Medical Specialties Commons^™

Addressing Geriatric Falls In The Outpatient Setting: A Prevention Initiative, Brian W. Gross

Family Medicine Clerkship Student Projects

With approximately 25% of older aged 65 or greater falling each year, and 20% of these incidents resulting in serious injury, falls are of significant concern for both the geriatric community and the healthcare system at large. In 2017, Vermont ranked 41st in the nation with respect to the percent of older adults with self-reported falls in the past 12 months, according to the United Health Foundation’s “America’s Health Rankings" report. Many patients at risk for falling remain uneducated regarding environmental, pharmacological, and/or behavioral risk factors that may be contributing to their fall risk. In addition, providers often have limited …

Beyond Acute Lyme, Nicholas Haslett

Family Medicine Clerkship Student Projects

Vermont has one of the highest rates of Lyme disease infection in the country. There is growing disagreement not only between the medical community and a growing patient population, but also within the medical community itself, around the issue of persistent syndromes that may or may not be related to a Lyme diagnosis. Many patients seek treatment for persistent symptoms outside of physician guidelines for either Post Treatment Lyme Disease or the contentious "Chronic Lyme Disease" via prolonged courses of IV antibiotics, colloidal silver infusions, electromagnetic frequency treatments, and more. Regardless of the debatable extent of spirochete carnage in vivo, …

Addressing Food Insecurity In The Clinical Setting, Annabelle Davey

Family Medicine Clerkship Student Projects

Food insecurity is defined as having inadequate resources to ensure that everyone in a household has enough food to be properly nourished, without disruptions. 12% of the population in Clinton County, NY is food insecure. The aim of this project was to identify barriers to clinicians addressing food insecurity, and to provide information for both patients and providers to improve utilization of food assistance resources among food-insecure patients.

Standardizing Asthma Management In Primary Care, Michael Vernon Chmielewski

Family Medicine Clerkship Student Projects

Asthma is a chronic, relapsing-remitting inflammatory airway disease that continues to increase in prevalence in the United States. When properly managed, patients with asthma experience less morbidity than those whose asthma is poorly controlled. Although the National Heart, Lung and Blood Institute (NHLBI) has published guidelines regarding the evidence-based diagnosis and management of asthma, many primary care practices do not fully utilize these best-practices. The purpose of this project was to develop a system of standardized protocols and a reference guide to promote adherence to evidence-based guidelines in asthma management for the Champlain Valley Physician’s Hospital Family Medicine residents and …

Screening For Developmental Delays During The Well-Child Visit, Ellen Walker Seyller

Family Medicine Clerkship Student Projects

Due to recent staffing transitions, family medicine physicians at Newtown Primary Care in Danbury, CT are now managing the care of an increasing number of pediatric patients. The goal of this project was to develop a screening tool to allow practitioners to assess for developmental delays during well-child visits. The tool includes 10-question surveys for ages 1mo, 2mo, 4mo, 6mo, 12mo, 15mo, 2yo, 3yo, or 4yo with a scoring guide and a list of some concerning signs at each stage.

Spirometry In Primary Care, Megan Garrido

Family Medicine Clerkship Student Projects

Prevalence of COPD in the United States is rising, yet many people with Chronic Obstructive Pulmonary Disease (COPD) diagnoses do not have diagnoses. In Vermont 18% of adults are current smokers and 27% are former smokers. The lack of provider and nurse training regarding indications, mechanism, interpretation and benefit of spirometry have limited it's use. Spirometry is recommended for both asthma & COPD diagnoses and management, and may provide better disease management.

Determining The Instructional Effectiveness Of An Online Resident Vaccine Curriculum, S. Elizabeth Williams, Shannon Clark, Barbara A. Pahud, Sharon Humiston, Donald Middleton, Kadriye O. Lewis

Posters

We developed four online modules through the Collaboration for Vaccine Education and Research (CoVER) project. The objective of this qualitative study is to determine the instructional effectiveness of the CoVER curriculum from the perspectives of medical residents.

Improving Cardiac Arrest Outcomes With Hands-Only Cpr, Ethan Witt

Family Medicine Clerkship Student Projects

Bystander CPR is one of the most effective and necessary components of cardiac arrest management, increasing survival rates by two to three times. However, rates of bystander CPR are inadequately low. Hands-only CPR has been found to be an effective intervention in the management of cardiac arrest and addresses many of the barriers to bystander CPR.

Patient Education On The Association Of Hormonal Contraception With Depression, Julia E. Hannigan

Family Medicine Clerkship Student Projects

Hormonal contraceptive agents are widely used by women during their reproductive years. In recent years, research has been released linking hormonal contraception with the initiation of antidepressant medication and a first diagnosis of depression. More research is still warranted in order to further elucidate the relationship between hormonal contraception and depression, but current evidence prompts the necessity for shared decision making between clinicians and women considering treatment with hormonal contraceptive agents. The goal of this project is to give providers easily accessible patient educational materials in the form of epic smart phrases to aid in informed decision making.

Implementation Of The Vermont Mini-Cog, Hillary E. Danis

Family Medicine Clerkship Student Projects

Cognitive impairment screening is important for early detection, diagnosis, and treatment of cognitive impairment and dementia. Additionally, screening is mandated as part of the Medicare Annual Wellness Visit. Colchester Family Medicine providers were surveyed about their current screening behaviors and then provided a training session on cognitive impairment screening and the Vermont Mini-Cog screening tool. Post-training, providers were surveyed about their likely future screening practices.

Social Stories To Facilitate Preparation For Healthcare Visits, Benjamin Grebber

Family Medicine Clerkship Student Projects

No abstract provided.

Food Label Made Easy, Hanaa Shihadeh

Family Medicine Clerkship Student Projects

The use of food labels and adherence to dietary recommendations are important, especially for those with chronic diseases due to the well known relation between chronic disease and poor nutritional habits. Although food labeling has been introduced since 1994 with the aim of combating obesity and diet-related chronic disease in the USA, the rates of food label use among US adults have decreased over the past decade.

Influenza Vaccine Participation In South Burlington, Vt, Rio Beardsley

Family Medicine Clerkship Student Projects

Influenza vaccination rates in Vermont have declined each year between 2013 and 2016. This study aims to understand why patients decline the annual influenza vaccine. The project was deployed via survey for all adult patients (18 years and older) at the South Burlington UVM Family Medicine practice in 2019. Further information about the influenza vaccine authored by the CDC was then provided to all participating patients, regardless of immunization status.

What's In Your Cup? Increasing Transparency And Confidence In Alcohol Use Screening And Brief Intervention, Dylan C. Koundakjian

Family Medicine Clerkship Student Projects

19% of Vermonters report drinking alcohol at levels which puts their health at risk, but many healthcare providers do not feel confident in addressing their patients' usage. This can stem from lack of experience with alcohol use, worries about stigma, and time constraints. However, data has shown that even 5-15 minute interventional conversations can significantly reduce a patient's risky drinking. This project aims to provide real-world, practical advice for having conversations around alcohol, and provides a conversion chart converting popular alcoholic beverages into standard drink equivalents.

Increasing Awareness Of Health Risks Associated With Vaping In Youths, Patricia Wang

Family Medicine Clerkship Student Projects

E-cigarette and use of electronic nicotine delivery systems is a growing trend among youths in the United States. According to the National Institute of Health 2018 Monitoring the Future Survey, the 10th and 12th grade increases in nicotine vaping are the largest ever recorded for any substance in 44 years of tracking youth drug use. Increasing evidence about the potential health risks of vaping, as well as prediction of future cigarette use or experimentation, underlines the need for more preventative health measures to curtail this growing drug epidemic. The aim of this community health project was the development of an …

Retinopathy Screening: Assessing Knowledge & Educating Diabetic Patients In Caledonia County, Vermont, Ian J. Mcclain

Family Medicine Clerkship Student Projects

Diabetic retinopathy is the most common cause of severe vision loss in US adults. It is estimated that less than 50% of patients with diabetes consistently receive annual eye exams. Diabetic patients in rural communities may face additional barriers towards receiving recommended eye care as these communities generally have lower incomes, lower insurance rates and older populations. This project sought to educate diabetic patients about eye disease in a rural Vermont primary care practice using an active learning modality.

Perceived Barriers And Trends In Hpv Vaccination Among Young Men In Newtown, Ct, Alexander D. Karabachev

Family Medicine Clerkship Student Projects

Human Papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States. Although the HPV vaccine has been proven to be effective and safe, the vaccination rates are significantly less compared to other vaccines. In males, HPV infection may lead to the development of numerous forms of cancer including oropharyngeal, anal and penile cancer, however, the HPV vaccination rate for males is significantly less than it is for females. This project aims to highlight various medical providers' opinions on the barriers to HPV vaccination for young men in Newtown, Connecticut, as well as, address methods for improvement including …

Global Health Experience In Botswana, Jared Willard

Posters

Describes a global health learning experience at the Botswana Baylor Center of Excellence with emphasis on treating pediatric HIV/AIDS patients.

Burnout And Resilience Among Pediatric Residents In Stockholm, Sweden: Findings From A Mixed-Methods Study, Lauren Poull, Sanaz Skyttner-Rahmani, Andrea P. Anderson, Weston T. Powell, Jiaqi Yin, Carolyn C. Foster, Maneesh Batra

Posters

Objective

 To measure the prevalence of burnout among pediatric residents at Karolinska University Hospital (KUH).
 To describe the local drivers of burnout and the protective factors that lead to resilience and workplace engagement.

Conclusions

 Prevalence of burnout among Swedish pediatric residents in this study was 39%, which is lower than reported in the US (50-60%).
 Drivers of burnout were identified across all four domains. They included local features of the learning environment, and many are modifiable.
 Protective factors include perceived control over scheduling, better mental and physical health, lower perceived stress, and being a parent. …

Mindfulness: An Underutilized Tool For Patients And Providers Alike, Candice Wolf

Family Medicine Clerkship Student Projects

A healthy body begins with a healthy mind, and a healthy mind begins with mindfulness. Mindfulness means paying attention on purpose and without judgment. It has been shown to reduce: anxiety, blood pressure, gastrointestinal distress symptoms, PTSD, pain, insomnia, depression, and healthcare cost. 63% of American’s are stressed about the future of the nation, money, work, the political climate, violence, and crime. Primary care providers have the opportunity to introduce patients to mindfulness to compliment and/or potentially replace current alternative pharmacologic options.

Promoting Tia Awareness: Decreasing Stroke Mortality In Vermont, Nicole Becher

Family Medicine Clerkship Student Projects

The death rate from stroke in Washington County, VT was nearly twice that of the state in 2015. Risk of death from stroke can be decreased by timely intervention, however many patients are unaware as to signs and symptoms of stroke, and when to seek medical attention. A brochure was developed and distributed, aiming to shorten the time between experiencing TIA symptoms and point of contact with medical professionals.

Social Support Groups Focused On Substance Abuse And Addiction Available To Patients In Franklin County, Vermont, Michael Nilo

Family Medicine Clerkship Student Projects

Substance abuse/addiction, especially of opioids, is a major problem in Franklin County, where resources are not easily accessible to patients struggling/in recovery. Educating patients about the availability of peer support groups/recovery centers and clinics in the community may provide an attractive resource for patients who need additional help.

Cbd: A Resource For Patients, Ryan G. Harned

Family Medicine Clerkship Student Projects

An educational resource for patients describing the current body of research on cannabidiol (CBD), the current legal landscape, regulatory and manufacturing considerations, drug interactions, and potential risks.

Osa Stop-Bang Screening Tool, Seth E. Wolf

Family Medicine Clerkship Student Projects

No abstract provided.

The Lake Clinic Cambodia, A Medpeds Experience . . ., Jeremy Jennings, Jennifer Watts

Posters

Describes global health learning experience providing ambulatory care in Cambodia.

Increasing Advance Directive Utilization In Hardwick, Vt, Maeve Lauren Donnelly

Family Medicine Clerkship Student Projects

This project was created to increase advance directive use at the Hardwick Area Health Center in Hardwick, VT. The project was aimed at creating awareness of the lack of advance directive use both to the providers and patients, so persuasive educational flyers were made to hang around the office. This project helped increase the attitude and awareness of the importance of advance directive planning.

Substance Use Disorder Treatment Decision Aid For Adults In Chittenden County Vermont, Elizabeth V. Mcleod

Family Medicine Clerkship Student Projects

Substance Abuse Disorders (SUDs) are a prevalent public health concern in both the national and local arena resulting in millions of dollars in pubic health costs and loss of life. Navigating the treatment options available in Chittenden County can be time consuming, difficult, and delay treatment. In order to help guide adult patients and their families in Chittenden County along their journey towards recovery from SUDs, a treatment decision aid was developed for choosing the right level of care.

Improving Patient Knowledge Of Antimicrobial Resistance And Appropriate Antibiotic Use In A Rutland County Acute Care Center, Stephen D. Daniels

Family Medicine Clerkship Student Projects

Antimicrobial resistant infections are one of the most prevalent global health concerns of our time. It is paramount that action be taken to do all we can to reduce the burden that these “superbug” infections bring in the form of both serious illness and financial strain on healthcare systems. As healthcare professionals, the onus falls on us to educate the public on basic knowledge regarding bacterial/viral illness, as well as proper antibiotic utilization, so that we can all work in coercion with one another to combat this global health concern. The here-in project describes an educational piece with this goal …

Educating Patients On Screening Guidelines And Expectations For Well-Woman Examinations, Cyrus Maxim Jalai

Family Medicine Clerkship Student Projects

Female patients seeing primary care in rural settings often do not seek out specialized care from a practicing OB/GYN, favoring instead to utilize their family practitioner to respond to their complaints. As such, it would be effective to work to educate these patients at their well-women examinations on routine screenings, immunizations, and health maintenance methods they should expect based on their presenting age. A handout simplifying and synthesizing the main screening and general health guidelines for annual well-women examinations may be helpful for female patients using primary care practitioners as their source for obstetric and gynecologic care.

Barriers To Smoking Cessation In Patients Enrolled In Suboxone Treatment Programs, Thomas L. Arnell

Family Medicine Clerkship Student Projects

Cigarette smoking is the leading cause of preventable death and disease in the United States, accounting for more than 480,000 deaths every year. The prevalence of tobacco use among substance abuse treatment program enrollees is substantially higher than that of the general population, with recent estimates ranging between 75-97%. The aim of this project was to identify specific barriers to smoking cessation in patients enrolled in suboxone treatment programs in Franklin County, VT. The most commonly cited barriers among survey responders were related to fear of the effects of tobacco withdrawl, while the most important barrier was related to fear …