The Portal of Geriatrics Online Education

Complex or Chronic Illness(es) in Older Adults

Interdisciplinary Health Profession Module Videos

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

Care teams often don't know how to effectively and efficiently collaborate when addressing a patient’s health. Depending on a patient’s needs, team leadership can shift at any given moment from one person to another. Because of this constant jockeying and adaptation, educating learners about their own interprofessional relationships is becoming incredibly important. These videos and the corresponding text supplements provide a context for interprofessional team members to discover more about what it takes to become a member of another profession. This knowledge, combined with their own experiences and clinical practice, will assist in preparing learners for the next-generation of team-based healthcare.

Educational objectives: 

After watching these short 2-3 minute videos, interprofessional teams will be able to contextualize their own relationship within the group dynamic, understand the educational requirements that go into other disciplines, and formulate an effective team-based learning approach for future activities.

Date posted: 
Tue, 09/27/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/27/2016
Contact Person/Corresponding Author:



Suggested Citation:
Interdisciplinary Health Profession Module Videos. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4827

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/4827

The Geriatric Experience Multimedia Menu for Residents and Medical Students on Geriatrics Rotation

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

This multimedia menu was created to add variety to a geriatrics rotation for third- and fourth-year medical students and family medicine residents while exposing learners to different aspects of the social and ethical issues integral to the care for older adults. The menu includes multiple books, movies, online videos and podcasts that learners may choose from during an assigned half-day of the rotation. Afterward, learners complete a written, personal reflection that is submitted to the course director. Reflective ability is an important skill for practicing physicians that is rarely taught in a formal curriculum. This simple menu broadens the breadth of the geriatric rotation and creates an opportunity to practice reflection. 

Educational objectives: 

After completing this experience, learners will:

1. Critically reflect on clinical experiences through the lens of multimedia portrayals of issues related to older adults. 

2. Discuss ethical issues related to the care of older adults. 

3. Describe new insights from a variety of media types and apply these insights to future practice. 

Date posted: 
Wed, 10/05/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/05/2016
Contact Person/Corresponding Author:



Suggested Citation:
The Geriatric Experience Multimedia Menu for Residents and Medical Students on Geriatrics Rotation. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4827

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: 
Wed, 09/23/2020
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/4827

Transitions of Care Workshop- Preparing 4th year Medical Students for Internship

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

Care Transitions are complicated and ineffective transitions result in poor patient outcomes and readmissions. The Association for American Medical Colleges (AAMC) has recently developed Entrustable Professional Activities (EPA) required for graduating medical students and two of the thirteen focus on transition of care issues. Residency programs are formalizing curricula around this topic as it is one of six focus areas within the Clinical Learning Environment Review (CLER) program, however graduating medical students have no formalized training in Care Transitions as of this time. This product provides a framework for practical training for graduating medical students and interns. A case based workshop on care transitions was created and utilized to instruct 4th yeard medical students and  Interns.  This included a small group didactic and a team based problem-solving session focused on a discharge case of a geriatric patient with multimorbidity. This curriculum was initially designed for medical students and interns on Internal Medicine, but can also be utilized to instruct learners in other fields and interprofessional learners.

Educational objectives: 
Define a care transition
Identify those at high risk for a complicated care transition
Apply specific risk assessment tools including the 8P’s, to estimate risk
Appraise the consequences resulting from ineffective transitions of care
Formulate a  safe care transition and discharge plan
Identify the important components of  successful transitional care
Additional information/Special implementation requirements or guidelines: 
Transitions of Care curriculum for 4th year medical students and Medical Interns
Interactive case based workshop to provide practical training on Transitions of Care
Small group classroom session with power point presentation and with a team based problem-solving component focusing on a discharge case of a geriatric patient with multimorbidit
Faculty Guide designed to guide active learning while students worked through the case in their teams
Publications from, presentations from, and/or citations to this product: 

Kranz, Kimberly, Strano-Paul, Lisa.  Preparing Graduating 4th year Medical Students for Internship- Implementing a Transitions of Care Workshop. Model Geriatric Programs: Geriatric Education Materials and Methods Swap. Presented at American Geriatric Society Annual Meeting Long Beach CA May 2016   

Kranz, K, Strano-Paul L, Go, R. Preparing graduating 4th year medical students for internship: Implementing a Transitions of Care Workshop. American Geriatric Society Annual Meeting, Long Beach CA, May 2016.

Kranz, K, Strano-Paul L, Go, R. Preparing graduating 4th year medical students for internship: Implementing a Transitions of Care Workshop. Women in Medicine Research Day. Stony Brook School of Medicine, Stony Brook, NY March 2016.

Kranz, K, Strano-Paul L, Go, R. Preparing graduating 4th year medical students for internship: Implementing a Transitions of Care Workshop. Clerkship Directors of Internal Medicine, Academic Internal Medicine Week, Atlanta, GA. October 2015.

                               

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



Suggested Citation:
Transitions of Care Workshop- Preparing 4th year Medical Students for Internship. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4827

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/4827

Ambulatory Geriatrics Curriculum for Internal Medicine Residents Module on BPSD: Agitation and Behavioral Problems in Dementia

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

In 2012, 5.4 million Americans are diagnosed with Alzheimer’s Disease.  Lifetime risk of experiencing BPSD (Behavioral and Psychological Symptoms of Dementia) is nearly 100%.  BPSD is associated with increased morbidity and nursing home placement and is potentially treatable.  The information in this curriculum has been created to help the general internal medicine residents have a structured approach to the evaluation and management of BPSD.  This is the 3rd topic covered in a four part ambulatory geriatric curriculum that was developed for internal medicine residents.  To learn more about the successful ambulatory curriculum developed, please  check out  manuscript by Chang C1, Callahan EH, Hung WW, Thomas DC, Leipzig RM, DeCherrie LV. A Model for Integrating the Assessment and Management of Geriatric Syndromes Into Internal Medicine Continuity Practice: 5-Year Report. Gerontol Geriatr Educ. 2015 Jul 9:1-15.

Educational objectives: 

At the conclusion of this module, learners will be able to:

  1. Define BPSD
  2. Evaluate BPSD
  3. Discuss the Guidelines for Management of BPSD
    • Nonpharmacologic Interventions
    • Pharmacologic Interventions
Publications from, presentations from, and/or citations to this product: 

Christine Changab*, Eileen H. Callahanab, William W. Hungc, David C. Thomasb, Rosanne M. Leipzigab & Linda V. DeCherrieab A Model for Integrating the Assessment and Management of Geriatric Syndromes Into Internal Medicine Continuity Practice: 5-Year Report Gerontology & Geriatrics Education. Published online: 09 Jul 2015. DOI:10.1080/02701960.2015.1031897.

Date posted: 
Mon, 09/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 09/12/2016
Contact Person/Corresponding Author:



Suggested Citation:
Ambulatory Geriatrics Curriculum for Internal Medicine Residents Module on BPSD: Agitation and Behavioral Problems in Dementia. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4827

Nonpharmacologic Management of BPSD: Behavioral and Psychological Symptoms of Dementia

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

In 2012, 5.4 million Americans were diagnosed with Alzheimer’s Disease.  Lifetime risk of experiencing BPSD (Behavioral and Psychological Symptoms of Dementia) is nearly 100%.  BPSD is associated with increased morbidity and nursing home placement and is potentially treatable.  The information in this curriculum has been created to help the general internist have a structured approach to the evaluation and management of BPSD. 

Educational objectives: 

Participants will be able to:

  1. Define BPSD
  2. Evaluate BPSD
  3. Discuss the Guidelines for Management of BPSD
Date posted: 
Mon, 09/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 09/12/2016
Contact Person/Corresponding Author:



Suggested Citation:
Nonpharmacologic Management of BPSD: Behavioral and Psychological Symptoms of Dementia. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4827

Geriatric Fast Facts Quizzes

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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/4827

Geriatricized H&P with Function and Delirium Risk Assessments

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

One important goal of the Wake Forest Geriatrics Principles for Specialists program is to train faculty, chief residents and fellows in the use of quality improvement techniques to enhance care for older adult patients that they serve.  As a product of this effort, chief residents and their faculty mentors in General Internal Medicine developed functional assessment and delirium risk assessment tools that have been incorporated into the history and physical template of the electronic medical record (EMR) to identify pre-hospital functional and cognitive limitations that affect admitted patients age 65 or older.  At present these tools are found in the note template of the following services: four general medicine teaching services, two cardiology services, the renal service, the hematology oncology service, the leukemia service, the Acute Care for the Elderly service, the cardiac critical care service, and the medical intensive care service. 

The functional assessment, implemented in July 2014, includes four questions to help determine a patient’s baseline functional status, including ability to complete activities of daily living and independent activities of daily living, ambulation status, and pre-hospital residence.  Analysis involving chart reviews pre-and post- functional assessment tool implementation showed increased documentation of functional history data in the EMR. 

The delirium risk assessment, implemented in July 2015, includes four items to help identify a patient’s cognitive status, including age greater than 80, a reverse spelling task, orientation to location, and illness severity.  Analysis of delirium incidence of hospitalized patients pre- and post- delirium risk tool implementation is planned for fall 2015.  Our hypothesis is that delirium incidence will rise as awareness and watchfulness by providers increases with use of the tool. 

While the results of implementing these physical and cognitive assessment tools are preliminary or still in process, anecdotal feedback received from case managers and other stakeholders in the discharge planning process indicate that they find such information incorporated in the H&P by admitting physicians to be valuable.  Further study is needed to determine whether such documentation expedites discharge planning, improves use of therapy services, or improves readmission rates or morbidity outcomes.  Next steps planned beyond testing of the delirium assessment tool include implementing a delirium prevention order set to standardize measures taken to decrease delirium among inpatients, followed by further evaluation of changes in delirium incidence, and eventual implementation of a delirium management order set.  The success of these measures within Internal Medicine could encourage roll-out of these tools institution-wide.

An additional benefit of this effort has been the educational value of supporting the training of residents in informatics so that they can contribute to developing solutions for improving patient safety and quality of care.  

Educational objectives: 
  1. To train residents and faculty in quality improvement techniques for the purpose of enhancing quality of care and patient safety for older adult patients.
  2. To involve residents in developing EMR tools that emphasize the importance of physical and cognitive assessments when admitting older adult patients to the hospital.
  3. To provide training opportunities in EMR informatics for residents and junior faculty.
Publications from, presentations from, and/or citations to this product: 

M. Wesley Milks, Farra Wilson, Ajay Dharod and Kirsten Feiereisel.  Abstract 347:  Identification of Functional Limitations on Admission by Internal Medicine Resident Physicians.  Circulation: Cardiovascular Quality and Outcomes. 2015;8:A347.

Contact Person/Corresponding Author:



Suggested Citation:
Geriatricized H&P with Function and Delirium Risk Assessments. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/4827

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