The Portal of Geriatrics Online Education

Curriculum/Syllabus

An instructional plan of lessons and objectives aimed at helping learners gain a particular set of skills and knowledge. This plan can include a reading list, syllabus, lesson plan or course outline. Sometimes describes the implementation of programs such as chief residency training or student mentor programs.

Postoperative Delirium Curriculum For General Surgery Residents

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

According to estimates, 50% of older adults will have an operation after the age of 65 with postoperative delirium being the most common complication in this age group. Even though delirium is common, the diagnosis is often overlooked and improperly treated. The American Geriatric Society surveyed surgical specialists and found that delirium was the geriatric clinical issue having the largest knowledge gap. Most surgical training programs still have little geriatric care incorporated explicitly into the curricula, and little explicit assessment of skills in caring for older patients. There is still a significant gap in formalized delirium education in surgical training programs. Our goal is to address this gap with this postoperative delirium curriculum for general surgery residents. Our objective is that through this geriatric surgical curriculum with a foundation consisting of delirium prevention, assessment, and management will ultimately lead to improved surgical care outcomes for older adults. This is a case based guide to compliment an online module through the Surgical Council of Resident Education (SCORE) website. We designed an online module on the SCORE website on postoperative delirium and this is an interactive case based small group exercise along with pre-post test, mini-cex, pocket card, and consultant check sheet. The case will require learners to go through a real surgical case, identify and modify risk factors, do delirium risk assessment, use a validated delirium screening tool (4AT), and come up with prevention and treatment options.

Educational objectives: 

After completion of the curriculum, the surgical resident will be able to:

  1. Identify the pathophysiological causes of postoperative delirium.
  2. Identify risk factors for the development of postoperative delirium.
  3. Recognize interventions to prevent postoperative delirium.
  4. Describe the common presentation of delirium and be able to distinguish delirium from dementia and depression.
  5. Recognize evidence based assessment tools (e.g. 3D CAM, 4AT, etc.) as reliable ways to screen for postoperative delirium.
  6. Describe the major effects that delirium has on surgical and patient outcomes.
  7. Correctly employed a validated delirium assessment tool (e.g. 4AT) to screen postoperative delirium in non-ICU older confused surgical patient.
  8. Calculate the correct delirium risk assessment score for a case scenario.
  9. Propose strategies for mitigating preoperative, intraoperative, and postoperative risk factors for a common general surgery case scenario.
  10. Identify "best-practice" non-pharmacologic and pharmacologic treatment strategies to manage postoperative delirium given a case scenario   
  11. Demonstrate to their attending or geriatric consultant the correct use of a validated delirium assessment tool to screen for postoperative delirium in non-ICU older confused surgical patient. 
  12. Perform prevention measures and monitor delirium development via evidence based assessment method (e.g 4AT) prior to geriatric consult.   

As a result of the curriculum, surgical residents will rate as important that surgeons should know:

1. Treatment strategies for postoperative delirium.

2. How to screen for postoperative delirium using a validated assessment tool.       

3. Strategies to prevent postoperative delirium.      

 

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

This was presented at the American Geriatricy Society Meeting and American Delirium Society Meeting.

Date posted: 
Wed, 02/13/2019
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 01/28/2019
Contact Person/Corresponding Author:



Suggested Citation:
Postoperative Delirium Curriculum For General Surgery Residents. POGOe - Portal of Geriatrics Online Education; 2019 Available from: https://pogoe.org/taxonomy/term/287

"TMI"... (Too Many Interpretations): Mr. Moore's Medication Misadventures!

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

This two hour interprofessional curriculum brings together fourth year medical students and third year pharmacy students in a hands-on, interactive small group session. Learners are given a guide briefly describing the case and delineating five health care members and their roles and expertise in Mr. Moore's healthcare team (Mr. Moore's partner, the outpatient pharmacist, the inpatient intern, etc). A pair of interprofessional facilitators guide learners through the case, utilizing different healthcare team members' roles and expertise to explore methods of medication organization and systemic barriers to accurate and safe discharge medication reconciliation. Learners discover and discuss discrepancies in high-risk medications, gain an appreciation of systems hurdles for patients and healthcare providers during transitions of care, complete an exercise in writing discharge medication instructions, and brainstorm action items to personally employ to overcome systemic hurdles for safer discharge medication reconciliation.

Educational objectives: 

By the end of the two-hour session, learners will work collaboratively to:

  1. Describe the roles and expertise of three health professions that can collaborate to reconcile medications and enhance safety of medication orders at the time of hospital discharge. 
  2. List three potential communication barriers between health professionals involved in discharge planning that contribute to medication errors in vulnerable older adults.
  3. Identify key components of discharge medication lists and instructions to communicate information safely to patients, caregivers, primary care providers and others on the healthcare team.
Date posted: 
Tue, 08/30/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 08/30/2016
Contact Person/Corresponding Author:



Suggested Citation:
"TMI"... (Too Many Interpretations): Mr. Moore's Medication Misadventures!. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/287

Error Disclosure: An Interprofessional Clinical Skills Session

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

The goal of this clinical skills session is for students to gain skills in working in teams during a particularly difficult situation: the team disclosure of medical errors.  There will be an encounter with a standardized patient (SP) acting as a family member, followed by feedback from the SP and for some students, a review of the recorded interview in a meeting with their mentors and mentor group.

Educational objectives: 

At completion of this case, the student will demonstrate effective team communication behaviors when:

  1. Discussing a medical error (by demonstrating four important principles),
  2. Planning for the disclosure (by demonstrating three important principles), and
  3. Conducting the disclosure (by demonstrating eight important principles).

The principles mentioned above are described in the online module.

Date posted: 
Mon, 10/12/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/12/2015
Product Viewing Instructions: 
Video can be accessed via geriSAGE.com>Educational Modules "Interprofessional web-GEM on Values & Ethics". Handout can be accessed on geriSAGE.com>Resources link>"IP Error Disclosure Handout"
Contact Person/Corresponding Author:



Suggested Citation:
Error Disclosure: An Interprofessional Clinical Skills Session. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/287

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/287

Patient Complexity and Interprofessional Team Care

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

Patient Complexity and Interprofessional Team Care is a geriatrics block rotation mini-course designed to improve medicine trainee’s understanding of health care teams.  It was developed in the setting of a new model of care collaboration for vulnerable seniors, Geriatric Resources for Assessment and Care of Elders.  The course is a blended curriculum offered during a 4-week residency block rotation in geriatrics. It is composed of a web-based, audio, PowerPoint lecture to introduce the Minnesota Complexity Assessment Method (MCAM) tool and application of the tool using paper cases.  The tool is then applied to actual patients discussed at an interprofessional team meeting of the GRACE care management program.

Educational objectives: 

Given a screening of the patient medical record, attendance at the patient’s GRACE interprofessional team meeting and completion of the Minnesota Complexity Assessment Method (MCAM) tool, the health professional trainee will identify patient situation complexity and describe ways that interprofessional team care members address patient care.

Given a printed Likert scale questionnaire, the resident will indicate positive change in degree of agreement with beliefs about interprofessional teams.

Publications from, presentations from, and/or citations to this product: 
Educational Strategies for Addressing Complex Patient Care Symposium
Aida Wen, MD, Todd James, MD, Miho Bautista, MD
October 21, 2013, 2013 Reynolds Grantee 11th Annual Meeting  in Coronado, CA

 

“Beliefs of Medicine Residents Regarding Interdisciplinary Teams,”  Poster presentation American Geriatrics Society Scientific Meeting, Grapevine, TX, May 2-5, 2013

Citation:  James, TC, Westmoreland, GR, Counsell SR. Beliefs of Medicine Residents Regarding Interdisciplinary Teams. J Am Geriatr Soc 2013; 61: Suppl s1; s157 (abstr C87).  http://onlinelibrary.wiley.com/doi/10.1111/jgs.122...

 

The poster described the 12-item physician survey to assess post-graduate medicine resident beliefs regarding interdisciplinary teams.  Resident responses demonstrated that interdisciplinary team participation is perceived as worthwhile. Yet, residents were uncertain about when their patient needed a team. There was significant agreement for having physicians as leaders of teams, and yet there was not clear agreement on team goals. Survey results support development of curricula for medicine residents geared toward teaching when a team approach is indicated and clarifying roles of various team members.

 

“Complexity and Interdisciplinary Team Care” Curriculum Presentation at Reynolds Grantee 9th Annual Meeting, St. Louis, MO, October 23 – 26, 2012

 

“Using a Complexity Tool with Geriatric Patients Teaches Residents Roles of Interprofessional Teams,” Buzz Session Presentation, InterProfessional Care for the 21st Century: Redefining Education and Care conference, Jefferson InterProfessional Education Center, Philadelphia, PA, May 18 – 19, 2012

 

“A New Strategy for Teaching Residents Roles of Interprofessional Teams” Poster Presentation at American Geriatrics Society Scientific Meeting, Seattle, WA, May 3 – 5, 2012.

Citation: James TC, Westmoreland GR, Arenson S, Counsell SR. A New Strategy for Teaching Residents Roles of Interprofessional Teams. .  J Am Geriatr Soc 2012; 60: Suppl s4;  s45 (abstr A84). http://www.americangeriatrics.org/files/documents/...

 

 “Academic Roles and Scholarly Activities” presentation, Faculty Forum, Indiana University Geriatrics, Indianapolis, IN, January 23, 2012

 

“Pilot Testing of a New Curriculum on Patient Complexity and Interdisciplinary Team Care” Poster Presentation at Collaborating Across Borders III, Tuscon, AZ, November 19 – 21, 2011.

 

 

 

Date posted: 
Wed, 04/03/2019
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 04/03/2019
Contact Person/Corresponding Author:



Suggested Citation:
Patient Complexity and Interprofessional Team Care. POGOe - Portal of Geriatrics Online Education; 2019 Available from: https://pogoe.org/taxonomy/term/287

When Eating Problems Arise in Advanced Dementia: An Interdisciplinary Trigger Video

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

This is an interactive seminar centered on a trigger video depicting a family meeting with the treating physician, the speech and language pathologist and the family of a patient with advanced dementia who suffers from dysphagia/poor oral intake. The seminar can be provided to a small group of 4-10 healthcare trainees (medical residents or students, nursing students, speech and language pathology students, social work students). The seminar is designed to present the learners with an interdisciplinary approach to conducting a family meeting on this topic. It starts with reading a case presentation, which is meant to emphasize the need for a family meeting, followed by playing the video until a trigger question comes up. At that point the participants are asked to reflect on the question and share their answers with the group. The group then watches the video exemplifying a way the question can be discussed. The process is repeated for all the trigger questions. At the end of the seminar the trainees are encouraged to debrief on language that could be modeled for goals of care discussions as well as aspects of the discussion that could have been approached differently. They are also provided with all the references used in the video as a resource for future family meetings. Trainees are asked to complete a short retrospective pre/post self-assessment survey. 

Educational objectives: 
  1. Review importance of completing advance directives (applied to patients with dementia); define surrogate decision maker, substituted judgment, and best interest concepts and discuss advance care planning for the case presented.
  2. Describe the natural history of advanced dementia.
  3. Become familiar with potential treatment burdens associated with tube feeding in patients with advanced dementia.
  4. Appreciate various options for eating/feeding in advanced dementia and swallowing problems.
  5. Analyze aspects of difficult conversations with surrogate decision makers.

 

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

Some of the materials for this seminar were presented during the Marketplace at the Reynolds Meeting in Las Vegas, Oct 7, 2014.

 

 "When Eating Problems Arise in Patients with Advanced Dementia- An Interdisciplinary Approach to

Communicating with Caregivers" This interactive seminar was presentated at the Annual

Assembly of the American Association of Hospice and Palliative Medicine Annual Meeting, February 2015, Philadelphia.

 

 

Date posted: 
Fri, 06/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 06/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
When Eating Problems Arise in Advanced Dementia: An Interdisciplinary Trigger Video. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/287

Discharge Planning and Care Transition Curriculum for Interns

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
3
Abstract: 

A discharge planning curriculum for internal medicine and family medicine interns consisting of two parts:

PART I: Five online self-study learning modules on:

  1. Multi-morbidity in Older Adults
  2. Hazards of Hospitalization
  3. Poor Discharge Outcome Risk Assessment
  4. Evidence Based Models of Care Transition
  5. Components of a Quality Discharge Planning

Each module consists of an introduction, learning objectives, pre-quiz, content, conclusion, and references. The online modules will emphasize knowledge and will consist of five learning modules covering the above listed topics. These topics were chosen to provide the broad knowledge base related to hospitalized older adults and their care transitions.

PART II

A live session is conducted utilizing and implementing multiple instructional strategies. This live session is divided into multiple segments or parts. Each segment is conducted utilizing a different instructional strategy and structured to encourage learner participation by incorporating at least one interactive activity:

Instructional Strategies

  • PowerPoint lecture with multiple choice questions and integrated audience response (clickers)
  • Co-teaching and expert panel discussion (incl. a therapist, hospital transition team member, and a social worker)
  • Minute paper (interval self-assessment and reflection on learning)
  • Case-based problem solving

Learning Outcomes

  • Knowledge
  • Skills
  • Attitudes
Educational objectives: 

At the completion of the modules, participants will be able to:

  • Define multi-morbidity and its effects
  • Identify the hazards of hospitalization and measures to prevent or minimize these hazards
  • Identify a medical patients at increased risk of poor outcomes post hospital discharge
  • Identify the components of a successful care transition
  • Identify the benefits of a structured discharge summary

At the end of the Modules and the IMPACT session, the Entrustable Professional Activities (EPA) expected of the interns includes:

  • Formulating a safe discharge plan for an older adult
  • Completing a high quality comprehensive discharge summary

 

Additional information/Special implementation requirements or guidelines: 

Non Indiana University (IU) faculty and students will need a guest account to access the online modules. Instructions on how to create an IU guest account can be found at:  https://kb.iu.edu/d/alqt

To create a guest account go to: https://itaccounts.iu.edu/

After a guest account has been created, send the e-mail address with which you created the guest account to: tociloab@iu.edu and access to the online learning modules will be granted to that e-mail/guest account.

Date posted: 
Mon, 10/06/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/06/2014
Contact Person/Corresponding Author:



Suggested Citation:
Discharge Planning and Care Transition Curriculum for Interns. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/287

Medical Student Interprofessional Team Exercise on Dementia Post-Hospital Care

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

This exercise is an introduction for 3rd year medical students to community-based Long-term care services and supports (LTSS) and home and community-based services (HCBS) for older adults with Alzheimer's disease. The targeted learners of the exercise at the University of Cincinnati are third year medical students beginning a two-day introduction to a four-month rotation block containing clerkships in family medicine, neurology, and psychiatry.

Educational objectives: 

1. Describe the challenges of post-acute care for older adults hopsitalized with cognitive impairment. 

2. List resources available to families from area community agencies that provide care to older adults. 

3. Describe a care plan, utilizing support from area agencies, for caring for an older adult with cognitive impairment in the home. 

Additional information/Special implementation requirements or guidelines: 

This is a 4 hour course with the following components:

  1. A lecture on the assessment of memory loss in older adults
  2. A faculty led interview of a caregiver
  3. A case-based exercise to learn about services available to assist AD patients and their families, in which students meet in small groups with representatives from 4 community agencies and create an interprofessional care plan that is then shared with the student group. 
Date posted: 
Wed, 10/01/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/01/2014
Contact Person/Corresponding Author:



Suggested Citation:
Medical Student Interprofessional Team Exercise on Dementia Post-Hospital Care. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/287

Advance Care Planning Curriculum

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

Advance care planning (ACP) is a critical component of quality end-of-life care, yet there is little formal training in medical school education.  This novel curriculum enables third-year medical students to practice communication skills and build confidence interviewing a patient about advance care planning, personal values and quality of life.  The curriculum consists of: a lecture, readings, demonstration video, and a mock interview with a senior “trained patient.”  Senior, volunteers were recruited from an independent senior building that is part of a retirement community.  "Trained patients" participate in a 1.5-hour training session preparing them for the interview and to evaluate students' clinical interviewing skills. Following the interview, students receive verbal feedback and written assessment of their skills from trained patients. Students also complete a self-assessment of skills survey, attend a debriefing session with faculty, and write a 250-word reflective essay about the encounter.  The Advance Care Planning online module developed by University of North Carolina Chapel Hill, POGOe product #19059, is a recommended component.

Educational objectives: 

After completing this curriculum, learners should be able to:

1. Define and differentiate among types of code status, health care proxies, and advance directives in Illinois.

2. Utilize effective communication techniques in completing an advance directive discussion with a patient.

3. Identify own biases and attitudes toward advance care planning.

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



Suggested Citation:
Advance Care Planning Curriculum. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/287

Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying Hypoactive Delirium When Obtaining Procedural Consent

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

Fellowship Programs must soon comply with the ACGME's Next Accreditation System (NAS) milestone performance tracking and reporting requirement and consider Entrustable Professional Activities (EPAs) to measure learner performance. At the Medical College of Wisconsin (MCW), geriatricians and cardiologists worked together to create and implement a geriatric cardiology educational OSCE for cardiology fellows. Key curriculum content gaps (hypoactive delirium recognition, use of cognitive assessment tools) were identified through cardiology fellow and faculty knowledge/performance gaps on a needs assessment survey/pretest. Curriculum content was delivered using the Objective Structured Clinical Examination (OSCE) educational/assessment method. Fellows self-assessed their competency level in those EPAs both pre and post OSCE curriculum intervention (Unable to Perform (1) - Teach Others (5)). The curriculum session included the OSCEs station followed by a debriefing session and learner self-evaluation.

This OSCE station may be given alone or combined in a two station OSCE session, with our other geriatric cardiology OSCE titled, "Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying End Stage Heart Disease & Clarifying Care Goals."

This resource, also available on MedEDPortal.

Educational objectives: 
  1. Identify subacute delirium in an undiagnosed early-moderate stage dementia patient
  2. Elicit a history substantiating dementia from the patient and daughter
  3. Recognize delirium using the CAM criteria and tool
  4. Determine decisionality of the patient (non-decisional) in regards to medical decision making
  5. Determine decisionality based on the 3 primary requirements for medical decision making (take in information, apply it to self, express a choice)
  6. Identify the decision-maker in the patient’s care (POAHC—daughter) to obtain consent for the cardiac catheterization procedure

Purpose of OSCE station:

By the conclusion of this session, learners will be able to better provide care to geriatric patients in the ACGME Competency Domains including:

  1. Medical Knowledge: through identification of delirium and potential contributing factors.​
  2. Patient Care: applying knowledge of delirium identification to the process of obtaining informed consent for a cardiac procedure.
Additional information/Special implementation requirements or guidelines: 

​Two standardized patients are required for each OSCE learner case (one geriatric "patient" and one "family member/caregiver"). Examination room to conduct OSCE, either with an examination table or bed for the "patient" and two chairs, one for the "family member/caregiver" and one for the fellow.

Publications from, presentations from, and/or citations to this product: 
Date posted: 
Tue, 08/26/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 08/26/2014
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying Hypoactive Delirium When Obtaining Procedural Consent. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/287

Pages

Subscribe to RSS - Curriculum/Syllabus