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
Barriers to Smoking Cessation in Patients Enrolled in Suboxone Treatment Programs

Thomas L. Arnell
Short-term Project
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 of increased desire to use drugs following smoking cessation.
Ensuring Adequate Recognition and Care for Lyme Disease

Menna Awadalla
Short-term Project
Lyme disease is a common issue in the Northeast United States, particularly in New Milford, Connecticut. Lyme is a readily treatable condition generally requiring a simple 2-3 week course of antibiotics. However, if patients cannot identify their symptoms and thus, do not come in for treatment, then that puts them at risk for developing chronic Lyme disease and fatal sequelae as a result. This project focuses on informing the local public about this issue by providing essential information regarding signs/symptoms, treatment, prophylaxis, and complications of Lyme disease.
The Truth About Vaccines

Ramin Badiyan
Short-term Project
Shedding light on childhood vaccinations
An exploration of the benefits and challenges associated with introducing point-of-care ultrasound to a rural primary care setting

Daniel Bak
Short-term Project
Castleton Family Health Center serves the western portion of Rutland County, which is designated as both rural and medically underserved. The regional Community Health Needs Assessment set goals to increase primary care visits, decrease inappropriate utilization of the emergency department, and work towards seamless care transitions without loss of information or gaps in care. Additionally, the Vermont Department of Health (Rutland region) identified both transportation limitations and a shortage of medical specialists as significant barriers to accessing care in the region. Point-of-care ultrasound may serve to address these community needs by improving the quality and continuity of care provided by primary care physicians.
Influenza Vaccine Participation in South Burlington, VT

Rio Beardsley
Short-term Project
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.
Promoting TIA Awareness: Decreasing Stroke Mortality in Vermont

Nicole Becher
Short-term Project
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.
Improving Awareness of Opiate Support Programs In Lamoille County

Samantha Bissonette
Short-term Project
Despite Vermont having doubled the rate per 10,000 people ages 18 to 64 receiving Medication Assisted Treatment (MAT) for Opiate Use Disorder (OUD) since 2012, there are still numerous barriers preventing patients from seeking treatment, including confusion about how to go about entering a treatment program, fear of stigma, and many others. Lamoille County has started to expand outreach to people struggling with OUD by having emergency services personnel, outpatient medical offices, and recovery centers hand out a county-specific information card with clear information about how to enter treatment and support programs. This project builds upon this existing initiative.
Osteoporosis: What to be aware of as a patient

Jonathan H. Borden
Short-term Project
The prevalence of Osteoporosis is increasing with the growing elderly population in our nation. Studies show that the incorporation of osteoporosis risk screening into primary care intake protocols significantly decreases the rate of osteoporotic fractures in patients. This project aimed to increase osteoporotic screening within a primary care office in St. Albans VT via the development and distribution of an “Osteoporosis: What to be aware of as a patient” brochure to patients that met the criteria for being at risk of being osteoporotic (women ages 65+, women who are post-menopausal but younger than 65, men ages 70+).
Counting Sheep & Counting ZZZs: A Therapeutic Approach to Better Sleep Hygiene

Cameron Burke
Short-term Project
Many adults present to primary care clinics with concerns that they are not getting sufficient sleep. In an effort to address this problem, I created an informational brochure educating patients on current sleep recommendations, instructing them on how to improve sleep hygiene, as well as describing how to keep a sleep diary to improve sleep efficiency.
Exercise Promotion for Patients with Mental Health Conditions in Milton, VT

Pirapon Leo Chaidarun
Short-term Project
Depression and anxiety are two highly prevalent mental health conditions and can often occur together. Research shows that sustained low-intensity exercise releases chemicals that promote nerve cell growth in the brain, which helps regulate mood and relieve symptoms. Exercise may seem like a logical solution for mental health to those with a medical background, but may be a new idea to many patients who are unaware of the added benefits of staying active.
Lyme Disease in Fairfield County, Connecticut: The Need to Know

Jack Chen
Short-term Project
There has been a steady rise in number of cases reported of Lyme disease in the past 25 years. In fact, it is the 7th most common reportable infectious disease in US with an estimated over 300,000 people diagnosed and treated each year. The total medical cost attributable to Lyme disease has been estimated to be as much as $1.3 billion a year with the total cost of Lyme disease testing estimated to be $492 million. Moreover, Lyme disease is associated with higher total health care cost and more outpatient visits over a 12-month period. According to the Connecticut Department of Public Health, the most number of cases of Lyme Disease in Connecticut is in Fairfield County. Therefore, education especially awareness and prevention is crucial to decrease the number of cases of Lyme each year, keep the cost down and have a healthier patient population without Lyme Disease.
Standardizing Asthma Management in Primary Care

Michael Vernon Chmielewski
Short-term Project
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 faculty.
Intimate Partner Violence: Improving Screening Rates in the Primary Care Setting

Alexandra E. Churchill
Short-term Project
The high prevalence of intimate partner violence (IPV) has led to recommended screening for all women of child-bearing age. Implementing validated screening tools within routine wellness visits at primary care offices facilitates awareness and patient support through identification and resource referral.
Implementing Easy-to-Read Advance Directives at the CMMC Family Residency

Elizabeth Congdon
Short-term Project
Advance directives have been shown to improve patient End-of-Life satisfaction, reduce surviving family depression and anxiety, and save money on end of life costs. Patients, especially low income patients and those on public health insurance, are often limited in their ability to complete Advance Directives due to low health literacy and complicated forms. This patient population is the bulk of the patient population seen at the Family Medicine Residency Clinic at Central Maine Medical Center. Residents at the Family Medicine Residency were educated on the PREPARE for your Care method of Easy-to-Read Advance Directives and online guidance for patients.
Improving Patient Educational Materials for a Suboxone Clinic in Southeastern Vermont

C. Wesley Cubberley
Short-term Project
Access to medical treatment for opioid use disorder plays a significant role in the ability of a community to support a person's recovery. In Springfield, VT, community workers and providers are attempting to organize a Suboxone (buprenorphine + naloxone) clinic in order to bridge the significant geographic and socioeconomic gaps implicit to this rural community's location. In order to garner interest and increase awareness of this forthcoming project, a short, accessible educational flyer was developed with the input of the health center's staff for future use.
Educating Parents on Newborn Health and Safety

Jenna Rose Dafgek
Short-term Project
More than 90% of unintentional injuries in children aged 5 years or younger occur in and around the home. Recommended infant care practices are below national target goals. Adherence to these recommendations increases when parents receive appropriate advice from multiple sources, including physicians. The goal of this project was to identify major newborn health and safety concerns. These concerns included car safety, safe sleep practices, and lead exposure. Educational handouts specific for age ranges spanning from first week of life to 1 year old were created for parents to address these issues.
Improving patient knowledge of antimicrobial resistance and appropriate antibiotic use in a Rutland county acute care center

Stephen D. Daniels
Short-term Project
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 in mind, and provides a projected financial advantage for a successful intervention.
Implementation of the Vermont Mini-Cog

Hillary E. Danis
Short-term Project
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.
Development of a Desktop Reference for Medication Assisted Treatment (MAT)

Andrew L. Darling
Short-term Project
This project was to develop a physician desktop reference to assist with medication assisted treatment (MAT) for opioid use disorder. It was developed in conjunction with MAT team members and family medicine physicians to serve as a reference of both commonly needed medical information and local contact information for community resources.
Addressing Food Insecurity in the Clinical Setting

Annabelle Davey
Short-term Project
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.
What To Expect: Patient Education to Improve Follow-up for Well Child Visits in Rutland, VT

Christina A. Dawson
Short-term Project
Well-child visits (WCVs) are the cornerstone of pediatric preventative care. Attendance at these visits may prevent illness, reduce adverse side-effects associated with some conditions, and improve health behaviors. Despite this fact, many patients are still missing routine visits, particularly in lower income communities across the United States, like Rutland, VT. The goal of this project is to implement the creation of parent educational handouts distributed at routine visits at CHCRR Family Practice in Rutland, VT, to provide anticipatory guidance and improve attendance of pediatric well visits from birth to 5 years old.
Promoting LGBTQ+ Inclusivity in Sex Education

Alexis Dela Cruz
Short-term Project
LGBTQ youths report less satisfaction with their sex education curriculum than their heterosexual counterparts. The discrepancy between heterosexual sex education and that of LGBTQ is alarming. Currently, as it is reported within the Unites States, students feel as though LGBTQ sex education and resources are not readily available. A brief handout of LGBTQ inclusive practices was created for educators to reference when creating future lesson plans. The aim of this presentation was to create a more open and inclusive dialogue surrounding LGBTQ+ health.
Falling Through The Digital Cracks: An EHR-Focused Approach to Promote Social History and Mental Health in the Outpatient Setting

Daniel De Los Santos
Short-term Project
Although they may not call prevention centers, people considering suicide usually do seek help; for example, 64% of people who attempt suicide visit a doctor in the month before their attempt, and 38% in the week before. Given the recent suicide of a father in Newtown, CT whose daughter was killed in the Sandy Hook Massacre, it needs to be asked if his suicide could have been prevented by having his physician discuss his mental health with him at his most recent check-up. Of equal importance, it must be asked if there are flaws within the EHR platform that make it more difficult for physicians to access or document a recent major life event while reviewing a patient’s chart. This project's goal was to remind providers about a recent stressful life event for a patient by implementing a specific problem list entry on the EHR titled “History of Recent Stressful Life Event".
Increasing Advance directive utilization in Hardwick, VT

Maeve Lauren Donnelly
Short-term Project
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.