Block Clerkship Projects

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The Importance of Continued Compliance with Completing Advance Directives in an Outpatient Setting

Maegan R. Neilson

Despite continued efforts with conversation, guidelines, and even law, studies still show that the compliance with completing advance directives amongst a global patient population remains around 3 in 100. Those in compliance are more often chronically ill, over 65, or in an acute or terminal care setting. The COVID-19 pandemic is evidence that anything can happen and that helping patients adhere to medical wishes should be a top priority for primary care providers and their patients of all ages and health. Because previous studies have proven to be effective in increasing AD compliance when highlighted, this project aims to reignite the successful workflow of incorporating advance care planning into non-acute outpatient visits.
Resources to Decrease Social Isolation in the Elderly

Alexandra Novelli

Social isolation has significant negative impacts on both the physical and mental health of the elderly. Older Vermonters face additional barriers to social engagement including living in a rural environment, lack of access to transportation, and financial barriers. The aim of this project was to provide information about opportunities for social engagement for older individuals by distributing a pamphlet at Colchester Family Practice in Colchester, VT.
Lifestyle Changes in Diabetes Management using Smartphone apps

Michelle Oberding

Type II Diabetes is a prevalent and costly disease in the state of Vermont. Making lifestyle changes decreases Hemoglobin A1c levels and the long term risk of complications from diabetes. Longitudinal programs help maintain these important changes but these programs are not always readily available. Using free smartphone apps may be an alternative for maintaining lifestyle changes.
Dry Eye: Patient Education

Mark Oet

Recent literature has shown increased incidence of dry eye and eye strain symptomatology during the COVID-19 pandemic, coinciding with an increase in screen time for almost all populations. This project aims to address this observation at a community level by creating a patient-friendly education pamphlet for Newtown Primary Care about dry eye and digital ocular strain based on American Academy of Ophthalmology guidelines.
Community Attitudes Towards Covid-19 Vaccination

John P. O'Keefe

Vaccination is a very valuable tool in combating the public health crisis of COVID-19 and will be essential in reducing transmission rates and deaths due to the pandemic. Public willingness to receive the vaccination in large polls has stayed well below the ~95% of the population needed to achieve herd immunity against the virus. Here were survey Vermonters to determine their attitudes towards receiving the vaccine and what sources of information patients use to inform themselves about the different vaccines available.
Diabetes Education and Exercise

Emily H. Oliver and Lauren Coritt

This project seeks to explore the current local options and resources for community members receiving care at Brookfield Primary Care in Brookfield, Connecticut. Furthermore, this project provided a pamphlet to increase provider and patient awareness about free and low-cost resources within the local community to encourage diabetic patients to increase their activity level. Ideally, this project will also break down notions that 'vigorous' exercise is the only good way to exercise.
Assessing and Improving Awareness of Safe Prescription Drug Disposal in Hinesburg, Vermont

Kaitlyn Peper

Millions of Americans misuse prescription drugs each year and over half of these people obtained a prescription from friends or family. Additionally, medications that are disposed of improperly lead to contamination of the environment. This project aimed to assess awareness of proper medication disposal amongst patients at Hinesburg Family Practice and to increase communication with patients regarding options for prescription drug disposal in Hinesburg, Vermont.
Screening for Disordered Eating Among High-Risk Groups

Julia B. Purks

Many patients with disordered eating will not present with objective manifestations such as low BMI, physical exam findings, or electrolyte abnormalities. Among patients that meet DSM-V criteria for an eating disorder, the majority do not fit criteria for anorexia nervosa or bulimia nervosa, but instead fall into a category known as "Otherwise specified feeding and eating disorders." As such, it can be difficult to identify these patients. This project proposes adding 2 validated screening questions to outpatient intake forms, or incorporating them into patient visits, to identify disordered eating among high-risk groups.
Low-cost At-home Cardio Solutions for Patients During the Covid-19 Pandemic

Anna G. Quinlan
Resource Guide for Autism Spectrum Disorders

Jennifer Risi

Children with autism spectrum disorder and their families have numerous needs for health and social support. The system through which they receive this support is complex and foreign to many parents. Interactions with patients and their families have made it clear that many of them do not know what resources are available to them or how to access these resources. Furthermore, healthcare provides frequently do not have the time to educate patients fully during visits. To address this, we created an educational pamphlet that acts as a resource guide for families with various unmet needs which can be handed out at primary care offices in Chittenden County.
Patient Perceptions on the COVID-19 Vaccine

Claudia E. Russell

With COVID-19 cases and deaths on the rise in Vermont and nationally, it will be important for as many people who are able to receive the COVID-19 vaccines when available. The WHO considers vaccine hesitancy to be a major threat to public health. This study aims to examine patient attitudes and concerns regarding the COVID-19 vaccine. An informational brochure about the recently approved Pfizer and Moderna vaccines was then distributed to all participants.
Patient Knowledge and barriers to care for their Type 2 Diabetes Mellitus (DM) Condition

Diana A. Salama

This project is investigating the patient knowledge and barriers that may be present which may contribute to a lack of effective care of their Type II Diabetes condition. This project is also investigating key components which may improve patient-centered care.
The Cures Act: How can we alleviate patient confusion and provider workload?

Michela Salusti Simpson

This project aimed to develop a better understanding of patient and provider needs at all UVMMC family medicine and urgent care offices in regards to the new Cures Act. Data was gathered via a 8 question multiple choice survey and we had 24 provider responses. Most providers have found that they are receiving more phone calls from patients with questions in regards to their medical notes or results since the enactment of the Cures Act. Providers mentioned common patient questions are about imaging results, CBC, and electrolytes. Nearly half of providers noted they have changed the way in which they write notes since the Cures Act and all providers felt that a handout with tips to interpret lab results would be helpful.
Improving Identification of LDCT Lung Cancer Screening Eligible Patients

McKenna L. Schimmel

USPSTF updated lung cancer screening guidelines this year to include all patients 50-80 years old who have 20+ pack years of smoking history and are active smokers or who have quit within the last 15 years. While providers and patients both support lung cancer screening efforts, only a small fraction of eligible patients end up getting screened annually. One way we can improve this metric is by making sure we are correctly identifying which patients meet screening criteria.
Impact of MyChart Communication on Provider Burden

Samantha R. Schuetz

Patient portals have shown promise in engaging individuals in the management of their health by allowing exchange of secure electronic messages with their providers. Increased messaging increases physician workload and contributes to burnout among primary care physicians. This project examines both patient and provider perspectives of MyChart messaging and suggests ways in which this tool can be better utilized.
Infant Care in Our Community: Development of an Infant Care Guide

Justin G. Schulz

Improving health outcomes for infants and parent-provider communication at FQHCs by designing patient/parent focused health education literature.
Perceptions on Childhood COVID-19 Vaccination

Grant M. Schumaker

COVID-19 vaccination, especially, in children has been a point of both political and scientific contention since its inception. The purpose of this project was to qualitatively assess patients' perceptions on COVID-19 vaccination for children between the ages of 5-11 years old using survey data. Understanding our patient's perceptions on why they may or may not support vaccination may guide how we approach discussing the topic. A total of 17 responses were collected from patients between the ages of 18-80 years old, with >75% of patients found to be in support, already vaccinated, or had a vaccine appointment scheduled for their child. The remaining who did not support the vaccine cited "not enough known" or "concerns for side effects" as reasons. This data gives a foundation into why people may or may not support administering the COVID- 19 vaccine to children and how we can start educating the public and guide the conversation when it comes to vaccines.
Assessing Barriers to Mental Health Resources

Young Bo Sim

This project was done to assess patients' barriers to mental health services in Newtown Primary Care. The project focused on identifying and developing questionnaires to assess if there were any perceived barriers and what those barriers were.
At Home Blood Pressure Monitoring

Aneesh Singal

Blood pressure measurements in the office are often falsely elevated and do not reflect a patients at-home measurements. This project explores the values of home blood pressure monitoring and includes a pamphlet for use at the Colchester Family Medicine office. It has information on how to check blood pressure, which cuffs to buy, and how to enter home measurements into Epic so the physician can easily view them.
Improving Sleep: Patient Education on Sleep Hygiene Techniques

Anya Srikureja

Approximately one third of adults in the United States sleep less than the recommended 7 hours a night. Insufficient sleep is associated with increase risk of chronic diseases and all-cause mortality. While pharmacologic sleep aids are available, cognitive behavioral therapy is recommended as an effective, first line treatment for insomnia. This project aimed to create patient education materials on sleep hygiene techniques that could be easily distributed by providers through the electronic medical record in order to help improve sleep for the patient population in Vergennes, Vermont.
Implementation of the Primary Care Mental Health Integration (PCMHI) Model: Information for Patients

Amy Stedman

UVMMC Primary Care is transitioning to the Primary Care Mental Health Integration (PCMHI) model of care, in which behavioral health and/or psychiatric treatment is provided within a primary care setting via in-house consulting clinicians. There are currently no standardized informational materials to educate patients on the details of the PCMHI program, which is a new treatment model for most patients and clinicians involved. Development of educational materials, as well as broader public health implications of the PCMHI model of care, are addressed.
Evaluating Patient and Provider Knowledge of Safe Pharmaceutical Disposal Procedures in Vermont through a Public Health and Environmental Lens

Emily R. Straley

Patient and provider knowledge of safe pharmaceutical disposal procedures is crucial from both a public health and environmental standpoint. Unfortunately, studies have shown that Vermont residents are largely unaware of safe drug disposal programs in their communities. This project evaluated patient knowledge of drug disposal practices and awareness of safe pharmaceutical disposal procedures at Hinesburg Family Medicine. A short phrase was created to better disseminate information about safe drug disposal in Hinesburg, which can be added to a patient’s after visit summary. Many patients report never discussing medication disposal with their physician. Therefore, increased provider communication regarding leftover and unused medications is critical to encouraging participation in safe drug disposal practices in Vermont.
Mental Health Technology During the Era of COVID-19

Michael Tabet

Mental health symptoms - especially those of depression and anxiety - have become more prevalent during the COVID pandemic. As seen in previous years, direct and indirect costs of depression can be staggering. Apps exist on smart devices that are based in evidence-based practices that can be therapeutic for mental health issues such as depression, anxiety, and insomnia. A simple handout with some suggested popular mental health apps and accompanying descriptions was created to be used in the CVPH Family Medicine clinic to increase awareness of these apps among patients suffering from depression, anxiety, and insomnia.
Patient Attitudes and Education about the COVID-19 Vaccine

Zeynep Tek, Faith Wilson, and Claudia Russell

We gave patients a survey about if they were interested in receiving the COVID-19 vaccine and if not why across three different sites in Vermont and Connecticut. We also made and handed out a pamphlet about commonly asked questions about the vaccine and what the state's distribution plan was. A majority of patients were interested in the getting the vaccine, and those who were unsure were worried about the long term side effects.
COVID-19 Vaccine Hesitancy Resources in Northern New York

Cyrus Neal Thomas-Walker and Maegan Cabrera MD

COVID-19 continues to be a significant health threat and has caused significant disease and mortality in the fall 2021 wave largely driven by the Delta Variant and complicated by unvaccinated patients. In the state of NY, approximately 40 patients died per day (7 day moving average) from serious COVID-19 illness during this time period. During this time, approximately 35% of Clinton County’s population is not vaccinated for COVID-19 and is subsequently unprotected from serious COVID-19 illness. This work discusses reasons for non-vaccination and strategies to combat vaccine hesitancy. Additionally, it includes a pamphlet for local distribution as well as a dot phrase to be utilized for patients seen in the outpatient setting to serve as a personalized reminder on the importance of receiving vaccination against COVID-19 and to answer questions identified as concerns for vaccine hesitancy.