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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Implementing an Intimate Partner Violence Screening at a Connecticut Family Medicine Practice

Nikkole Turgeon
Short-term Project
Intimate partner violence (IPV) is a significant public health problem throughout the United States. The aim of this project was to implement a validated IPV screening form into the work flow of the Newtown Primary Care office and increase awareness about IPV throughout the office. The Hits, Insults, Threatens, Screams (HITS) screening form was implemented and resources from local domestic violence agencies were obtained for the office. A system was set up for patients who screen positive to be referred to the in-house therapist and to local domestic violence agencies. Future steps could include further training and education for the office.
Resources for staying active during the COVID-19 pandemic

Peter K. Twining
Short-term Project
During the COVID-19 pandemic, many patients find it difficult to stay active. Staying active when gyms are closed and school sports are cancelled can make staying active especially difficult. The purpose of this project was to compile a list of resources for patients to use to stay active and healthy at home during the pandemic.
Improving Primary Care Access for the Housing Insecure in Washington County

Kristina J. Valentine
Short-term Project
For this project I went to two local hotels in Washington Co that were providing shelter for people experiencing homelessness during the COVID-19 pandemic. I would survey them on their barriers to primary care and tried to connect them to local providers. I then tracked how many individuals were able to have an appointment with a provider.
Walk and Talk

Carly H. Watson
Short-term Project
Implementing outdoor walks into the daily routine of residents at long-term care facilities.
Community Health Interventions to Reduce the Burden of Radon-Related Lung Cancer

Benjamin Weaver
Short-term Project
Exposure to radon is the second leading cause of lung cancer in the United States. One in seven homes in Vermont has elevated levels of radon, but most patients are unaware of radon as a risk factor for lung cancer or that radon testing and mitigation services are available to them. To promote increased testing and mitigation of radon we screened patients presenting to a Family Medicine practice in Vermont about whether they had had these services done in their home. We also developed a patient education resource for providers to give to patients who had more questions about radon exposure, how to get it tested, and what can be done to reduce the radon levels within their homes.
Medication-Assisted Withdrawal and Alcohol Use Disorder Treatment in the Ambulatory Setting

Jacob Okie Weiss, Javad Mashkuri MD, and Marissa Patrick APRN
Short-term Project
Alcohol use disorder (AUD) represents a significant burden of disease in central Vermont, but receives little attention and resources compared to other drivers of morbidity and mortality. As part of a community health improvement project, primary care providers in central Vermont were surveyed regarding current practices and perceived barriers related to the effective treatment of AUD. 69% of respondents reported treating alcohol withdrawal syndrome (AWS) and 83% reported treating AUD. Respondents indicated concern about the safety and efficacy of the medications they currently prescribe and expressed interest in learning about other evidence-based treatments for AWS and AUD. The most frequently cited barriers to the treatment of AUD were lack of time and resources for adequate follow-up; patient’s unwillingness to decrease use; and provider lack of knowledge and comfort in treating AWS and AUD. The authors make several recommendations to improve care for patients struggling with AUD, including incorporating peer recovery coaches into primary care settings; providing CME opportunities for clinician training in evidence-based treatments for AWS and AUD; and implementing a decision-making protocol to determine the appropriate setting for patients experiencing AWS.
Educating Patients on the COVID-19 Vaccination

Jenna Wells and Sara Brennan
Short-term Project
Patients are frequently coming into clinics with misinformation and frequently asked questions regarding the COVID-19 vaccine. The goal of this project was to address these frequently asked questions by educating patients and sparking conversation regarding the vaccine when patients came to their clinic appoints. This was accomplished via a handout that was given to patients on arrival.
COVID-19 Vaccine Information and Patient Opinions

Faith E. Wilson, Zeynep Tek, and Claudia Russell
Short-term Project
As the COVID-19 vaccine becomes available in Vermont, many patients have questions about the safety and efficacy, who it will be available for, when they can expect to get the vaccine, if their doctor would recommend it for them. These important questions are taking valuable time during already short patient visits, and as information is constantly evolving it is difficult to give a concise answer to many questions. This project outlined the basics of the vaccine and answered many FAQs.
Health Care Delivery to the Homeless Population in the Greater Danbury Community: A Needs Assessment

Ariella Yazdani
Short-term Project
- The Greater Danbury Region has substantial health resources; two hospitals, community health centers and health clinics. Residents who lack health insurance struggle to access the full continuum of care, especially outpatient and preventative care. Although a vast majority of people in Danbury have health insurance, it is unclear if individuals living with homelessness are amongst this insured population and have equitable access to healthcare. Two transitional housing programs in Danbury were identified and interviewed directly. A qualitative assessment of healthcare delivery to members of these programs was then performed.
Streamlining Teledermatology in Primary Care

Hakeem Yousef
Short-term Project
The use of telemedicine as a tool to aid in seeing patients has increased dramatically since the onset of the COVID-19 Pandemic. Skin problems are one of the many medical issues seen via telemedicine, and many patients and providers may find some difficulty maneuvering through this new age of technology
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.
OneCare Vermont ACO Quality Metric Evaluation

Alexander Braun
Short-term Project
This project explores OneCare Vermont ACO quality metrics and how they can be used to improve patient care and reimbursement in a Vermont family medicine practice. Perspectives of physicians within the practice and others familiar with OneCare Vermont operations are shared. Several metrics were identified as areas for improvement within the practice by comparing ACO metrics with patient data.