Family Medicine Clerkship Student Projects

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  Motivation for MAT

  Jacob Bernknopf

  Short-term Project

  The goal of this project was to discover a commonality in why patients begin the MAT program. This will hopefully make it easier for future providers to help future patients articulate why they need to make the change in their life. This can be especially beneficial in patients dealing with concurrent stimulant or alcohol use.

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  The Preventative Health Care Shortage: A Look at the VT and CT Community Perspectives and Medical Student Interest

  Brittany Botticelli, Jenna Elkhoury, and Michael L. Lawler

  Short-term Project

  With the permission of Kenneth Palanza et al, we adapted and modified a previously generated survey that allowed us to better understand the motivations and barriers of medical students to enter primary care. The survey was dispersed to all medical students at LCOM as well as third and fourth year medical students at Ross University and American University of the Caribbean (AUC). We analyzed preliminary data from 100 respondents.

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  Helping People Overcome Barriers to Exercise Through In-Office PT Exercise Evaluation Referrals

  Matthew Charles Hill Brandt

  Short-term Project

  Utilization of a poster in a primary care exam room advertising Physical Therapy Exercise Evaluations in an effort to help patients overcome barriers to exercising. The goal of the project is to capture people in the contemplative/preparatory stage of behavior change and help them reach the action and maintenance phases to improve health.

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  PSA Screening - Patient Decision Aid

  Michael Brown

  Short-term Project

  PSA screening decision aid

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  Non-medical Cannabis Use Screening and Advising

  William Dean Brown

  Short-term Project
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  The State of Sleep: What Keeps Vermont Up at Night?

  Magalie Carey

  Short-term Project
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  Examining Provider Burden from the 21st Century Cures Act

  Jordan Carver

  Short-term Project

  The 21st Century Cures Act enacted new protocols in Spring 2021 requiring all patient notes and reports to be made available electronically as soon as they are finalized. In order to study the initial impact of this change on physician burden, a survey was sent out to Burlington, VT providers to assess impacts to their workflow.

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  Family Medicine Community Project

  Daniel Castro

  Short-term Project

  The goal of this project is to improve diet and nutrition literacy in the community. Though Vermont ranks low in the US in terms of obesity, it is still estimated the 60% of Vermonters are either overweight or obese. This represents an area of need in terms of improving diet and nutrition education to combat obesity, the health issues it produces, and the subsequent strain on the medical system

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  Assessment and Awareness of Mental Health Conditions among Refugees in Vermont

  Sandi Caus

  Short-term Project

  Refugees experience profound hardship in their home-country, displaced country and throughout the period of re-settlement. Experiences like direct or indirect exposure to traumatic events, torture, sexual abuse and stigmatized refugee identity post-resttlement are major risk factors for the development of mental health coniditions inlcuding PTSD, depression and psychosis. Despite major risk factors for the development of mental health conditions, culturally-specific mental health stigma persists as a major barrier to addressing mental health among refugees. This project emphasizes techniques and self-education that can be utilized to improve mentah health screening and identification among refugee patients in Vermont.

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  Preventive Healthcare Education in Primary Care

  Anna B. Chamby

  Short-term Project

  Primary and secondary prevention are vitally important mainstays of primary care. Every well visit at Newtown Primary Care involved some discussion of preventive health screening and services and relied on patient recall or EHR document search for last screening/intervention dates. We aimed to find ways to make use of wait times for in-office visits that could also potentially improve efficiency during patient encounters and help educate patients about preventive health measures.

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  Lifestyle Changes in Covid-19 Pandemic and Impact on Modifiable Stroke Risk Factors

  Kelly J. Chan

  Short-term Project

  Stroke is one of the leading causes of mortality and disability in the USA. Underlying conditions such as hypertension, diabetes and cardiovascular disease predispose an individual to increased risk of stroke. In addition, the Covid-19 pandemic presents many challenges to these patients in terms of active health management and maintenance. A screening tool was developed to assess patient patterns of lifestyle behavioral changes measured by modifiable risk factors for stroke (medical condition management, diet, exercise, and smoking habits).

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  First Contact: Headache Management in Primary Care

  Sydney Chatfield

  Short-term Project

  Primary headaches are one of the most common and debilitating disorders experienced worldwide. Many people are unaware of the everyday triggers and continue to take over the counter medication with little to no relief. Primary care providers are often the first or only people patients will address the issue with, but are faced with time constraints and lack of resources. I created an educational pamphlet on common triggers and solutions for patients to begin to think about root causes of their headaches and implement lifestyle changes.

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  Improving Access to Meditation and Mindfulness for the Management of Anxiety, Stress, and other Chronic Diseases

  Alex Cohen and Jesse Naumann

  Short-term Project

  Chronic diseases can have an enormous burden on not only an individual’s quality of life, but their economic output as well. The challenge is that many patients with a chronic disease are not fully treated despite many different medications and doctor’s appointments. Mindfulness is an extremely beneficial tool that can be used as an adjunctive treatment for different chronic health diseases including anxiety, depression, insomnia, chronic pain, and many others. An enormous barrier is that many patients are unsure about what mindfulness truly is, and where one can go about accessing mindfulness resources. Our goal was to create a quick and easy smart phrase that providers can add to any after-visit summary that provides basic information about mindfulness, different resources to access free mindfulness meditations, and our own unique 8 minute mindfulness meditation for patients to try free of charge.

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  Primary Cardiovascular Disease Prevention

  Kaileen Cruden

  Short-term Project

  Cardiovascular Disease is the leading cause of death in the United States, causing about 1 in 4 deaths. Cardiac rehabilitation is often only suggested to patients AFTER a hospitalization for serious heart conditions such as heart attack or heart failure. Data demonstrates the decrease of a secondary cardiac event for individuals who were enrolled in cardiac rehab as well as an improvement in cardiac risk factors including: decrease in lipid levels and insulin resistance with increased smoking cessation and exercise tolerance. Levels of depression and anxiety also improved in this population. This leads us to ask: How can we take what has been proven to improve heart health and prevent secondary cardiac events to prevent primary cardiac events?

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  It's a Walk in the Park: The health benefits of exercising in nature and a beginner's guide to hiking in Connecticut

  Elena Dansky

  Short-term Project
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  Walking Towards a Healthier Future: A Pocket Guide to Walking Routes in Colchester and the Health Benefits of Walking

  Kevin DiBona

  Short-term Project

  The obesity epidemic is a complex problem necessitating a multifaceted long-term response. While there is no single solution to this decade-evolving issue, exercise remains one of the most important health interventions available. This project aims to serve as a resource for patients seeking to lose weight; outlining some of the walking routes local to Colchester Vermont, as well as the health benefits of a sustained exercise plan.

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  Emergency Medicine Super Utilizers and the Role of Targeted Community Paramedicine

  Nathan E. Dow

  Short-term Project

  Frequent emergency department (ED) users, colloquially known as “frequent fliers,” are a small population that account for a disproportionately large number of ED visits. Depending on the criteria used, ED super users may constitute as little as 1% of the individuals seen through the department, while accounting for up to 60% of the visit volume. There is an associated stress on the 911 system and a public health concern with burdening of already busy emergency departments. Unsurprisingly, ED super users have an associated financial cost. A 2015 Milwaukee area pilot program provided community outreach to only 39 of their well-known ED utilizers and still managed to return just over one million dollars in cost savings to the healthcare system. This patient population is frequently characterized by chronic illness including cancer, mental health disorders, substance use disorders, chronic kidney disease and chronic obstructive pulmonary disease (COPD).

  At the University of Vermont Medical Center (UVMMC), a community outreach program is being assembled. Using both grant and internal funding, HealthNet paramedics and ED nurses will provide community-based care to the top 100 utilizers of the UVMMC Emergency Department. Methods include outreach to patients missing primary and subspecialty appointments, tracking pill counts, monitoring prescription refills, assessing medication adherence at home visits and assessing and addressing social determinants of health including housing and food stability. The program aims to decrease ED and EMS utilization, reduce health system costs and ultimately, improve patient outcomes. A similar program might be considered at CVPH, potentially utilizing CVPH Family Medicine staff for community outreach, as well as the clinic itself as a primary care alternative to frequent ED evaluation for chronic medical conditions.

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  Kangaroo Care in the Community: Creating antenatal informational resources for providers and expectant parents

  Emma Dunne

  Short-term Project

  Obstetric care providers at the Community Health Centers of Burlington create, implement, and coordinate resources to help support parents through pregnancy, delivery, and child rearing. The COVID-19 pandemic has altered the accessibility of existing resources, exacerbating the need for creative support of prenatal learning, breastfeeding, and postpartum socialization. Regular skin-to-skin contact between newborn infants and their parents is a low-cost, low-risk intervention with demonstrated benefits to breastfeeding, infant and parent physiology, emotional health, and bonding. This project aimed to establish antenatal informational resources for providers and expectant parents about the potential benefits of skin-to-skin care in the community setting.

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  Addressing Rational Barriers to Lifestyle and Behavioral Modification

  Ahmed Eldakroury

  Short-term Project

  Rational barriers contribute to resistance towards initiating, restarting or maintaining lifestyle/behavioral modification. Such barriers include lack of confidence in the proposed intervention(s), exaggerated perspectives, unsubstantiated beliefs and feelings of futility/hopelessness in the setting of past failures or relapse. Lifestyle and behavioral modification are core elements of preventative health and mental health—identifying and addressing erroneous thought processes, perspectives or beliefs that contribute to hesitancy may empower patients to trust the process and put an honest effort towards making those changes. Thus, a motivational pamphlet was created for patients with the goal of addressing hesitancy/resistance towards initiating or maintaining lifestyle/behavioral modification. The pamphlet attempts a different approach to motivational priming using mechanisms such as (1) informing and emphasizing the tangible changes in brain architecture that result from continued effortful thinking and reorientation, (2) surveying different demotivating thoughts while providing examples of cognitive techniques to reorient dissonant thought processes towards more rational and evidence based analyses. Additionally, the pamphlet attempts a discussion on relapse with the goal of restructuring the thoughts of defeat and hopelessness that impede progress and prevent effortful persistence. Future work should be targeted at evaluating the efficacy of this approach and fine tuning elements in the clinical motivational process.

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  Preventative Health Care Shortage

  Jenna A. Elkhoury

  Short-term Project

  The primary care shortage is major problem that impacts people in rural and often low income communities. Our project seeks to address the primary care workforce shortage affecting the Vermont and Connecticut communities by better understanding current medical school student perspectives on primary care as a career of interest. Attractors and deterrents of primary care were highlighted through a survey distributed to all medical students at the Larner College of Medicine at the University of Vermont.

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  Nutritional Habits: Encouraging Simplicity and Consistency

  Alim Esemenli

  Short-term Project

  Nutrition plays a crucial role in development of diseases that are the leading causes of morbidity and mortality in the Unites States. However, due to reasons such as time limitations, lack of clear guidelines, and what seems like a sense of hopelessness felt by providers and patients alike upon lack of results, discussions around nutrition may lack in frequency, consistency, and/or adequacy of duration, Research shows that flexibility of mindset, as well as achievability and sustainability of nutritional goals, play a key role in achieving success in weight This project proposes a three-page document that can potentially help primary care providers support and monitor nutritional behavioral changes determined by their patients.

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  Skin Cancer, Skin Biopsies and Mohs Surgery: Patient Education

  Negar Esfandiari

  Short-term Project

  Skin cancer is the most common cancer in the United States. There are three main types of skin cancer: Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma. While Melanoma is less common than Basal Cell and Squamous Cell Carcinoma, it has a higher mortality rate. If diagnosed in earlier stages, Melanoma has a significantly better prognosis and lower patient costs. Most skin cancers are diagnosed through skin biopsies. Vermont has one of the highest rates of skin cancer. The goal of this project was to develop a patient handout to bring patient awareness to skin cancer and describe the different types of skin biopsies (shave, punch and excisional), as well as Mohs surgery.

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  DASHing into a Healthier Life

  Megan N. Eubank

  Short-term Project

  Almost half of all US adults have hypertension (high blood pressure), which is a major risk factor for heart disease and stroke. Hypertension can be controlled through a combination of diet, exercise, and medications. The DASH diet has been proven to lower blood pressure in as little as two weeks. I created a brochure and Epic SmartPhrase that explains and simplifies the DASH diet for patients.

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  Frequently asked questions by patients about exercise

  Julie Evans

  Short-term Project

  A significant portion of patient visits at Milton Family Practice are related to one or multiple aspects of metabolic syndrome. Exercise is a common topic during these visits either brought up by patients or providers. This project focused on creating a handout for patient education with answers to commonly asked questions pertaining to exercise and resources in the community.

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  The Use of Technology for Mental Wellbeing in the Era of COVID-19

  Adam Fakhri

  Short-term Project

  Prevalence of mental health issues has increased during the time of COVID-19. There are many contributing factors to consider, the main one reported has been social isolation due to quarantine precautions. Members of the community have spent extended periods of time at home and away from their loved ones during this pandemic. Many patients have reported many life events occurring including deaths in the family without the ability to even mourn with their family members. This has taken a toll on the community, especially in Vergennes where this small tight knit community that has relied on its tight social bonds for wellness. There has been a trend of depressive symptoms rising in the community as well as an increase in reported anxiety. There is a shortage of mental health services through therapists and psychiatrists during this time, and a possible solution is the use of technology, specifically phone apps to aid with mental health concerns for members of the community who are unable to meet with a specialist. This project consists of a handout containing 7 apps for mental wellbeing reviewed by the Anxiety and Depression Association of America (ADAA).