Block Clerkship Projects

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Promoting Antibiotic Stewardship

Saurabh Patel

Antibiotics are not always prescribed optimally in the outpatient setting for common respiratory illnesses. Providers also spend time reiterating the same facts to patients about antibiotics and why their use is not warranted for their common cold symptoms. By providing a visual aid that can capture the attention of patients and present concise, easy to retain facts, we may lessen the amount of time providers spend counseling. At the same time, we are able to get patients to contribute to the fight against antibiotic overuse, antimicrobial resistance, and healthcare associated infections.
Adolescent Sex Education

Carolyn Payne

This project identified a significant need for adolescent sex education and curriculum development in Vermont and the United States. A comprehensive sex education presentation was developed, reviewed by experts in the field, and piloted at The Boys and Girls Club of Burlington. Subjective results were positive and future strategies to teach students, evaluate effectiveness, and expand impact were developed.
Marijuana Use Counseling During Pregnancy

Adam Petchers

Penobscot County, Maine has among the highest rates of marijuana use in the country, and Maine has recently voted to legalize recreational use of marijuana. Research has shown that pregnant women frequently seek out and are dissatisfied with information regarding the safety of marijuana use during pregnancy. We surveyed Family Medicine providers at the Center for Family Medicine at Eastern Maine Medical Center in Bangor Maine regarding their counseling of pregnant patients on the topic of marijuana use. From the results, we created an information sheet to aid providers in marijuana use counseling with pregnant women.
Sports Injury Prevention in Danbury, CT

Cori Polonski

Sports Injuries, especially overuse injuries, cause a significant amount of morbidity and public health cost, especially for young athletes. Importantly, many of these injuries can be prevented with proper training and some novel approaches to warm-up and training. To address this concern, I worked with Orthopedic Specialists of CT and the athletic trainers at Danbury High School to come up with some educational materials for patients on effective ways to prevent sports medicine injuries.
Rural Teens and Stress

Morgan R. Pratt

Stress is significantly associated with risk taking behavior and increasing depression/anxiety among teens. There is no shortage of stressors experienced within the teenage years.This project's aim is to create a pamphlet that can be available for teens in rural Vermont. It will contain apps for healthy lifestyle, stress, mood, mindfulness as well as local help line numbers for teens in crisis and signs and symptoms of anxiety and depression.
Narrative Medicine: Improving Patient Care and Shifting Office Culture

Yazen Qumsiyeh and Julia Shatten

Chronic pain and depression are both prevalent in the Unites States and often co-exist in the same population. According to the literature, there is no consensus between providers as to the best practice of treating chronic pain and concomitant depression. Narrative Medicine, a medical model that uses a patient’s illness narrative to make meaning of their disease, allows patients to tell their stories of chronic pain and other important aspects about their life, while it helps providers better understand patients’ experiences with pain. This project will assess the current culture and attitudes of providers treating chronic pain conditions at the Center for Family Medicine at Eastern Maine Medical Center. It will also assess their current understanding of Narrative Medicine and the Northwestern Life Story Interview. We found that providers who dread visits with patients with chronic pain conditions are more likely to feel less confident when treating those patients.
Connecting Seniors in Franklin County Vermont to Community Resources

Autumn Reilly

Vermont currently has the second oldest population in the country and the elderly population is continuing to increase. Senior citizens define aging successfully as having good health, strong friendships, and being able to participate in activities. In order to meet the needs of seniors it is important to find ways to better connect them with available community resources. The aim of this project was to create a pamphlet of community resources available to seniors in Franklin County, Vermont to aid in connecting them to community involvement and support.
Breast Cancer Screening - Helping Patients Choose

Fran Riley

Breast cancer imaging has been covered broadly in the lay press. Many questions have been raised in the past few years, which bring confusion to patients in terms of risks vs benefits. In addition, new research shows dense breasts to be a significant risk factor to developing breast cancer, warranting additional modalities. All of this requires the patient to have an understanding of the risks versus benefits so they can choose what's best for them. This project creates an information brochure for patients, using numbers to give patients objective perspective to inform their decision.
Preventing Falls in the Elderly

Rebecca Robbins

Falls are the leading cause of fatal and non-fatal injuries for older Americans, leading to 27,000 deaths every year and almost 3 million emergency room visits. Many view falls as just part of getting older; however fall risk can be significantly diminished through appropriate screening, education and community programs. Through literature review and talking to members of the local community, I learned about how fall risk is assessed along with what education and programs are provided for those at increased risk of falling. This project sought to educate patients about simple steps that can be made to decrease their fall risk and to educate providers about screening tools available to assess fall risk and how to work with patients who have an increased risk of falling.
Indirect Approach to Intimate Partner Violence

Jasmine Y. Robinson

Discussing Intimate Partner Violence can be difficult, and has many barriers. An indirect approach to speaking with patients about domestic violence, whether is is sexual, physical, emotional or financial can be achieve with patient's trust in a physician if they withhold judgement.
Identification of Barriers to Organ Donation: A Primary Care Interventional Approach

Brittany L. Rocque MSc

Organ transplantation provides a potentially life saving intervention for patient with end-organ failure as well as substantial cost-benefit with relation to Medicare expenditure. Despite the advantages of transplantation, deceased organ donors are in short supply and many patients die or lose quality years while awaiting transplantation. Registered organ donor rates are relatively low in our opt-in system being 52% nationwide and only 44% in Vermont, which is below the >50% per state goal. Non-organ donor patients were given and informational brochure and surveyed regarding their attitudes and beliefs toward organ donation.
Assessing Transportation Hurtles in Lamoille County, VT

Brian J. Rosen

Rural areas are often characterized by low population densities, and large distances between available services and the population they serve. Lack of transportation in these areas makes access to services even more challenging. Access to primary healthcare was listed as the number one concern for patients in 2015 Copley Hospital Service Area (Lamoille County) and lack of suitable transportation was a major reason for this lack of access. The primary purpose of this project was to assess the medical transportation options for patients without appropriate transportation in Lamoille county, and to produce a flyer educating the patients about their options. The second goal was to educate the providers at Morrisville Family Health Care about the transportation struggles their patients face.
Primary Care to the Rescue, Again! Autopsy and the Death Certificate

Emily E. Ryan

An pre and post testing, an educational module, a presentation, and a dot phrase were developed to improve providers' knowledge of the hospital autopsy and the correct completion of death certificates.
Recognizing Depression in Elderly Patients

Maia Sakradse

Recognizing depression in elderly patients can be challenging. Lack of awareness of mental health issues amongst elderly patients, ideas that depression is a normal part of aging, and confusing symptoms of depression as symptoms of other conditions are just a few of the challenges. Providing patient information about the signs and symptoms of depression in older patients may help encourage patient to talk to their doctors about depression.
Concussion

Kasra Sarabakhsh

Concussions are very common, especially among young athletes and students. Most patients are encouraged to rest and avoid activities that are physically and cognitively demanding. However, there is not much education regarding alcohol use after a concussion and its detrimental effects on brain recovery.
"Beaver Fever" - Giardiasis in Vermont

Anthony Sassi

“Beaver Fever,” or Giardiasis, is caused by a single-celled parasite called Giardia intestinalis. According to the most recent reports by the CDC, Vermont consistently has the highest rate of Giardia infection in the nation. Since the risk of infection for Vermonters is so high, it is important for both patients and providers to understand the transmission, symptoms, and treatment of this very common disease.
Increasing Access to Dental Services in Windham County, VT

Adam Michael Schlauch

Adults and children in Windham County, VT have limited access to dental care. A goal of the Community Health Team at Grace Cottage Hospital is to increase access to dental care through the proposal of a mobile dental clinic.
Colorectal Cancer Screening

Eric Schmidt

The USPSTF gives Colorectal Cancer screening a Grade A recommendation, beginning at age 50 years and continuing until age 75 years. Screening colonoscopies are proven to show dramatic decreased incidence and mortality from colorectal cancer. This project evaluates the percentage of patients at Stowe Family Practice and Community Health Services of Lamoille Valley who are meeting these guidelines. Using chart reviews and patient interviews, the project seeks ways to increase screening rates through provider-patient shared decision making tools and educational materials for the office.
Vermont Food Insecurity: Implementing screening tools and interventional assistance at Thomas Chittenden Health Center

Quinn Self

Hunger Free Vermont estimates that over 11% of Vermonters experience Food insecurity defined as a lack or access to adequate nutritious food due to lack of money or other resources. Food insecurity has been linked with numerous health problems including obesity, depression, poor school performance, heart disease, anemia and increased number of hospitalizations. Despite the adverse health outcomes associated with food insecurity, primary care providers don't usually screen for it. There are short validate tools to screen with high sensitivity and specificity for food insecurity. The goal of this project was to generate a screening poster for waiting rooms and an information pamphlet for patients and providers that highlights local resources that can help address food insecurity.
Narrative Medicine: Improving Patient Care and Shifting Office Culture

Julia Shatten and Yazen Qumsiyed

Assessing the effects of narrative medicine on the doctor patient relationship, office culture and the management of symptoms in patients with chronic pain and depression in a primary care setting.
Headphones and Adolescents: Hearing Loss Prevention

Taylor Sommer

Headphone use of adolescents is on the rise due to increased availability of personal listening devices. Hearing loss has also increased in adolescents. This project aims at preventing noise-induced hearing loss by educating adolescents on proper use of headphones.
Promotion of Skin Protection in Children in Waterbury, VT

Kelsey M. Sullivan

Background: Vermont has among the highest rates of skin cancer in the nation. Between 2001 and 2005, Vermont had the highest incidence of melanoma of any state, 63% higher than the national average. It is also estimated that if children under 18 regularly used sunscreen of at least SPF 15, the incidence of squamous and basal cell carcinomas would decrease by 78%. Modeling by the EPA and CDC suggests that recommended sun protection measures could prevent 11,000 cases of skin cancer, 50 deaths, and $30 million in cancer treatment costs nationwide. Intervention: To create an information sheet on skin protection and skin cancer prevention to be included in well-child visits at the Waterbury Health Center. Method: I integrated state-specific data, national data, and epidemiologic facts about the risks of sun exposure and other risks for skin cancer with recommendations made by the UVM Dermatology residents who I interviewed, in order to create a brief yet fairly comprehensive fact sheet on skin protection in children.
Improving Breastfeeding in New American Communities of Burlington, VT

Amelia V. Tajik

Community Health Centers of Burlington (CHCB), a Federally Qualified Health Center (FQHC), provides healthcare services including social work and financial assistance to these New American communities. The flagship site, Riverside, provides a specialized OB clinic where many of these community women obtain prenatal and postnatal care. Continuing to understand the barriers these communities and families face in providing the recommended healthcare to their newborns allows mission-driven CHCB to most effectively communicate, support, and effectively direct resources to these barriers. Barriers and challenges to breastfeeding were identified during this rotation through confidential interactions with patients, shared with the staff and providers at CHCB.
Management of Prenatal Depression

Soraiya Thura

Depression affects many women during and after pregnancy. As many as 1 in 5 women will experience a depressive episode during their pregnancy, however, studies have shown that less than 20% of these women will discuss their symptoms with their healthcare provider and receive care. Barriers to treatment include poor screening, lack of understanding about safe treatment, and stigma against mental illness in pregnant women. This project aimed to address this issue locally, by presenting to a group of family medicine providers in Vermont on the topic of prenatal depression screening and treatment. The presentation was received well and developed further discussion on research looking into maternal depression at this site.
A Patient's Perspective on Lower Urinary Tract Symptoms

Curran Uppaluri

Lower urinary tract symptoms (LUTS) have been increasing in incidence and prevalence in the United States. With a large annual health care cost, an association with a significantly reduced quality of life, and an aging population, LUTS is increasingly becoming more of a burden on the health care system. The American Urological Association created a symptom index in 1992 that assesses for the severity of seven LUTS associated with benign prostatic hyperplasia. This project seeks to address the question of which symptoms from the index score are more common; whether certain symptoms are more concerning from a patient’s perspective.