Family Medicine Clerkship Student Projects

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  Healthy Affordable Food in Milton, VT

  Nicholas D. Brunette

  Short-term Project

  Access to healthy affordable food is a common issue in nationally and in Vermont. This project aims to provide resources for patients and families at Milton Family Practice who need access to healthy food options.

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  Healthy Affordable Food in Milton, VT

  Nicholas D. Brunette

  Short-term Project

  Food insecurity disproportionately affects those of lower socioeconomic status and ultimately leads to poorer health and excess healthcare expenditures. Providing local and online resources for healthy affordable eating to patients of Milton Family Practice may help address some of these concerns.

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  Implementation of an Ultrasound Screening Program in a Rural Family Medicine Practice for Abdominal Aortic Aneurysms

  Rachel Carpenter

  Short-term Project

  The American Academy of Family Physicians (AAFP) supports the USPSTF recommendation of a one-time screening assessment of all men aged 65 to 75 years old who have ever smoked for an abdominal aortic aneurysm (AAA) via ultrasonography – grade B recommendation. Despite this, few eligible patients are referred specifically for screening and many patients that are screened only have it performed as an incidental finding of other indications for imaging. AAA screening, when done, has demonstrated up to a 40% reduction in AAA specific deaths and a 3% reduction in all cause mortality after 13 years follow up. The initiation of ultrasound use in a primary care clinic has the potential to not only increase AAA screening but also lead to more widespread use of this imaging modality on a comprehensive level.

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  Barriers to Head and Neck Cancer Treatment in Rural Populations

  Amy K. Chang

  Short-term Project

  Head and Neck cancer (HNC) patients have unique outcomes and resource needs. They often experience debilitating speech, nutrition, respiratory, and psychological problems, requiring a multidisciplinary team. Additionally, they also require more support in terms of alcohol and tobacco support, whether that be an addiction medicine specialist or a support group. The coordination of these specialists is difficult in a rural setting with limited resources. Furthermore, HNC is more prevalent in developing countries and rural populations due to use of known etiological factors like tobacco and alcohol. The combination of high prevalence and low resources in rural populations may lead to suboptimal treatment and worst outcomes.

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  Community Services for Patient Referral Document

  Jett Choquette

  Short-term Project

  Patients have a need for referral to a variety of services that directly relate to their health and wellbeing that are not generally included in the traditional referral system of healthcare networks. These services include (but are not limited to) social work support, pandemic support, elderly services, LQBTQ+ services, intimate partner violence services, functional medicine, and substance use disorder and mental health support and treatment. Because these services are not part of the traditional healthcare referral system, healthcare providers may not have an up-to-date list of organizations and programs in the community that could provide these needed services. This is especially important in the current era when there has been increased turnover of healthcare workers at all levels leading to low institutional/community knowledge. To address this need, a community service patient referral document was developed after interviewing healthcare workers in the community and reviewing patient needs throughout the family medicine clerkship to inform resource selection.

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  Trust Your Gut: Promoting gut health through updated nutrition education

  Christina Cobb

  Short-term Project

  Physician time and nutrition education are limited, yet lifestyle changes, including healthy eating, are often the primary intervention for both preventing & managing chronic conditions, such as cardiovascular disease, hypertension, and type 2 diabetes. There is growing evidence of the importance of gut health & the microbiome’s link to several aspects of health, including the immune system, mental health, and metabolic syndrome. Through collaboration with two dietitians, a "promoting gut health" patient handout was created and existing nutrition handouts were updated to reflect current dietary recommendations.

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  Demystifying the Advance Directive Conversation for Healthcare Providers

  Trevor Daniel Coles

  Short-term Project
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  Primary Care Management of Alcohol Withdrawal

  Julie Connor

  Short-term Project

  Alcohol use disorder (AUD) is prevalent yet undertreated in rural Vermont. Approximately half of those with AUD who stop drinking experience alcohol withdrawal. Alcohol withdrawal can range from uncomfortable to life threatening symptoms. Untreated alcohol withdrawal can also lead to recurrence of alcohol use. The mainstay for management of alcohol withdrawal has been inpatient or intensive outpatient programs. However, there are barriers to accessing these programs including availability of beds, patient reluctance, lack of transportation, not knowing about these programs, and cost. Primary care management of alcohol withdrawal is safe, accessible and has the potential to reduce symptoms of alcohol withdrawal, improve engagement with treatment for alcohol use disorder, and reduce alcohol related health complications. In this project, a patient instruction sheet and self-assessment of withdrawal symptoms to be used as part of a protocol for primary care management of alcohol withdrawal.

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  A Quality Improvement project on Gender Affirming Hormone Therapy for transgender patients in a rural Vermont clinic

  James S. Contompasis

  Short-term Project

  A Quality Improvement project on Gender Affirming Hormone Therapy for transgender patients in a rural Vermont clinicA Quality Improvement project on Gender Affirming Hormone Therapy for transgender patients in a rural Vermont clinic that provided protocols and consent forms for masculining therapy to the practitioners at that clinic who wish to prescribe gender affirming hormone therapy (GAHT)

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  IPV: Why Don’t We Screen for Those Committing Acts of Violence?

  Hannah K. Cook

  Short-term Project

  State of the evidence for screening for IPV in men or those who are committing acts of violence.

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  Adolescent Anticipatory Guidance

  Anna M. Corbalan

  Short-term Project

  This project focuses on creating an educational resource specifically for adolescents and young adults regarding the anticipatory guidance for this age group. Although adolescence is generally a healthy time for most, many health or social problems will start or peak during this time. Therefore, it is a crucial time to incorporate preventive guidance and increase health literacy to avoid unhealthy chronic behaviors in adulthood.

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  Covid-19, Cold, Flu? What To Know and What To Do

  Ryan Cournoyer

  Short-term Project

  A review of Covid-19 symptoms vs the common cold and influenza. Discusses what to do if you think you are sick and when to seek medical care. Helping prevent community Covid-19 transmission and influx of mildly symptomatic patients into primary care clinic and emergency rooms.

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  Diabetic Retinopathy Screening in Primary Care: Workflow Optimization

  Andrew DesLauriers

  Short-term Project
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  Basic At-Home Exercises for Common Areas of Pain

  Willie Dong

  Short-term Project

  Physical Therapy (PT) is often the first-line management for subacute MSK pain seen in the primary care setting. For various reasons patients may be opposed going to PT. For patients that are interested, there is often a latent period before an appointment can be made. Providing resources, including a pamphlet, with all-inclusive, simple at-home exercises may help to accelerate recovery.

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  Increasing Awareness and Understanding of the Health Assistance Program: A Patient Resource

  Arley Donovan

  Short-term Project

  The Health Assistance Program (HAP) through the University of Vermont Medical Center/Porter Medical Center is a resource for patients in the Network who are struggling to pay for expensive but effective and clinically appropriate medications like injectables for diabetes, anticoagulation drugs or inhalers due to cost, underinsurance or interruption in insurance. The HAP/UVMMC Mail Order Pharmacy helps eligible low- and middle-income families who make at or below 400% of the federal poverty limit get prescription medications at no cost, even if they have insurance. Lack of awareness and understanding about this program by patients and providers could potentially lead to patients self-discontinuing important medications due to cost when they do not have to. This in turn may lead to worsening outcomes and unnecessary emergency room visits and hospitalizations.

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  Improving Patient Education Surrounding Imaging Modalities

  Tayler Drake

  Short-term Project

  Musculoskeletal complaints are among the most common problems seen in family medicine clinics. Patients may expect that every musculoskeletal complaint requires imaging, however, they may leave the clinic without a referral to radiology. This discrepancy between reality and expectation may strain the patient-provider relationship. The goal of this project is to educate patients regarding imaging modalities and when it is appropriate for imaging to be ordered in the workup of a musculoskeletal complaint.

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  Mammography among Nepali New Americans

  Rose Eiduson

  Short-term Project

  This presentation describes an effort to increase uptake of mammograms among Nepali New Americans at the Community Health Centers of Burlington, VT. After interviewing the Medical Director and hearing from patients about barriers to mammography, an infographic and Powerpoint slide was created and will eventually be translated into Nepali. Future efforts to improve uptake of mammography could include a preventative care course for New Americans and/or a coordinator assigned to preventative care efforts.

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  Circumcision for the Male Infant: Patient Education and Cultural Humility

  Grace E. Eisenbiegler

  Short-term Project

  Male circumcision is a religious and cultural decision that has become increasingly medicalized. Many families make decisions about circumcision based on culture and family without true informed consent. There is a need for unbiased information, prior to delivery, about circumcision, so that families may make an informed decision that is right for them. A one page document was created as an addition to the clinic's pregnancy guide with information on risks and benefits of circumcision, complications associated with the uncircumcised penis, cultural significance, and care of the uncircumcised penis.

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  Addressing Post –COVID-19 Pandemic Depression

  Aria Elahi

  Short-term Project

  This community project explores the impact of the COVID-19 pandemic on mental health, particularly focusing on depression, and introduces an intervention in the form of a pamphlet distributed at Newtown Primary Care. The pamphlet addresses individuals experiencing worsened depression due to the pandemic, regardless of COVID-19 infection status, and includes the PHQ-2 and PHQ-9 screening questionnaires for self-assessment. Insights from interviews with Newtown Primary Care were instrumental in designing the pamphlet.

  Results reveal that the pandemic has substantially affected patients' mental health, increasing the need for resources. Patients diagnosed with pre-existing depression experienced worsening symptoms due increased stressors due to the pandemic compounded by current socioeconomic and health problems.

  The pamphlet advises patients to take PHQ-2 and PHQ-9 tests and share results during primary care visits for further discussion. It offers mental health resources such as hotlines, including the Substance Abuse and Mental Health Services Administration National Hotline and National Suicide Prevention Hotline. Notably, the pamphlet highlights Nuvance Health's COVID Recovery Program for lingering post-COVID symptoms that impact mental health.

  Ultimately, the pamphlet seeks to bridge gaps in mental health support, encourage and empower patients to seek help, and raise awareness about available resources with the aim of improving mental health outcomes.

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  Home Exercise for Patients With Limited Access and Resources

  Justin L. Esteban

  Short-term Project

  Patients with limited resources and who are socioeconomically disadvantaged, don’t have the time or resources available to partake/pursue exercise. Having a home workout program may prove to be beneficial to patients who don't have access to a gym, equipment, or are otherwise constrained by time.

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  Mapping Pediatric Vaccination Schedule

  Mialovena C. Exume

  Short-term Project

  Taking care of a child can be daunting and parents/guardians/families often report not being sure of what vaccinations their child might need and when. This project aims to provide a map of the pediatric vaccination schedule from birth to 18 months. This project also provides a booklet to help families track vaccination in the hopes of increasing vaccination adherence and providing education on routine recommended childhood vaccines.

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  Referred by your PCP

  Lud H. Eyasu

  Short-term Project

  A complication of a small or new primary care office is difficulty in providing additional support for patients outside of the office visit. Some referral center do not assist patients referrals for mental health providers and services. This project set out to create a list of in-network psychiatrists that can be distributed to patients at a New Canaan, CT primary care office to facilitate these patients' quest to find a mental health provider.

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  Colorectal Cancer Screening Options

  Juwairiyyah Fatima

  Short-term Project

  Colorectal cancer is a leading cause of mortality in the United States. The USPTF recommends screening starting at age 45. Many options exist for colorectal cancer screening. This project explores the use of a handout explaining the various screening tests available to patients as a means of improving screening rate in one primary care clinic population.

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  Barriers to Implementation of Point-Of-Care Ultrasound in Primary Care: Interval Change

  Joel Feier

  Short-term Project
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  Supporting Caregivers of Patient with Dementia

  John E. Fernan

  Short-term Project

  Being a caregiver for an adult with dementia can be a demanding job. In 2021, an estimated 11 million family members provided 16 billion hours worth of care to people with Alzheimer’s and other dementia. Beyond the financial burden, the strain of caregiving also increases risk for emotional stress and can take a toll on physical and mental health. The goal of this project was to help reduce caregiver stress by increasing awareness of support resources. A template in the EMR was created to compile a list of these resources along with general caregiving tips. This template was made available to family medicine providers to share with patients who care for someone with dementia.