The Portal of Geriatrics Online Education

Thoracic Surgery

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/465

"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/465

Assessing Capability of Medical Decision Making Capacity

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

A multifacted program focused on Assessment of Medical Decision Making Capacity. It includes the following education and assessment tools:

 

  • Elder Care Provider Sheet, “Medical Decision-Making Capacity”
  • A needs assessment for all medical and surgical specialties
  • Just-in-time reference cards
  • Mini-CEX to assess residents

 

Educational objectives: 

Determine if the patient has the:

  • Ability to clearly communicate their choice for treatment or non-treatment
  • Ability to understand the relevant information (regarding medical condition and treatment)
  • Ability to understand the situation and the consequences of treatment options
  • Ability to reason about treatment choices, consistent with personal values

 

 

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 Geriatric Education Center."
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: 
Mon, 09/28/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 03/29/2018
Contact Person/Corresponding Author:



Suggested Citation:
Assessing Capability of Medical Decision Making Capacity. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/465

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/465

Powerpoint: Medicare, Medicaid and Discharge Planning

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

This is a Powerpoint presentation designed to provide the backbone for a talk to primary care or specialty residents responsible for discharging hospitalized Medicare patients to another level of care. It reviews the available post-acute options (LTACH, AIR, SNF, LTC, home health) and provides just the information on Medicare and Medicaid that are critical to understanding the patient’s options. The presentation includes Medicare financial information and criteria for coverage specific to 2014, and Medicaid information specific to NC, so some modification and updating may be necessary for use in other venues or later years. The presentation can be accomplished in 45 minutes leaving room for questions in a one-hour time block. A decision-tree diagram is included as a handout that can be provided with the talk and provides a succinct summary for future reference.

Educational objectives: 

1. Review a few key elements of Medicare and Medicaid eligibility and benefits

2. Distinguish between Inpatient and Observation status for Medicare patients

3. Be able to clearly state a patient’s discharge needs

4. Know the various discharge options and the key differences between them

5. Apply the criteria for Medicare coverage of various discharge options

Date posted: 
Fri, 10/03/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 10/03/2014
Contact Person/Corresponding Author:



Suggested Citation:
Powerpoint: Medicare, Medicaid and Discharge Planning. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/465

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/465

Wake GPS Quality Improvement Project Handbook

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Other Intended Learner Audiences: 
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/465

AEGIS - Surgical Informed Consent of the Geriatric Patient: First Do No Harm

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

Informed Consent is an essential surgical skill that has moral, ethical and practical implications for the older patient. This module uses three video trigger tapes that present the “Typical” surgical informed consent, its potential aftermath, and follows with an example of an “Effective” informed consent. This module is part of the Advanced Education in Geriatrics for Surgeons (AEGIS) project.

Educational objectives: 

Upon completion, learners should be able to

1. Describe the informed consent process including components

2. Discuss unique concerns for the geriatric surgical patient during consent

Date posted: 
Wed, 12/04/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 12/04/2013
Product Viewing Instructions: 
Videos are located on the PHUSC Geriatrics Channel on Youtube
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , , , , and . AEGIS - Surgical Informed Consent of the Geriatric Patient: First Do No Harm. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/465

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/465
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