Family Medicine Clerkship Student Projects

These projects were completed by students in the University of Vermont Family Medicine Clerkship. Block Clerkship Projects were completed during a five-week period, while Longitudinal Clerkship Projects were completed over the course of a 12-month longitudinal clerkship.

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Promoting Measles Prevention and Awareness

Elizabeth P. Lanata
Short-term Project
Assessing Prescriber and Staff Readiness for Change and Evaluation of Chronic Pain Management

Collin J. Anderson
Short-term Project
Survey-based study of opioid prescribers and staff members at a community health center. Designed to assess current opioid prescribing practices, management of chronic pain patients, and readiness for future change.
Sun-Safety: Assessing Barriers and Promoting Sun-Safe Practices for Vermonters.

Joy A. Benner
Short-term Project
Skin cancer continues to be the most common cancer in Vermont and the United States. About one in five Americans will develop skin cancer in their lifetime. Vermont currently ranks second highest in the country for melanoma skin cancer rates. Rates continue to rise and skin cancer is impacting patients at younger and younger ages. Although several factors play into development of melanoma, a large risk factor for developing skin-cancer in one's lifetime is UV exposure. One way to combat this is to encourage regular sun-safe practices, such as daily sunscreen use, seeking shade, and wearing sun-protective clothing. The aim of this project was to assess barriers to sunscreen use and evaluate current skin cancer statistics and sun-safe practices to create a SmartPhrase. Because providers only mention sunscreen in 0.9% of visits, the hope is that this SmartPhrase will be an easy and efficient way for providers at Colchester Family Practice to encourage sun-safe practices for their patients.
Distribution of Resuscitative Measures in Lamoille County, Vermont Schools

Jared J. Bomba
Short-term Project
This study evaluates the availability of resuscitative measures within the public schools of Lamoille County, Vermont. This includes primarily access to Automated External Defibrillators (AEDs), naloxone (Narcan), and epinephrine auto injectors (Epi-pens) subsequent to recent introduction of naloxone into schools in response to widespread opioid addiction in the region.
Utilizing Social Media to Improve Health Education: Should We Hit Like?

Audrea Bose and Naira Goukasian
Short-term Project
Social media presence in day to day lives is expanding, especially among younger generations. Preventative medicine is becoming the forefront of patient care. Where do the two meet? Healthcare preferences have been shown to vary by age. The younger generation is essentially ready for virtual healthcare access. In our clinical sites, we noticed a common theme of patients being unaware of preventative health practices, risk factors for diseases, or about diseases they already have. Many patients rely on their doctors for this information, but when they don’t have immediate access to their doctor, don’t regularly see their PCP, or maybe just forget what they were told, it can be difficult for people to find easily accessible and accurate health education. We also noticed that ‘accessibility’ is different for everyone and with the rapidly developing technological age, we wanted to analyze how this difference is stratified, based on age in these communities, and if using social media would be an acceptable method in this community to increase health education in all ages. The question is, can we target the masses virtually and effectively with minimal cost? And is this something patients want?
Addressing Adolescent and Young Adult Mental Health During the COVID-19 Pandemic

Megan Boyer
Short-term Project
This quality improvement project at South Burlington Family Medicine aimed to investigate the mental health of individuals ages 13-25 in our practice during the COVID-19 pandemic. Eligible patients received a PHQ-9 questionnaire with two additional questions related to COVID-19. Recommendations for future interventions to serve this population were made based on these preliminary findings, with the goal of doing a full PDSA cycle in the near future.
Oral Health Screening for at-risk Adults

Karla I. Brandao
Short-term Project
Oral health screening and prevention is common during well-child checks. However, this screening in adults is not as consistent. In addition, oral health has been implicated in a variety of medical conditions, making it a very important factor in systemic disease. The goal of this project is to create an oral health screening tool which can be distributed to adults, especially adults who are at high risk due to diabetes, substance use disorder, pregnancy, etc. Those with positive screening should receive a handout with some resources and information.
Updating Concussion Protocol Information Pamphlet

Susan K. Campbell
Short-term Project
Creating a concussion protocol pamphlet that helps guide patients through recovery with evidence based advice.
Pap Smears in the Somali Immigrant Population

Garrett Chan
Short-term Project
Lewiston, Maine is home to a population of Somali refugees. Women within this community have faced cultural and language barriers that have prevented them from obtaining Pap smears. We have collaborated with a local health clinic, where a cultural broker and member of the Somali community who is familiar with this population, to understand challenges Somali immigrant women face in cervical cancer screening. Together, we developed a pamphlet and health resource card, both in Somali, to lower barriers to care.
Increasing Public Perceptions of Stroke

Juan A. Conde and Juan Conde Fabela
Short-term Project
Analysis of publicly available data for the selected county of Rutland Vermont was performed to understand the underlying health problems affecting the county. Although VT overall has better health status indicators, including better access to care, and lower rates of chronic diseases than the nation, pockets of the state have higher rates of chronic diseases including obesity, DM, and cerebrovascular accidents.

Increasing awareness of stroke risk factors and symptoms is a cost-effective method to reduced stroke burden and provide successful treatment.
Evaluating knowledge and educating patients about diabetic retinopathy screening in Washington County, VT

Delaney Curran
Short-term Project
Evaluating knowledge and educating patients about diabetic retinopathy screening in Washington County, VT

Delaney Curran
Short-term Project
Diabetic retinopathy (DR) is a leading cause of blindness in adults. Early detection and subsequent treatment of DR has been shown to be effective at saving vision and medical costs. However, adherence to annual dilated eye exams is relatively poor among people with diabetes. This project in Waterbury, VT aimed to identify patients' potential knowledge gaps about the connection between diabetes and eye disease, educate patients about DR with a 2 min educational video in the primary care office, and then assess their level of interest in getting an eye exam after watching the video.
Creating a standardized workflow for providers at South Burlington Family Practice, South Burlington VT for documenting and diagnosing attention-deficit/hyperactivity disorder in pediatric patients aged 0-17

Racquel Sales De Castro
Short-term Project
An initiative of the Vermont Child Health Improvement Program (VCHIP) is to improve the attention-deficit/hyperactivity disorder (ADD/ADHD) pediatric diagnostic process in both family medicine and pediatric practices in the state of Vermont. This project specifically on improving this process at South Burlington Family Practice in South Burlington Vermont but is generalizable to all practices caring for pediatric and adolescent patients. For this project emphasis was placed on creating a standardized workflow that is followed by all providers in the practice, creating educational material for caregivers who present with a behavioral concern for their child or adolescent, and establishing an efficient way to deliver screening tools to caregivers as well as teachers/guidance councilors in a fashion that will promote completion and return to the practice in a timely manner.
Addressing Exercise Accessibility in Winter Conditions in Milton, Vermont

Liam du Preez
Short-term Project
Exercise is a critical aspect of health maintenance, especially in the context of chronic medical problems such as diabetes, heart disease, and obesity. Weather and climate conditions in Vermont directly impact Vermonters' ability to exercise, and this results in negative impacts in their health maintenance and healthcare costs nationally and locally. This project explores the direct and indirect impact of decreased exercise and explore a modality for informing patients on how to stay active safely in the winter.
Improving HPV Vaccination Rates

Emily Eichner
Short-term Project
HPV is a very common infection and can cause multiple types of cancers. The HPV vaccination is effective at preventing these infections and subsequent cancers. The HPV vaccine is most effective when given to adolescents; however, the vaccination rates for girls and especially boys remain low. Many reasons exist for parent's choice not to have their kids' vaccinated against HPV. Identifying and addressing these barriers through educational materials for parents will hopefully help improve HPV vaccination rates and reduce rates of these preventable cancers.
Hepatitis C Education and Screening in a Rural Northern Vermont MAT Clinic

Jack Fitzsimons
Short-term Project
Increases in hepatitis C infection rates have mirrored increases in opioid use disorder. This project attempted to determine screening rates of HCV in a medication assisted treatment clinic for opioid use disorder. Additionally it attempted to provide education to patients that had not been screened for HCV.
Easily Digestible: Addressing Food Literacy with Short Educational Videos

Kalle J. Fjeld
Short-term Project
Food literacy is the knowledge and skills needed to select and prepare food as well as determine food intake. These skills are necessary for a healthy diet, which is a major contributing factor to chronic disease prevention and management. People with diseases such as diabetes and cardiovascular disease can have great benefit from improving diet quality through increasing at-home food preparation and consumption of fruits and vegetables. In partnership with a Food Farmacy pilot program at Hudson Headwaters Health Network in Glens Falls, NY this project sought to use web-based food literacy education for a population of 40 patients with diabetes. Short, simple videos on basic fruit and vegetable preparation were created and published on YouTube. Follow-up interviews with patients were conducted to assess the reach and efficacy of this intervention.
Promoting Healthy and Active lifestyles with Home Exercises in South Burlington, VT

Jonathan Gau
Short-term Project
The barriers to exercise that patients face are often multi-factorial. Whether its due to weather, financial costs, lack of time, or if the individual simply isn't a gym person, we see a number of patients everyday who are not regularly exercising. This brochure is meant to provide patients during office visits with a tangible source of information that provides examples of in-home exercises, categorized by difficulty, that they can perform without any additional equipment.
Harm Reduction in the Emergency Department

Alexa J. Golden
Short-term Project
The number of overdose deaths in Vermont has been trending up over the past several years. A majority of these fatalities involved synthetic opioid fentanyl. The Emergency Department (ED) at Central Vermont Medical Center delivers medication assisted treatment (MAT) through the Rapid Access to MAT (RAM) program. This program has connected many people in the region to treatment for opiate use disorder. However it was identified that we lacked connection to harm reduction services for those not interested in MAT. Harm reduction education was provided for recovery coaches and ED nursing staff. Harm reduction kits containing life-saving supplies such as naloxone and fentanyl test strips, safer use information, and local harm reduction services were developed for distribution through the ED.
Assessing the Need and Desire for Nutritional Education

Marc Robert Hammond
Short-term Project
Many people suffer from health conditions that may be affected directly by diet and nutrition including diabetes, hypertension, hyperlipidemia, iron deficiency anemia, obesity, coronary artery disease, and cerebrovascular disease. Education of providers and patients alike may help decrease the prevalence of these health issues and their sequalae. The St. Albans Community has slightly poorer health and nutrition when compared to the entire state of Vermont. Patients in an outpatient primary care clinic in St. Albans, VT were provided with a survey that would assess:

The patient’s confidence in their nutritional skills and knowledge

Their willingness to go to a nutrition appointment Their preference in who would provide the nutritional education to them Results from the survey were used to attempt to understand some of the driving forces for poor nutrition.
Integrating Oral Health in Primary Care to Reduce Early Childhood Caries (ECC): Evidence-Based Guidelines and Recommendations

Alyssa Heiser
Short-term Project
Early childhood caries (ECC) is the most common chronic disease affecting children, despite being almost 100% preventable. ECC has become associated with a multi-factorial etiology including poor feeding practices, enamel hypoplasia, oral colonization by cariogenic bacteria, and demineralized tooth structure due to metabolism of sugars by tooth-adherent bacteria. ECC can lead to school absences, poor school performance, difficulty sleeping, attention problems, slower social development, and poor overall health. According to U.S. Preventative Services Task Force (USPSTF) guidelines, all children are at potential risk for developing ECC beginning at the time of first tooth eruption. While there are no validated multivariate screening tools to determine which children are at higher risk for ECC, there are a number of individual factors that elevate risk, including lack of preventative oral health care and screening before the age of 3 years old. The American Academy of Pediatrics (AAP) recommends fluoride varnish in the primary care setting every 3-6 months starting at tooth emergence. Thus, primary care providers can play a major role in screening for and preventing ECC by initiating fluoride varnish and providing parents and/or caregivers with information on proper oral hygiene for their children at routine well-child visits.
Identifying Barriers to Sunscreen Use and Sun Safety Education

Seneca Hutson
Short-term Project
Using your phone as a weight-loss tool

Sidika Kajtezovic
Short-term Project
Over one-third of the population in the United States is obese. Obesity is a risk factor for many chronic diseases, such as type 2 diabetes, cancer, hypertension, asthma, myocardial infarction, stroke, osteoarthritis and other psychological disturbances. Patient often find it challenging to make dietary changes in order to lose weight. This project focused on the use of a smart phone application to track daily caloric and nutritional intake, as well as exercise, to help patients lose weight.
Type 2 Diabetes Medication Breakdown

Kristen Keene
Short-term Project
There are many new medications for treatment of type 2 diabetes and these medications have many positive effects that go beyond lowering blood glucose. However, many of these medications are expensive and some insurance plans don’t cover them. Many patients struggle to pay for their diabetes medications and providers often are unsure of which medications will be covered by insurance. This project was designed to enhance patient education regarding diabetes medications and potential costs associated.
Type 2 Diabetes Medication Breakdown

Kristen Keene
Short-term Project
There are many new medications for treatment of type 2 diabetes and these medications have many positive effects that go beyond lowering blood glucose. However, many of these medications are expensive and some insurance plans don’t cover them. Many patients struggle to pay for their diabetes medications and providers often are unsure of which medications will be covered by insurance. This project was designed to enhance patient education regarding diabetes medications and potential costs associated.