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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Patient Education: OTC Medications for Upper Respiratory Infection

Lauren A. Okamoto
Short-term Project
Upper respiratory infection (URI) is among the top three diagnoses in the outpatient setting. Symptomatic relief is the reason for the most visits related to this diagnosis in the first couple of weeks after the onset of illness. Patient education on OTC medications for this use is often a component of these visits. The goal of this project is to create a standardized tool for patient education and reference to improve efficiency of education as well as patient understanding and future use of resources.
Tracking Home Blood Glucose through MyChart

Zachary T. Osborn
Short-term Project
Self-monitoring of blood glucose (SMBG) is a crucial tool in the management of Type 1 and Type 2 diabetics on insulin, and for Type 2 Diabetics who are titrating medications and/or undergoing lifestyle changes. Patients often fail to bring in their SMBG readings (or monitor at all) for a variety of reasons, hindering efforts to adjust their therapy. This project sought to address this gap through educating patients and providers about the EPICs ability to track SMBG readings submitted through MyChart.
Tracking Home Blood Glucose through MyChart

Zachary T. Osborn
Short-term Project
Self-monitoring of blood glucose (SMBG) is a crucial tool in the management of Type 1 and Type 2 diabetics on insulin, and for Type 2 Diabetics who are titrating medications and/or undergoing lifestyle changes. Patients often fail to bring in their SMBG readings (or monitor at all) for a variety of reasons, hindering efforts to adjust their therapy. This project sought to address this gap through educating patients and providers about the EPICs ability to track SMBG readings submitted through MyChart.
Tracking Home Blood Glucose through MyChart

Zachary T. Osborn
Short-term Project
Self-monitoring of blood glucose (SMBG) is a crucial tool in the management of Type 1 and Type 2 diabetics on insulin, and for Type 2 Diabetics who are titrating medications and/or undergoing lifestyle changes. Patients often fail to bring in their SMBG readings (or monitor at all) for a variety of reasons, hindering efforts to adjust their therapy. This project aimed to address this issue by educating patients and attendings about EPIC's ability to log blood glucose measurements through MyChart.
Approach to Providing Culturally Sensitive Gynecologic and Obstetric Care for Somali Women

Izabella Ostrowski
Short-term Project
Many refugees have fled Somalia over the past 30 years due to political instability and civil war. Since 1980, over 8,000 refugees have settled in Vermont, with about 9% of refugees being from Somalia. Community Health Centers of Burlington (CHCB) provides prenatal and primary care to many Somali women in the community. There are known gynecologic and obstetric health disparities for Somali women, such as significantly lower completion rates of mammography and pap smears than non-Somali patients. Research has shown that an understanding of cultural health beliefs and values are crucial for creating tailored prevention programs for refugee women. This project aims to outline several examples of beliefs, values and traditions of Somali women that are important for students and providers to know in order to provide the most culturally sensitive care.
Accessibility and Normalization of wearable pronoun identification in healthcare professionals

Dinukie-Chantal Perera
Short-term Project
Healthcare can be an incredibly intimidating machine to all demographics of patients. One uniquely challenged group are patients who are gender diverse, trans, and/or gender nonconforming. This group of patients experiences systemic discrimination through institutional practices embedded in healthcare.

Gender affirming care can be improved on many levels, but one straightforward and actionable way to support gender diversity and demonstrate enthusiasm and awareness for the community is to encourage the use of pronoun pins/ labels in individuals willing to use them.
Patient Education: Sexual Violence, Intimate Partner Violence, and Healthy Relationships

Elise A. Prehoda
Short-term Project
Sexual and Intimate Partner Violence are a public health crisis across the United States. In Vermont alone, nearly 7% of the population experiences sexual and/or domestic violence annually. Despite these numbers, less than 20% of those affected seek assistance. Increased access to education materials regarding these topics will serve to increase dialogue with at risk patients who might otherwise refrain from discussions on home or social environment. By increasing discourse and education, we hope to more frequently identify and assist patients who are experiencing violence in their relationships as well as prevent the formation of unhealthy relationships at the level of adolescence.
Differentiating Annual Wellness Visits and Health Maintenance Visits

Benjamin N. Price
Short-term Project
Due to recent changes in workflow at the office, many visits that should be Medicare Annual Wellness Visits are incorrectly scheduled as health maintenance visits (yearly physical). These mistakes are not always identified leading to confusion for both patients and providers and unnecessary bills for the patient
Cervical Cancer Screening in the LGBTQ+ Community: Dispelling Common Misconceptions and Improving Patient Comfort

Rebecca B. Rawlings
Short-term Project
LGBTQ+ patients are more likely to forgo cervical cancer screening due to common misconceptions/misguidance about who needs screening and increased likelihood to experience emotional and/or physical discomfort during screening visits. This project aims to educate LGBTQ+ patients about cervical cancer screening and provide them with tools to improve their experiences during screening visits.
Cervical Cancer Screening in the LGBTQ+ Community: Dispelling Common Misconceptions and Improving Patient Comfort

Rebecca B. Rawlings
Short-term Project
LGBTQ+ patients are more likely to forgo cervical cancer screening due to common misconceptions/misguidance about who needs screening and increased likelihood to experience emotional and/or physical discomfort during screening visits. This project aims to educate LGBTQ+ patients on cervical cancer screening recommendations and provide them with tools to improve their experiences during screening visits.
Lifestyle Modifications to Support Mental Health

Alexa W. Rosenthall
Short-term Project
Increasing healthcare delivery to the Abenaki people through health screenings

Warrick Sahene
Short-term Project
Utilizing health screenings can increase the number of Abenaki individuals identified with comorbidities related to diabetes and hypertension. Education and resources for health maintenance are also provided to this patient population through physician counseling.
Addressing Access and Installation of Appropriate Child Safety Seats within Fairfield County

Alexandra Sarkis
Short-term Project
Motor vehicle crashes account for a vast majority of all fatal injuries in children and adolescents. Child safety seats have been shown to reduce mortality from motor vehicle crashes greatly; however, several studies have demonstrated that as many as 9 out of 10 car seats are installed incorrectly. Given the evident reduction in mortality when using a child safety restraint appropriately, the goal of this project was to educate the community about proper car seat installation techniques and to provide additional resources for families interested in obtaining a car seat safety check within the county. An additional goal was to provide transparency and subsequently improve access to car seats for families who may not be able to obtain their own.
Nature Is The Best Medicine

Nathan Schweitzer
Short-term Project
This project examined the cost of mental health diagnosis on the health care system and how interactions with green space and nature increase mental health wellbeing. A Vermont state government program to increase access to state parks through primary care providers offices is highlighted. Interviews were conducted with a community psychologist discussing interaction with nature and its effects on mental health. The second interview was with a member of the volunteer board for the Governors council on fitness discussing the origins of the state park program.
Easy and accurate transition between common beta blockers: a QI project

Sam Short and Amalia Kane
Short-term Project
Hypertension is a common condition that often worsens with disease progression and/or age alone. The management of hypertension often requires multiple drug therapy. Beta blockers can be useful for this, and are often prescribed for other comorbid conditions such as angina or heart failure. Yet, not all beta blockers have the same effect on blood pressure and it can be advantageous to transition patients to non-selective agents such as carvedilol. However, dose conversions are not 1:1 and inappropriate transition can be dangerous. No readily accessible resources are available to aid the clinical management of this problem. This project aims to compare two common beta blockers to bridge this gap.
Increasing Screening for Barriers to Transportation at a Family Medicine Clinic in Rural Upstate NY

Noah Sorkow
Short-term Project
Inconsistent access to reliable transportation is a significant barrier to medical care in rural New York. Lack of transportation results in missed medical appointments, poor management of chronic conditions, and increased preventable emergency room visits. Increasing routine screening for this social determinant of health can reveal underlying barriers to care, promote referrals to case workers and increase resource allocation. This project sought to increase routine screening via the promotion of smart phrases to be included in routine wellness documentation in the EMR, in conjunction with a didactic session for current family medicine residents.
CBT in Primary Care

Brianna J. Spano
Short-term Project
This is a community improvement project designed to address the growing need for and shortage of mental health care in Vermont. The project focuses on creating a brief training tool and guide for primary care physicians to be able to incorporate cognitive behavioral therapy in their practice.
Bridging the Gap between Healthcare and Haircare

Devan Spence
Short-term Project
Patients are likely to see their barbers and beauticians more often than their primary care physicians, when applicable. This project is centered around empowering "paraprofessionals" such as hairdressers and barbers with knowledge to bridge the gap in identifying skin cancer early in its course. Hairdressers were interviewed at two separate locations, "The prestige" and "Dave's Barbershop." They were presented with questionnaires before and after attending 10-minute presentation on identifying various types of skin cancers and reviewing a brochure. Results indicated hairdressers felt more confident in identifying skin cancer post-presentation, on average scored themselves 4 points higher on a scale of 1-10 (with 10 representing feeling the most confident).
Barriers to Exercise: Fitness Made Simple

John A. Steinharter MS
Short-term Project
Lifestyle modification is a necessary component of managing chronic illnesses in order to obtain the best outcomes. Exercise has been shown to be efficacious at improving outcomes in a number of different clinical contexts. Patient adherence to exercise as a lifestyle modification is lower than desired due to multifactorial etiology including socioeconomic constraints, disability, chronic pain, and motivation. This project attempts to address all four with a site specific educational pamphlet.
Let's Talk Menopause: A Brochure Educating and Empowering Women in Menopause

Delaney Sztraicher
Short-term Project
More than 6 million women in the United States experience menopausal and postmenopausal symptoms annually. Although up to 80% of women experience vasomotor symptoms, there continues to be stigma surrounding conversations of menopause and its associated symptoms. Due to this pervasive taboo, women often dismiss or ignore their symptoms. This neglect leads to greater utilization of healthcare resources and increased productivity losses with an ultimate economic burden of more than $810 billion in the US. Studies have shown that when empowered with education women feel better prepared to manage their symptoms. This project aims to dismantle the stigma by providing women with resources and education regarding menopause to empower them to seek support and guidance as they progress into this next stage of their life.
Signs, Symptoms, and Clinical Approach to Monkeypox

Sean Wang
Short-term Project
Supporting Patient Education During Infant Formula Shortage: Washington County, VT

Rachel A. Wayne
Short-term Project
The infant formula shortage is a current national public health concern. Many guardians of formula-fed infants are struggling to find appropriate nutrition for their babies. Families of low socioeconomic status are being disproportionately affected because many of them rely on the Women, Infants, and Children program (WIC) to obtain formula, and their formula options through this program are limited. This project aims to provide Vermont families who have formula-fed infants with education and resources to navigate the formula shortage and keep their children healthy and fed.
Accessibility of Nutritious and Healthy Foods to Older Adults

Kristen Wright
Short-term Project
Food insecurity rates are high among older adults who have chronic conditions and/or are homebound. These patients have functional limitations, comorbidities limiting their mobility, and often are socially isolated or live alone, all of which impact their ability to access or make healthy meals. As food insecurity rises, so do the health care costs related to inaccessibility to healthy food, involving the increased risk or prevalence of chronic conditions like hypertension, diabetes, and cancer. This project aimed to understand the barriers older adults face in accessing and making healthy meals, and to educate health care providers and patients on recognizing food insecurity and utilizing resources to improve patient accessibility and availability to better nutrition and thus better health.
Promoting Community Health During the COVID-19 Pandemic

Erik J. Zhang
Short-term Project
The COVID-19 pandemic has affected aspects of health and community beyond the acute phase of COVID-19 infection, including chronic health conditions, mental health, substance use, food insecurity, access to healthcare, and housing insecurity. Further, existing disparities in these factors and other social determinants of health such as socioeconomic status, education, neighborhood, and physical environment have been exacerbated by the response to the COVID- 19 pandemic. Community members face negative health impacts as a result of the COVID-19 pandemic and response. They should be made aware of community resources for immediate and long-term solutions to the difficulties they experience.
Know Your Rights

Victor Abraham II
Short-term Project
In today's growing immigration crisis, patients and providers should be aware of their rights and how to protect their patient's confidentiality adequately. Decreased knowledge of patient rights and immigration status has reduced care quality. This project seeks to increase provider and patient knowledge on immigration and associated patient rights.