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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Determination of Return to Play in Infectious Mononucleosis

Tessa R. Barclay
Short-term Project
Splenic rupture is a rare, but potentially life-threatening, complication of infectious mononucleosis. Splenic rupture is generally uncommon four weeks after infection onset, however given the long incubation period and prodromal symptomatology characteristic of infectious mono, it can be difficult to determine an individual patient's risk in the clinical setting. Additionally, diagnostic labs have high false negative rates in the first 1-2 weeks of infection. To help alleviate diagnostic uncertainty and protect patients against outcomes such a splenic rupture, an evaluation and consolidation of the available literature yielded a simplified schematic of advisable activity levels for each stage of infection.
Healthcare Workers Understanding of Food Insecurity in Hinesburg VT

Nate Benner
Short-term Project
Food insecurity is a worldwide public health issue, and is even pervasive among relatively affluent communities in the United States. This project evaluated healthcare workers comfort in the topics of epidemiology and locally available resources with respect to food insecurity before and after an informational presentation. Results showed overall improvement in comfort on these topics following the presentation. Future research should be aimed at understanding if this changes referral rates.
Naloxone Administration: An Educational Video

Jennifer Boccia
Short-term Project
Identification of the need for client education on the use of naloxone opioid reversal kits.
Educating High School Students on the Negative Health Effects of Vaping

Nicholas Bompastore
Short-term Project
E-cigarettes surpassed conventional cigarettes in 2014 to become the most commonly used tobacco product among youth. Vaping exposes users to multiple toxins that have been shown to cause asthma and other lung diseases, heart disease, neurologic problems, and cancer. The goal of this project was to provide educators at Londonderry and Bishop Guertin High School, and physicians at Primary Care of Hudson, with evidence based information on the harmful effects vaping has on adolescents. The information was given in the form of a pamphlet that was designed to appeal to teens and written at a level they would understand.
List of Local Resources for Substance Abuse Disorders in Burlington, VT

Gesca Borchardt
Short-term Project
List of local resources in Burlington, VT for the treatment of substance abuse disorders. The list was modified into a smartphrase and added to Epic. The providers of South Burlington Family Practice were given access to this smartphrase.
Needs Assessment: Complementary Medicine (CM) Services

Zara S. Bowden
Short-term Project
In 2012, 33.2% of U.S. adults used complementary health approaches, spending over $30 billion. Despite this substantial investment and a growing body of research supporting the use of these approaches, access to them is still limited in the Primary Care setting. While Central Maine Medical Center’s Family Medicine Residency (CMMC FMR) has historically acknowledged the importance of an holistic approach to care, many of the complementary health approaches previously offered are no longer available. To determine specific, patient-identified needs regarding these approaches, a Needs Assessment was performed by surveying established patients presenting for appointments at CMMC FMR. The data collected through this assessment was used to underscore priority needs and to propose action plan items for future incorporation of complementary health approaches into CMMC FMR’s practice.
Prostate Cancer Screening Guidelines: Providing Patient Education

Michael Burton
Short-term Project
The United States Preventative Services Task Force (USPSTF) is planning to update their prostate cancer PSA screening guidelines to a category C from category D grade. This could potentially lead to confusion among both providers and patients as they have become accustomed to the previous guidelines and there has always been much discussion among providers about whether to offer the test. This project seeks to provide information to patients about the upcoming change so that they are more informed and able to better participate in discussion with their doctor about the pros and cons of PSA testing.
Improving Sleep: Promoting Sleep Hygiene Techniques

Katherine Clifford
Short-term Project
About one third of adults in the U.S. get insufficient sleep, defined as less than 7 hours of sleep per 24 hour period, with similar statistics in Chittenden County, Vermont. Poor sleep/insomnia is a common complaint of patients visiting their primary care providers, and has many important consequences for physical and mental health. While sedative hypnotic medications and over the counter sleep aids are commonly used, they have many important side effects. Cognitive behavioral therapy for insomnia (CBT-I), which includes sleep hygiene techniques, is recommended as an effective, first line nonpharmacologic intervention for chronic insomnia. This project sought to create an educational patient handout to promote sleep hygiene techniques, a behavioral intervention aimed to improve sleep in the patient population at Hinesburg, VT.
Smoking Prevention Program for Adolescents: A Hands-on Approach

Sean Closs
Short-term Project
This project is an initial pilot idea for hands-on experiences to reinforce smoking prevention in adolescents. The proposed idea is to have students specifically those identified 'at-risk', being given opportunities to interact with pathology specimens on-site at the hospital, introduce spirometry, and real-world panel discussions. The resources of the hospital provide a unique opportunity for promotion of this public health goal.
Management of Mental Health Illness: an Actionable Non-Pharmacologic Approach

Cody J. Couperus
Short-term Project
Mental health illness is a pervasive and incurs tremendous cost onto society. Patients benefit from a multi factorial approach to treatment including non-pharmacological methods. This project includes development of a handout utilizing compiled resources and motivational interviewing to facilitate patient use of these interventions.
A healthcare provider perspective in overcoming the psychological and emotional barriers of advance care planning: The need to normalize the conversation

Karamatullah Danyal
Short-term Project
Barriers to advance care planning in the patient population were explored. The need to normalize the conversation was identified. A more attention grabbing pamphlet was designed.
The Association of Hormonal Contraception with Depression

Pamela Derickson
Short-term Project
Hormonal contraceptives are widely used by women during their reproductive years. Currently, over 100 million women worldwide use the pill, and 82% of sexually active women in the USA will use oral contraceptive pills at some time during their reproductive years (Carrol, 2017). Oral contraceptive use, especially among adolescents, is associated with subsequent use of antidepressants and a first diagnosis of depression, suggesting depression may be a potential adverse effect of hormonal contraceptive use (Skovlund, 2016). This project focused on educating health care providers at the Community Health Center of Burlington, VT (CHCB) about the association of depression and oral contraceptives. The data was presented to physicians, nurse practitioners, physicians assistants, and pharmacists at CHCB, and subsequent providers were interviewed for more specific reactions to the data.
Providing a Health and Wellness Resource Guide to Senior Patients in Western Connecticut

Pooja T. Desai
Short-term Project
Senior patients (>60 years) have a higher prevalence of chronic diseases, physical disabilities, mental illnesses, and other co-morbidities, when compared with younger patient populations. In the Primary Care setting, prevention and control of health problems of elderly patients necessitates a multifaceted approach incorporating active collaboration of health, social welfare, rural and urban development, and legal sectors. Through research and community outreach, I found that identifying available senior resources was an important need in the Western Connecticut community. My interviews and research guided the creation of an informational handout on the available resources for senior patients. Resources incorporate many aspects of health, including fitness and wellness, housing, socialization and recreation, medical needs, medical equipment and technology, support groups, and transportation. This handout was given to all patients ages 60 and older.
Caregiver Stress And Resources for Support

Alex DiSciullo
Short-term Project
Caregiver stress is a major problem which can increase morbidity and mortality rates. Caregiver stress is often overlooked and underadvertised. Making individuals aware of resources that can help them provide care can mitigate their stress and improve quality of life for themselves and their loved one.
Ambulance response times in a rural VT town: Is there a role for FEMA’s “Ready” training in Hinesburg, VT?

Kyna Silvana Donohue
Short-term Project
The purpose of this project was to examine the ambulance response times in a rural town in Vermont. The goal was to determine if there is a role for FEMA's "Until Help Arrives" campaign to increase bystander ability to provide immediate and life-saving medical care.
Adult Oral Health Access and Advocacy

James Duguay
Short-term Project
Many adults lack adequate preventative oral healthcare due to multiple factors. Oral health is important due to its effects on systemic health as well as for quality of life issues.
A Patient Centered Intervention to Promote Primary Care Based Screening for Diabetic Retinopathy

William B. Earle
Short-term Project
Diabetic Retinopathy is the leading cause of blindness in patient's age 25-74 in the world. Onset of disease is insidious and early intervention is the only way to reduce morbidity. On average only 60% of diabetic's get an annual eye exam, but in the Western Connecticut Health Network (WCHN) that number is closer to 32%. This project sought to educate and encourage patients to take advantage of a new tele-medicine, primary care based diabetic retinopathy screening program starting at Brookfield Family Medicine (part of the WCHN).
A Patient's Guide to Smart Research

Zachary Winston Ehret
Short-term Project
Patients may not know where to look when researching a health issue. This may lead them to resources that are not supported by research and may become an issue for their own health. Some websites may be filled with medical jargon, which can potentially exacerbate anxiety about a particular condition or cause concern for unrelated health issues. A handout compiling a list of resources would be helpful to providers and beneficial to patients.
Routine Immunizations in Chester, VT

Wyll T. Everett
Short-term Project
Alcohol Support Groups: Alternative to the AA Model

Tim Fields
Short-term Project
Alcohol abuse accounts for 88,000 deaths and $249 billion annually in the United States. At this point there is not a great evidence based model for the best form of group support. While AA and the twelve step model is the most frequently used group format, it has many limitation especially in small Vermont towns. This proposes an alternative model designed to work well in smaller communities.
Shingles & Pneumococcal Vaccines: Recommendations for Older Adults

Benjamin Flinn
Short-term Project
As the immune system tends to weaken over time, patients aged 50+ begin having increased risk for certain potentially preventable diseases, especially shingles and pneumonia. Although there are vaccinations to protect against these diseases, there are many significant barriers preventing patients from receiving the vaccines that they need, including potentially confusing guidelines, concerns over risks, and recent changes to vaccine recommendations. This project aims to produce a clear and concise educational brochure to help overcome some of these barriers, and to drive patient-provider conversation about their vaccine recommendations.
A Physician's Guide to Motivational Interviewing

Anthony J. Gallegos
Short-term Project
Recommending lifestyle changes to patients is a crucial part of a primary care physician's role. Guiding patients to make behavioral change is a challenge physicians must face on a daily basis, and based on current literature, it can be delivered more effectively in the form of motivational interviewing as opposed to traditional advice-giving. This project aims to provide physician's with a quick reference guide to Motivational Interviewing to display at their desk, as well as a template to be filled out with the patient detailing their plans for change. Together, these tools can improve the delivery of advice, and strengthen physician-patient relationships to more effectively achieve long-term health goals that require a behavioral change from the patient.
PSA Screening in Lewiston Maine

Francis G. Gause IV
Short-term Project
PSA Screening Patient Information for 2017 guidelines
Improving Access to Mental Health Care for Trauma Patients

Kassandra Gibbs
Short-term Project
It can be difficult to locate a mental health provider in Vermont. Consequently, many individuals with mental illnesses look to their primary care physicians to fill this gap. This project highlights difficulties faced by patients with PTSD and complex PTSD in Chittenden and Addison counties in finding a therapist or psychiatrist. A resource handout was created with instructions on how to find a therapist in VT and a list of practitioners in Addison and Chittenden counties who specialize in trauma. In addition, a patient information sheet that answers some questions about PTSD and complex PTSD and also provides a list of mindfulness exercises that can be used by patients while they are waiting to find a mental health practitioner.
Incorporating Naloxone Education Into Routine Primary Care

Eli Goldberg
Short-term Project
Opioid overdoses are a growing public health concern in Vermont and nationwide. Naloxone can save the life of someone who overdoses, if those around them know how to use it. This project investigates the feasibility of offering naloxone education as an element of routine primary care encounters with patients who do not use opioids themselves.