The Portal of Geriatrics Online Education

Simulation

A representation of a process, activity, organization or object where the learner participates. Sometimes employs the use of a simulation model or a computerized program.

Simulation Curriculum for Geriatric Medicine Fellows

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

This material consists of a suite of nine simulated clinical cases, divided into three separate sessions of three cases each, intended to be conducted in a simulation center with simulated patients.  Cases are designed to teach geriatric medicine fellows and other appropriate learners basic geriatric assessment skills (Session one), how to navigate difficult situations in long-term care (Session two), and high-level communication skills in palliative and end-of-life care (Session three).  Each case consists of a multi-page document outlining scripts for the learner as well as the roles (patient, family member, facility staff, etc) portrayed by actors, necessary props and supporting materials, and instructions for evaluating and debriefing the learner.  Also contained in each document are Entrustable Professional Activities (EPA), Curricular Milestones (CM), and Reporting Milestones (RM) relevant to the case.

Educational objectives: 

- Efficiently and effectively assess and manage common geriatric syndromes in a variety of clinical settings.

- Demonstrate the ability to navigate difficult communication scenarios in a long-term care environment, while providing leadership, mediating conflict between interdisciplinary team members and/or family members, and providing high quality care.

- Provide compassionsate, patient-centered care at the end of life, using high-level communication strategies.

Additional information/Special implementation requirements or guidelines: 

n/a

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

None, though plans to present this at AGS/ADGAP in 2019.

Date posted: 
Mon, 11/12/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/08/2018
Contact Person/Corresponding Author:



Suggested Citation:
Simulation Curriculum for Geriatric Medicine Fellows. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/41

Barney Smith - A Progressive Palliative Care Standardized Patient

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

This six part progressive standardized patent serves re train medical students to care for an older adult with a life limiting condition, including making the diagnosis of multiple myeloma, breaking bad news, transitions of care from the hospital to home and curative care to palliation, through advance directiive discussions, and eventually into hospice and his death. The six encounters occur from Year 2 through Year 4 of the medical school curriculum , with a scripted five year span of patient care. Educational modalities include standandized patients, simulation, web-based modules, and small group discussions. 

Educational objectives: 

1) Provide medical care for an older adult with a life limiting condition from their diagnosis through their death

2) Understand the roles of the medical provider and other health care disciplines, as individual providers and as a team, in caring for an older adult with a life limiting diagnosis as they transition from the hospital to home and from curative care to palliation

3) Assist family caregivers in identifying caregiver responsibilities and potential caregiver burden

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Barney Smith - A Progressive Palliative Care Standardized Patient. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/41

VirginiaGeriatrics.Org

:  
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: 

The VirginiaGeriatrics.Org website consists of 6 primary resources and a secondary list of resources for further research. These primary resources include a video archive of the geriatric grand round lecture series, interactive pre-clinical basic science geriatric case studies for medical students, more advanced geriatric case studies for clinical residents, a quick consult guide for geriatric consults, an "ask the expert" discussion resource, and various educational materials related to the Virginia Geriatrics Society Conference. Additionally, spread through the website are external educational resources to complement the core material. Finally, there are some resources for patients and families that may be interested in contacting clinics and/or geriatricians.

Educational objectives: 

Listed through 6 primary education sections (Grand Rounds, Med Student Materials, Resident Materials, Quick Consults, Ask the Expert, etc)

Date posted: 
Thu, 09/22/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 09/22/2016
Contact Person/Corresponding Author:



Suggested Citation:
VirginiaGeriatrics.Org. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/41

Building Caregiver Partnerships Through Interprofessional Education

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

Family caregivers are on the frontlines managing complicated chronic illnesses, assisting with day-to-day functioning, and providing direct care to manage symptoms and improve the quality of life of their loved ones. Yet, health professions students, medical/surgical residents, and care providers receive little, if any, training on the vital role that caregivers play on the healthcare team and how, effective partnering optimizes patient care throughout the illness trajectory and at end-of life.

The goal of Building Caregiver Partnerships through Innovative Interprofessional Education is to create effective partnerships between healthcare providers and family caregivers to reduce the burdens, ease suffering, and enhance the meaning of the caregiving experience for the patient, family and health care providers.  The project centers on a 20-minute film, No Roadmap: Caregiver Journeys, which features the compelling stories of four caregiving families. The film and companion discussion guides as well as resources for case-based learning and structured clinical encounters are freely accessible on the website. http://www.neomed.edu/medicine/palliativecare/building-caregiver-partnerships/

The website is designed so that faculty can easily select the materials that best fit their learners’ needs and the time constraints within their programs. The curricula is appropriate for medical, pharmacy, nursing, and other health professions educational programs at both undergraduate and graduate levels. Additionally, tools have been developed for interdisciplinary team-based forums and health provider training.  For medical/surgical residency programs, relevant ACGME milestones are identified. 

Educational objectives: 

The objectives of the educational tools are to prepare learners to:
• Describe home-based eldercare as a shared experience and the importance of building a relationship with family caregivers and care recipients based on trust, compassion and open communication; 
• Describe the vital role of family caregivers as important, but under recognized, members of the health care team;
• Discuss the meaning and challenges of family caregiving;
• Engage caregivers in meaningful discussions to identify the needs, values and goals of their caregiving family;
• Identify resources to address caregiver concerns and provide ongoing support; and
• Provide holistic team-based care to family caregivers that improves the quality of life for the care recipient and the caregivers. 

 

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

~~Date/Location Meeting/Forum Presentation Title Presenter(s)
Jan 28-31, 2016, Phoenix, Arizona; Society of Teachers of Family Medicine; 45 min presentation;  Exploring Caregiver Journeys: A Curricular Tool for Family Medicine Clerks;  D. Sperling; J.T. Thomas

March 10-13, 2016; Chicago, Ill;  American Academy of Hospice and Palliative Medicine;  60-min workshop; Using Film to Foster Empathetic Partnerships between Care Providers and Family Caregivers;  J. Drost; E. Scott; M. Scott; D. Damore; S. Radwany

May 19-21, 2016; Long Beach, Ca; American Geriatrics Society; Poster; Building Caregiver Partnerships Through Innovative Health Professions Education; E. Scott, S. Radwany, D. Drost, K. Baughman, B. Palmisano, M. Sanders

May 19-21, 2016; Long Beach, Ca; American Geriatrics Society; Educational Product Session; Building Caregiver Partnership Through Innovative Health Professions Education; J. Drost; B. Palmisano

May 25, 2016; NEOMED Department of Family and Community Medicine Resident Scholarship Day; 15 min presentation; Exploring Caregiver Journeys: A Curricular Tool for Family Medicine Residents; D. Sperling; J.T. Thomas
 

Date posted: 
Mon, 12/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 05/19/2017
Contact Person/Corresponding Author:



Suggested Citation:
Building Caregiver Partnerships Through Interprofessional Education. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/41

Introduction to the Geriatric History and Physical Exam

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

With a growing number of older adult patients entering the health care system and fewer students and residents pursing geriatric medicine,1,2 it is critical to prepare all medical students, no matter their specialty choice, with the basic knowledge and skills needed to care for the older adult population. 

The Geriatric History and Physical Exam Skills Module was designed to orient pre-clinical medical students to the common screening tools, physical exam maneuvers and common findings relevant to older adult patients.  This highly interactive module also presents pertinent modifications that need to be made when interviewing and examining the population.  The resource is most useful for second year medical students who have been introduced to history and physical exam skills on normal adult patients.  Requiring about 15 minutes to complete, this module incorporates self-assessment questions, radiographic images and high yield concepts for an early medical student.

 

References

  1. Golden, A. G., Silverman, M. A., & Mintzer, M. J. (2012). Is geriatric medicine terminally ill?. Annals of internal medicine, 156(9), 654-656.
  2. Golden, A. G., Silverman, M. A., & Issenberg, S. B. (2015). Addressing the shortage of geriatricians: What medical educators can learn from the nurse practitioner training model. Academic Medicine, 90(9), 1236-1240.

 

Educational objectives: 

By the end of the module, a learner will be able to:

  1. Recognize pertinent modifications for the interview and clinical exam of older adults
  2. Practice functional assessment and physical exam maneuvers of older adults by responding to questions
  3. Identify common findings in the geriatric exam
  4. Utilize screening tools to identify common geriatric syndromes
Date posted: 
Thu, 02/04/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 02/04/2016
Contact Person/Corresponding Author:



Suggested Citation:
Introduction to the Geriatric History and Physical Exam. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/41

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/41

Cognitive Assessment in the Elderly

:  
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: 

This module demonstrates how to administer the Montreal Cognitive Assessment Test (MoCA).  The MoCA was created to screen patients who present with mild cognitive complaints and who usually perform in the normal range on the Mini-Mental State Examination or MMSE.

Educational objectives: 

After reviewing the module, learners should be able:

  • to know when to utilize the MoCA to screen a patient.
  • to know how to perform and score the MoCA.
Additional information/Special implementation requirements or guidelines: 

Quicktime is needed to view this video.

Author:  Mary Ellen Quiceno, MD

Geriatrician:  Belinda Vicioso, MD

Medical Illustrator: Lindsay Oksenberg, MA

Date posted: 
Tue, 12/02/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 12/02/2014
Contact Person/Corresponding Author:



Suggested Citation:
Cognitive Assessment in the Elderly. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/41

An Inter-Professional Education Delirium Simulation Pilot Project

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

Case Overview: Ida Mae Homer is an 80 year-old woman with a 5-year history of Alzheimer’s disease.  Her granddaughter has been staying with her for the last 3 days while her daughter (her usual caregiver) is out of town.  Mrs. Homer is becoming increasingly confused and agitated with increased urinary frequency and incontinence as well as insomnia.  Her granddaughter has tried using Benadryl to help her sleep, however nothing seems to be helping.

Simulation: The set-up for the simulation includes the medical and nursing students reviewing a delirium web module (POGOe #20503) as well as a Situation, Background, Assessment, Recommendation (SBAR) video attached on the right side of this page, then completing pre-test delirium assessment (Delirium Knowledge Survey) and an assessment of attitudes toward teams in training (KidSIM) prior to the simulation.  Next, each medical and nursing student pair meets approximately 10 minutes prior to the simulation to review instructions, introduce themselves, and discuss thoughts and plans for caring for an agitated patient.  The team is then escorted to the “Emergency Room” where the patient and granddaughter (both are standardized patients) are waiting (faculty observes from control room).  The patient is agitated and anxious and is trying to get out of bed.  The team should elicit information from the granddaughter and recognize that the use of Benadryl and the probable urinary tract infection are the likely etiologies of delirium.  The team has a variety of medications available on the med cart (lorazepam, haloperidol, morphine, and hydroxyzine) as well as restraints, and the patient has “IV” access.  The simulation lasts 20 minutes, and approximately 10-15 minutes into the simulation, once the patient is stable and a plan has been established, the medical student calls the “attending” in the control room, and using SBAR, checks out the patient over the phone.  The faculty member then ends the simulation, and the entire team (faculty member, 2 students, and 2 standardized patients) leave the room for an approximately 15-20 minute debriefing session.  Simulations can run staggered if there are resources to have 2 teams and 2 standardized patients, otherwise the next simulation would begin once the debriefing session ends.

Goals for the simulation and topics for discussion during debriefing session:

  1. Diagnose delirium using CAM
  2. Identify potential causes for delirium
  3. Identify appropriate pharmacologic management for delirium (medication as well as dosage)
  4. Inter-professional collaborative practice
  5. Situation, Background, Assessment, Recommendation (SBAR)
Educational objectives: 
  1. The students will be able to evaluate a patient with agitated delirium.
  2. The students will be able to outline appropriate treatment for a patient with delirium.
  3. The students will be able to work effectively with students in other professions in the care of a patient with agitated delirium.
  4. The students will be able to achieve 80% on post-test Delirium Survey.
  5. The students will improve their attitudes and beliefs about teams in training (KidSIM).
Publications from, presentations from, and/or citations to this product: 

The results of this inter-professional education delirium simulation has been presented at the American Academy of Neurology's Consortium of Neurology Clerkship Director's annual meeting, highlighting educational tools.  The results have also been presented at the Johnson County Community College's Annual Healthcare Simulation Conference.  This pilot project has also served as preliminary data for the University of Kansas' successful Reynold’s Foundation Next Steps grant application.

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



Suggested Citation:
An Inter-Professional Education Delirium Simulation Pilot Project. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/41

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/41

Elder Abuse Simulation

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

Elder abuse is expected to rise as the number of elderly frail patients increase.  Signs of elder abuse or neglect often mimic normal physiological aging process, thus clinicians should be well trained to identify signs of elder abuse or neglect to institute proper investigation and intervention.  

Educational objectives: 

By the end of the session, participants will be able to:

  1. Recognize and identify signs and symptoms of elder abuse and/or neglect 
  2. Identify appropriate actions to take to address the issue of elder abuse and or neglect
Date posted: 
Thu, 06/19/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 06/19/2014
Contact Person/Corresponding Author:



Suggested Citation:
Elder Abuse Simulation. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/41

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