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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Accessing Healthcare in the Era of COVID-19 for Youth Experiencing Homelessness

Ray Mak
Short-term Project
Youth experiencing homelessness face multifactorial challenges in obtaining adequate health literacy. The COVID-19 pandemic has increased the need for healthcare as well as heightened confusion with the spread of health misinformation. This project aims to provide a step-by-step guide for when youth should seek medical treatment for COVID-19 to avoid unnecessary medical costs.
Promoting Measles Prevention and Awareness

Elizabeth P. Lanata
Short-term Project
Smoking Cessation Patient Intervention in Connecticut Primary Care Clinic

Fay Abdullah
Short-term Project
Cigarette smoking is associated with numerous adverse health effects. As such, USPSTF recommends clinicians provide smoking cessation interventions to patients. The aim of this project is to develop a consistent method for providing patients at the Newtown Primary Care facility in Newtown, Connecticut with a smoking cessation intervention during their annual physical exam.
Connecticut Anemia Screening Guidelines

Amelia Anderson
Short-term Project
This handout serves to educate clinicians and other providers as to when anemia screening should be done. It contains a summary of the recommendations made by several national organizations as well as Connecticut-specific requirements.
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.
Promoting weight-loss via smartphone health applications (MyFitnessPal)

Michael S. Barnum
Short-term Project
Obesity has become a public health crisis in the United States. 68% of men and 64% of women in the United States are considered overweight or obese. Obesity is being addressed through a variety of strategies, the use of mobile apps is a relatively new development that could prove useful in helping people to develop healthy dietary habits. Tracking the consumption of certain foods and drinks may potentially help individuals achieve an improved understanding of their dietary patterns. The goal of this project was to develop and provide educational materials on the use of MyFitnessPal to patients seeking dietary advice.
Myth Busters: The Flu Shot During a Pandemic

Elizabeth Baumgartner
Short-term Project
Under-vaccination is a problem across the country, including influenza vaccination in Vergennes, VT. Members of the community at PMC - Primary Care Vergennes endorsed a few common reasons when declining the annual flu shot, noted by providers at the clinic. The project yielded two flyers for the office - one that addressed these common "myths" and another that addressed new considerations for influenza vaccination during the pandemic.
Telemedicine Quality Improvement

Isidora R. Beach
Short-term Project
Telemedicine use has increased dramatically since the advent of the COVID-19 pandemic in the spring of 2020. However, not all patients and physicians were prepared for this rapid change, and little evaluation of these new mechanisms for delivery of healthcare has occurred thus far. This community project explores patient and physician perspectives on the use of telemedicine in place of in-person visits and makes recommendations for future improvements. Ultimately, telemedicine use will not likely diminish any time soon, making it increasingly important to triage patient visits to determine which would lend themselves well to the telemedicine format. As this project shows, not all visits do, which has lead to both physician and patient dissatisfaction since the change.
Promoting Physical Activity in School-Aged Children During the COVID-19 Pandemic

Abigail H. Belser
Short-term Project
Due to the COVID-19 pandemic, children and adolescents are engaging in less physical activity and are increasing their sedentary behavior. These changes can lead to long-lasting negative lifestyle behaviors, which increases risk of health complications.

To ensure safety during the pandemic, guidelines have created restrictions on physical education and sports, which are both primary physical activity outlets for children and adolescents. Children and adolescents have to find alternate ways and resources to meet the recommended 60 minutes of physical activity daily.

An informational pamphlet was created to educate parents and children of current physical activity recommendations, with resources and ideas on how to incorporate 60 minutes of physical activity into their daily life. These were distributed to patients at the Milton Family Medicine Practice in hopes of increasing physical activity during the COVID-19 pandemic.
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?
Increasing Awareness of Added Sugar in the Outpatient Setting

Lauren Bougioukas
Short-term Project
An estimated 80% of Americans consume more than the recommended daily amount of added sugar. Added sugar consumption significantly increases risk for cardiovascular disease mortality, and is associated with body weight, type 2 diabetes, and metabolic syndrome. In the United States, added sugar consumption contributes to public health costs related to cardiovascular disease ($555 billion spent in 2016) and diabetes ($245 billion spent in 2012). Particularly in New York, nearly 40% of all New York deaths in 2014 could be attributed to cardiovascular disease and 10.5% of New York adults had diabetes in 2017. In addition to added sugar overconsumption, many Americans have difficulty reading a Nutrition Facts Panel and nutrition education can be difficult to achieve in an outpatient primary care setting due to many competing demands.

The purpose of this project was to develop easy-to-read, educational office literature about added sugar for patient waiting and exam rooms at Champlain Valley Physicians Hospital Family Medicine Center in Plattsburgh, New York. Office literature included information about the recommended daily amount of added sugar, potential health consequences, information about reading a Nutrition Facts Panel, and common foods and drinks containing added sugar with suggested alternatives. Preliminary results suggest the office literature has effectively motivated patients to try healthier alternatives and has served as a springboard for discussion with the provider.
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.
Screening and Monitoring Social Determinants of Health for Migrant Workers in Vermont

Richard Brach
Short-term Project
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.
PHQ-9, but in Spanish

Jose Calderon
Short-term Project
Spanish speaking patients are often missed for depression. A common issue is lack of awareness of the Spanish version of the PHQ-9
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.
Medical Students and home-based Primary Care : Education Outside of the Clinic

Sally Clark
Short-term Project
Home-based primary care has tremendous utility for homebound patients and those who have serious functional limitations. Patients who utilize home-based primary care have significantly lower rates of hospital admission and 30-day readmissions. Incorporating a home-health visit into the Family Medicine Clerkship rotation for MS3s will help medical students understand the importance of primary care while also learning about a patient's unique environment.
Food Security during Remote Schooling

Julia Lane Clemens
Short-term Project
This project examined how remote schooling during the coronavirus pandemic affected patients' food security. Patients were surveyed about their access to food and how this had changed during the pandemic. Recommendations were made to the clinic following data collection.
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
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.
Evaluating knowledge and educating patients about diabetic retinopathy screening in Washington County, VT

Delaney Curran
Short-term Project
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.