessional competencies.
  • Learner will understand the role of interprofessional collaborator.
  • Learner will observe and demonstrate the knowledge, skills and attitudes necessary to be an interprofessional collaborator according to CIHC and IPEC competencies
Publications from, presentations from, and/or citations to this product: 
Poster Presentation: Interprofessional Collaborator Curriculum
InterProfessional Care for the 21st Century
Redefining Education & Practice
Jefferson University, Philadelphia, PA
October 2014
Date posted: 
Tue, 06/14/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 04/03/2019
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Collaborator Mini-Course. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/218

Chief Resident Workshop in Bad News Communication & Learner Feedback

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

Incoming chief residents from all departments participate in a 90 minutes workshop with the dual objectives of teaching a model for sharing bad news and preparing these physician leaders to give feedback to learners about this important skill.  After reviewing a 6 step model for bad news communication, the chief residents share bad news with standardized patients using two cases of older adults with a new or recurrent cancer diagnosis.  The standardized patients all receive training about the workshop's objectives in a separate session prior to the workshop.  After communicating with the standardized patient, the chief resident receives feedback from the patient, a trained faculty small group facilitator and 1-2 other chief residents.  After both cases are completed, the chief residents gather for a large group discussion about the challenges and opportunities in providing feedback to learners about sensitive topics.  This workshop has been conducted for the past three years, and has received positive evaluations from the participating physicians and the school's Graduate Medical Education Office.

Educational objectives: 
  1. Recognize bad news communication as a core physician skill
  2. Understand the 6 basic steps used to initially deliver bad news
  3. Practice giving feedback to a resident whom delivered bad news
  4. Identify & discuss challenges of providing feedback about a sensitive topic
Date posted: 
Thu, 10/02/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/02/2014
Contact Person/Corresponding Author:



Suggested Citation:
Chief Resident Workshop in Bad News Communication & Learner Feedback. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/218

Wake GPS Quality Improvement Project Handbook

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

This handbook was developed for the Geriatrics Principles for Specialists (GPS) Program of Wake Forest School of Medicine.  In order to facilitate improvements in clinical care of older adult patients, it provides an overview of key steps for the development, implementation, and evaluation of quality improvement (QI) projects by graduate medical learners (i.e., residents and fellows) and faculty members. For each given step, the handbook reviews the associated purpose, content, and deliverables, and provides links or citations to additional learning resources.  The handbook is available in both PDF and ePub versions.

Educational objectives: 

The educational objectives of the handbook are to inform learners about:

  1. The model for improvement framework for selecting an improvement target to develop into an actionable project.
  2. The audit and feedback and technique for obtaining data and jump starting system change.
  3. Process mapping the steps to a given outcome.
  4. Assembling a care team to review the project plan.
  5. Planning a test of change using the concept of the PDSA cycle.
  6. Measuring outcomes.
Date posted: 
Wed, 10/01/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/01/2014
Product Viewing Instructions: 
To download the eBook version of the Wake GPS Quality Improvement Handbook, please go to the Wake Geriatrics website.
Contact Person/Corresponding Author:



Suggested Citation:
Wake GPS Quality Improvement Project Handbook. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/218

Can You Swallow This? A Practical Approach to Dysphagia

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

This interactive, "hands-on", small group session emphasizes a practical approach to the diagnosis and management of dysphagia in older adults.  Created by a speech and language pathologist and geriatrician team, the session begins with a brief overview of swallowing anatomy and phases.  A small group brainstorming session then highlights potential etiologies of dysphagia, followed by the use of video fluoroscopic studies and the learners' sampling of thickened liquids and trials of swallowing manoeuvers to make learning "stick".

1) The session starts with the facilitator reviewing a PowerPoint presentation (9 slides).  These slides cover the session learning objectives, the definition of dysphagia and review of  health consequences of dysphagia, and orient the learner to swallowing basics through cross-sectional diagrams of the head and neck describing swallowing anatomy and phases of swallowing.

2) The session continues with a small group brainstorming session with learners working in groups of two or three to fill in a chart listing "what conditions/diseases may lead to dysphagia or aspiration?" The group lists the etiologies under the three headings of swallowing phases (e.g., oral, pharyngeal, esophageal).  The facilitator has the groups share findings with the large group, highlighting key points.

3) The facilitator returns to the PowerPoint Presentation, reviewing key factors in identifying dysphagia through history and physical examination (4 slides).  Evaluation through video fluoroscopy is demonstrated through 5 short video clips (e.g. normal swallow, aging swallow, aspiration, thick/thin liquids modifications).

4) Learners try nectar and honey thickened liquids to experience potential therapy/treatment options and to then practice basic compensatory swallowing strategies.

 

Educational objectives: 

Educational Objectives:

1. Identify the 3 phases of swallowing (oral, pharyngeal, esophageal) and conditions causing potential dysphagia.

2. List 5 factors (clues) that a patient may be at risk for aspiration.

3. List treatment options for aspiration (swallowing exercises, position changes, dietary modification).

Additional information/Special implementation requirements or guidelines: 

Educational Objectives:

1. Identify the 3 phases of swallowing (oral, pharyngeal, esophageal) and conditions causing potential dysphagia

2. LIst 5 factors (clues) that a patient may be at risk for aspiration

3. List treatment options for aspiration (swallowing exercises, position changes, dietary modification)

 

Of Note:

This exercise is designed to cover the practical aspects of swallowing and dysphagia.  It's goal is to help learners identify risk factors for aspiration in older adults and to be able to then implement an initial assessment plan to evaluate the condition further.  Trial of the liquids is done to increase empathy and understanding of the risks and benefits of modifying liquid consistence for patients and the challenges of postural and behavioral modifications as well.  The teacher/facilitator does not need to be an expert in swallowing and dysphagia.  The materials provided are an initial point for teaching and the Frequently Asked Questions/References  (Ask the Speech Therapist Sheet) is designed to supplement the session and to provide a starting place for further study.

While the session is most easily taught as a small group session (6-8 learners), it was taught at the American Geriatrics Society Clinical Skills session to approximately 60 learners.  The small group portions were completed by having learners work with one or two persons next to them to complete the Dysphagia Etiologies Chart, and liquids were passed on trays.

Materials needed for the session:

1. Session Agenda - facilitator (one)

2. Session Agenda - Participants (one for each participant)

3. PowerPoint presentation with included 5 video clips

4. Dysphagia Etiologies sheets - blank (one for each participant or for each small group)

5. Dysphagia Etiologies sheet - answer key (one for the facilitator)

6. Nectar and honey consistency thickened liquids.  These may be made with a starch/thickener product such as "Thickit" (mix the starch with water according to ratios in the product directions - be aware that the liquids thicken further upon standing, so you may need to thin the liquid out with more water), or by purchasing pre-thickened liquids in the two consistencies ( a more expensive, but easier approach).  It is a time-saver and stress-reducer to have the liquids prepared in the small cups prior to the session.  They may be place on the table or passed around via a tray.  It is important to identify which liquid (nectar or honey thickened) is in which cup.  This may be done with a marker "N" or "H" on the cups, or by simply using two different style/color of cups.

7. Small, disposable cups (2 per learner)

8. Spoons and napkins, tray (optional)

9. Frequently Asked Questions/Reference Sheet

 

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

Presented at:

Wisconsin Geriatrics Board Review Course and Update, Lake Geneva, WI, Sept, 2013

Wisconsin Family Medicine Winter Refresher Course, Oconomowoc, WI February 2014

 American Geriatrics Society Annual Meeting, Clinical Skills Session, Orlando, FL, May 2014

Date posted: 
Mon, 09/29/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 09/29/2014
Contact Person/Corresponding Author:



Suggested Citation:
Can You Swallow This? A Practical Approach to Dysphagia. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/218

Hearing Loss in the Elderly

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
0
Abstract: 

This PowerPoint video and audio discusses the pathophysiology, evaluation and treatment of hearing loss. Communicating with patients with hearing loss will be taught, all in less than 6 minutes.

Educational objectives: 

Understand the causes of hearing loss

Be able to better communicate with patients who have hearing loss

Date posted: 
Mon, 06/30/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 03/16/2018
Contact Person/Corresponding Author:



Suggested Citation:
Hearing Loss in the Elderly. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/218

Delirium: Prevention and Management in Hospitalized Elders

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
999
Abstract: 

This course is intended for interdisciplinary members of the healthcare team in the hospital setting to improve knowledge of issues surrounding delirium in the elderly hospitalized patient. This 23-question module focuses on the evidence behind the recognition, prevention, and management of delirium in the geriatric patient.

Educational objectives: 

Upon completion the learner will be able to:

1. Use the Confusion Assessment Method to screen for delirium.

2. Understand features that differentiate delirium from dementia.

3. Name at least  five risk factors for delirium and techniques that target each risk factor to prevent the development of delirium.

4. Name at least three drugs that should be avoided in the geriatric patient.

5. Understand basic principles to the management of delirium, including work-up, behavioral management, and pharmacologic management.

6. Understand the importance of documentation of delirium and ways to improve transitions of care.

Additional information/Special implementation requirements or guidelines: 

This program will consist of 23 multiple choice questions on delirium in the geriatric patient in the hospital setting. The module will begin with two questions every other day in a single email from the website, www.qstream.com. This website will facilitate the delivery of questions and answers to the participant. You must log in to the website from the link posted above.

  •  If a question is answered incorrectly, the participant will receive the same question 5 days later.
  •  If a question is answered correctly, the participant will receive the same question 14 days later.
  •  If the participant answers the question correctly two times in a row, the question is then retired from the program and  is no longer repeated.
  •  The participant will complete the program when all 23 questions are retired (each question is answered correctly twice in  a row).  However, CE credit may be given when the program is 80% completed.

Given these parameters, it is estimated that the participant will complete the program in less than three months.

Participants may receive credit or contact hours ONLY by completing 80% of the questions in a module AND completing the end of module survey in LESS than four months time of enrollment.

Date posted: 
Wed, 11/13/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 11/13/2013
Product Viewing Instructions: 
You must register for the class and create a username
Contact Person/Corresponding Author:



Suggested Citation:
and . Delirium: Prevention and Management in Hospitalized Elders. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/218

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