Block Clerkship Projects

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PSA Perspectives

Kirsten Martin
Adolescent and Young Adult Medicine: Supporting An Often Forgotten Population

Isabelle Mason

The actions and lifestyle choices adolescents and young adults make have profound effects on their future health and well-being. Unfortunately, these patients are often scarce among family practice lineups, making it difficult for physicians to provide impactful preventative care. This project looks at how to help reach these oft-forgotten patients.
Prostate Cancer: Patient Education for Changing Guidelines

Richard Mendez

In May 2012 United States Preventative Services Task Force (USPSTF) recommended against prostate cancer screening, Grade D, with no other recommendation for providers. Since prostate cancer continues to be among the most common cancer in the United States among men, patients were exposed to previous guidelines during routine visits and require updated educational materials for primary care visits.
Combating Childhood Obesity

Rebekah Misir

Assessing childhood obesity in Danbury, CT and combating it through counseling.
Window of Opportunity for Opiate Dependence

Scott C. Mitchell II

Opiate dependence is a prevalent problem and there is a need for current regional information for those seeking to break opiate dependence. There is a small window of opportunity for these patients to seek and find help before they give up and return to using. This project provides a pamphlet with current resources for opiate dependent individuals to get help in a rapid period of time for the Bangor, Maine area.
Incontinence and Pelvic Floor PT in the Primary Care Setting

Nikolas A. Moring

Stress incontinence and overactive bladder are two causes of decreased quality of life in the general population. Many patients report a long latency between the onset of symptoms of incontinence and identification and treatment. This project aimed to provide educational materials to both providers and patients about incontinence to help better identify patients who may benefit from pelvic floor physical therapy. Pelvic floor physical therapy has been demonstrated as a safe, non-pharmacological intervention for stress incontinence which may be overlooked in the primary care setting.
Understanding Dual Energy X-Ray Absorptiometry (DEXA) Bone Scan Results and Treatments

Jennifer C. Morris

Patients come into the St. Albans NOTCH primary care office for a follow-up to their DEXA scan to learn about what their results mean and discuss any questions/concerns. This brochure will help to standardize the information presented by providers about the results.
Recommendation for Routine Prenatal Screening for Hepatitis C

Althea L. Morrison

Hepatitis C prevalence and incidence are on the rise, both nationally and in Vermont. This project aims to assess the feasibility and potential benefit of implementing routine prenatal Hepatitis C screening, as opposed to screening only patients who fall within the high exposure risk category. Routine prenatal screening is a simple and cost effective means of increasing the early detection and treatment of Hepatitis C.
Improving Awareness of Colon Cancer Screening in the Homeless Population of Burlington, Vermont

Alexis Nadeau

Homeless populations are significantly less likely to access preventative cancer screening, yet this is a major cause of morbidity and mortality in this population. In the general population, colorectal cancer affects 1 in 20 people and is the number 2 cancer killer. Rates of colorectal cancer screening are particularly low in homeless populations. A poster was developed and posted in the waiting room of Safe Harbor clinic, a homeless health care program center, in order to increase education and awareness about colon cancer screening and colonoscopy.
Building Confidence in the Prescribing and Monitoring of Pre-exposure Prophylaxis (PrEP) in Vermont

Scott Neary

Vermont has the goal of zero new transmissions of HIV in the state by 2020. PrEP is a key component of achieving this goal. As of 2016 less than 50% of physicians felt confident in discussing and prescribing PrEP to their patients. This health project created a reference for physician's to utilize when prescribing and monitoring patients on PrEP
Patient Education: Importance of Diabetic Foot Care

John Paul Nsubuga

Diabetes is about the leading causes of mortality in united states, estimated to cause greater than 80,000 deaths annually. With the ongoing obesity epidemic, the prevalence and incidence of this debilitating disease is on the rise. Diabetes the leading cause of non-traumatic lower extremity amputation in United states. These amputations are often preceded by infected non-healing foot ulcers. It is therefore of at most importance to continue educating diabetic patients on proper foot care management to prevent ulcer formation. This project aims to create a patient educational brochure about the importance of proper diabetic foot care, while providing easy to follow guidelines that will go a long way in helping prevent diabetic ulcers.
Lyme Disease Prevention in Western Connecticut

Tyler Oe

Lyme disease is a bacterial infection that is endemic to the Northeastern region of the United States, specifically Connecticut. Spread by the deer tick, Lyme can produce a constellation of symptoms that can adversely impact an individual. Living in Connecticut transfers a significant amount of risk to individuals and understanding the appropriate prevention techniques should afford protection from deer tick bites. Having a robust resource on preventative measures and signs and symptoms of Lyme will provide a foundation for minimizing the risk of getting Lyme disease.
Outpatient management of mood disorders by the family physician

Elizabeth O'Neill

It is well-known that the demand for psychiatric care in the US is higher than the supply of psychiatric clinical providers. Vermont, in particular, has a paucity of psychiatric providers and there are minimal providers in Chittenden County and the greater Burlington area. Many patients with psychiatric conditions are inconsistently managed given the lack of available outpatient providers, particularly for patients on Medicaid. Often times, patients suffer from psychiatric episodes that require an emergency department visit or inpatient stay, and they may leave the hospital with an outpatient medication regimen that can then be carried out by a primary care provider. Patients should not have to endure a psychotic episode bringing them into the hospital in order to receive appropriate psychiatric care. A possible solution to this gap in care would be for primary care providers to be armed with the knowledge and skills to appropriately and sustainably manage psychiatric conditions on an outpatient level. Tools to summarize the evidence and current guidelines around prescribing, testing, surveillance, and other drug-related parameters may enable providers to quickly assess the recommendations during a busy clinical day, especially if such tools were consistently updated and embedded into the electronic medical record. This project focuses on management of mood disorders in the outpatient family medicine clinic; a "one-pager" table summarizing guidelines around commonly prescribed mood stabilizers in the setting of bipolar disorder was created and displayed in the Hinesburg Family Medicine clinic.
Outpatient Management of Mood Disorders by the Family Physician

Elizabeth S. O'Neill

It is well-known that the demand for psychiatric care in the US is higher than the supply of psychiatric clinical providers. Vermont, in particular, has a paucity of psychiatric providers and there are minimal providers in Chittenden County and the greater Burlington area. Many patients with psychiatric conditions are inconsistently managed given the lack of available outpatient providers, particularly for patients on Medicaid. Often times, patients suffer from psychiatric episodes that require an emergency department visit or inpatient stay, and they may leave the hospital with an outpatient medication regimen that can then be carried out by a primary care provider. Patients should not have to endure a psychotic episode bringing them into the hospital in order to receive appropriate psychiatric care. A possible solution to this gap in care would be for primary care providers to be armed with the knowledge and skills to appropriately and sustainably manage psychiatric conditions on an outpatient level. Tools to summarize the evidence and current guidelines around prescribing, testing, surveillance, and other drug-related parameters may enable providers to quickly assess the recommendations during a busy clinical day, especially if such tools were consistently updated and embedded into the electronic medical record. This project focuses on management of mood disorders in the outpatient family medicine clinic; a "one-pager" table summarizing guidelines around commonly prescribed mood stabilizers in the setting of bipolar disorder was created and displayed in the Hinesburg Family Medicine clinic.
Patient Education on the Shingrix Vaccine

Arjun Patel

The CDC recommends that most adults over the age of 50 get the Shingrix vaccine for protection against shingles (herpes zoster). Many patients at the WCHN Southbury Primary Care clinic in Connecticut are eligible for vaccination but are unaware of this newer vaccine or are unsure if they need the vaccine based on their past medical history and vaccination history. A brief, easy to understand handout was made to educate patients on the Shingrix vaccine and address frequently asked questions.
Diet Management for Adult Onset Diabetes Mellitus Type 2

Michael A. Persaud

In Southbury, Connecticut, diabetic diet management is an issue that perturbs both primary care providers and their patients. This project seeks to ameliorate the lack of readily available resources for diabetic dietary considerations. A brochure was made including helpful dietary information for patients that are unable or unwilling to see a Certified Diabetic Educator. As the incidence of diabetes continues to rise, patient education will be a powerful tool to help patients manage their diabetic care.
Motivating Patients to Complete Advance Directives

Eva Petrow

Advance directives are important clinical tools for assuring that patient’s end-of-life goals are met. Earlier referrals to palliative and hospice care through health care planning could better assist Vermonters in attaining their care goals. This project sought to improve advance directive completion in Vermont, increase awareness of health care planning among patients, and aid discussion between patients and providers in the clinic.
PSA-based Prostate Cancer Screening: What to Tell Our Patients

Andrew Pham
Establishing a pediatric prenatal visit at The Health Center (THC) in Plainfield, VT

Katherine Price

The AAP has long recommended a prenatal visit as part of the continuum of well-child care. However, this visit is underutilized by new families. Most prenatal education focuses on labor and childbirth with little to no information about parenting and the postpartum period. The PRAMS VT Survey 2012-2014 identified “a class for new parents (parenting, not childbirth)” as a requested resource by respondents. The pediatric prenatal visit provides infant care guidance and can connect families with community organizations that provide postpartum education. The Health Center (THC) does not currently have an established pediatric prenatal visit for expecting parents.
Tips for Successfully Managing Your Type 2 Diabetes

Allison Reeder

Type 2 diabetes is a disease that is all too common in our country. There are a variety of lifestyle modifications that can have a positive impact on disease control, such as watching sugars and fats in the diet and getting consistent exercise to decrease weight. Patients should receive better education on how to control their disease without medications so that the cost of diabetes in the United States does not continue to rise.
A Patients Guide To Back Pain

Russell R. Reeves

Lower back pain is debilitating problem that impact millions of Americans every year. Despite the widespread and recurrent nature of this problem, many patient are unaware of nonpharmacologic steps they could take to reduce their pain and prevent recurrences. This project looks to present a pamphlet informing patients in central Vermont about steps they can take to alleviate their pain and where to find physical therapy.
Identifying Food Insecurity and Increasing Access to Nutrition in Brandon, VT

Jacob B. Reibel

Food insecurity is a significant problem in Vermont affecting over 10% of the population in 2016. Access to nutrition is an important social determinant of health with long term implications for our communities. In order to increase awareness of existing infrastructure to reduce food insecurity in Rutland County, a resource guide was created with information about local food pantries, community dinners, and assistance obtaining 3SquaresVT benefits.
Halting Progression of Stasis Dermatitis: Community Perspectives and Strategies for Prevention

Allison B. Robbins

Complications of stasis dermatitis including venous ulcers, osteomyelitis, and cellulitis all significantly increase morbidity and mortality of disease. Progression beyond stasis dermatitis and avoidance of the aforementioned complications are preventable with patient education and adherence to basic therapies including compression stockings and lifestyle modification. Therefore the goals of this project were to: assess the community’s understanding of stasis dermatitis and their awareness of its complications; use this information to help healthcare providers tailor their preventative health counseling accordingly; and provide education for patients on stasis dermatitis, its complications, and therapies/behavioral changes to prevent disease progression.
Bridging the Gap: Putting Nutrition Knowledge into Practice

Monica Rodgers

Obesity is highly prevalent and has overwhelmingly been shown to negatively impact health outcomes for patients. Poor dietary habits are an important contributor to obesity. Formal interviews with local healthcare providers and informal interviews with patients indicated a need for resources for patients who have already completed nutrition education classes or already have the knowledge they need but are unable to implement it to regularly prepare nutritious meals at home. A book of nutritious, filling recipes adapted to include many vegetables, low added sodium, and relatively inexpensive ingredients was compiled for health care professionals to provide to this target population to facilitate and inspire the preparation of healthy meals at home.
Patient Education about Influenza Vaccination

Michael Rodriguez

Only 37% of adults in the US received the influenza vaccine in 2017-18. Clearly there is a gap between the known benefits of the influenza vaccine, the risks of influenza, and the number of patients obtaining influenza vaccine. An educational flyer was created to address common concerns or myths about the influenza vaccine in order to encourage vaccination at Brookfield Family Practice.