Family Medicine Clerkship Student Projects

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  Anxiety Screening in a Rural Primary Care Setting

  Erzsie Nagy

  Short-term Project

  Anxiety disorders are one of the most commonly occurring mental health condition. It is recommended to screen for anxiety in adults under the age of 65, but there is insufficient research to make this recommendation for older adults. Caledonia County in northeastern Vermont is a rural area with a large proportion of older adults, and this unique population could benefit from anxiety screening.

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  Management of Low Back Pain in the Outpatient Setting

  Casey Norton

  Short-term Project
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  Addressing Resource Gaps for Autistic Adolescents and Adults

  Christopher Pham

  Short-term Project

  Autistic patients of all ages often experience greater difficulty accessing healthcare and worse health outcomes compared to neurotypical peers. Additionally, patients who are older when they are diagnosed as autistic (e.g. later adolescence, adulthood) frequently report increased comorbid medical problems and problems with mental and emotional health. Healthcare providers often feel they have inadequate knowledge and skills to confidently treat autistic patients, and are also often unaware of what resources are available to support patients. This project describes efforts to better equip primary care providers in Hardwick, VT with resources to support autistic patients, and discusses anticipated outcomes of similar interventions.

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  GLP-1 Receptor Agonists & Dietary Recommendations...What We Know So Far

  Olivia Richardson

  Short-term Project

  GLP-1 receptor agonists have been increasingly prescribed to both diabetic patients as well as overweight/obese patients. However, there is ambiguity on dietary recommendations that should be made to these patients to avoid nutritional deficiencies/muscle wasting. This project includes a literature view on what current recommendations are for these patients.

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  Understanding Colposcopy: Cervical Cancer Education For Somali Women

  Jill C. Rogers

  Short-term Project

  Cervical cancer is highly preventable and treatable through HPV vaccination and screening tests like Pap smears and colposcopies, yet stark disparities in incidence and outcomes persist worldwide. Eastern Africa, including Somalia, has the highest cervical cancer burden globally; Somalia’s incidence and mortality are approximately fourfold and tenfold those of the United States, respectively. Chittenden County, Vermont, is home to over 600 Somali New Americans, a population shown in past studies to have significantly lower cervical cancer screening rates than non-Somali patients in the US. Numerous barriers contribute to these disparities, including language and literacy challenges, cultural and religious beliefs, stigma, distrust of interpreters and the healthcare system, and shame and fear regarding female circumcision. This project aims to bridge the gap in cervical cancer screening rates for Somali New Americans in Vermont. In partnership with the Vermont Language Justice Project, I developed translated audiovisual resources in both Somali and Maay Maay to explain what cervical cancer is, the importance of screening tests, and how and why a colposcopy is done. These accessible, culturally sensitive tools aim to improve patient comprehension, facilitate shared decision-making, and increase screening completion with the goal of reducing disparities in cervical cancer outcomes.

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  Lead Testing Patient Education to Improve Primary Prevention of Lead Poisoning

  Sung Bin Roh

  Short-term Project

  Lead poisoning is an expensive problem for the state of Vermont. Primary prevention of lead poisoning in Vermont could generate at least $40 million. Information about lead testing is inaccessible and the accuracy of lead tests are dependent on proper use and surface material. Because lead tests are designed to be highly sensitive, false positives can occur. Understanding which tests are accurate for different materials and what can interfere with tests can help prevent false positives. Creating and disseminating education materials about lead testing can aid primary prevention by identifying lead hazards.

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  Improving Obstructive Sleep Apnea Support in Rural Primary Care: Enhancing Patient Resources and Provider Tools

  John L. Rustad

  Short-term Project

  Obstructive sleep apnea (OSA) is a prevalent but underdiagnosed condition, particularly in rural populations with limited access to specialist care. This project aims to enhance OSA identification and management in a rural Vermont clinic by implementing an integrated patient education and screening initiative. Key interventions include a patient information pamphlet, a standardized screening tool, and a referral pathway to streamline diagnosis and treatment. Provider feedback highlighted the benefits of these resources in improving patient awareness, screening accuracy, and referral efficiency.

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  Gender Affirming Care within Primary Care in Northern New York

  Julie Scholes

  Short-term Project

  Gender affirming care is an integral part of healthcare, but is often difficult to identify or access. Primary care providers have the skillset to provide gender affirming care but identify education and resources as barriers to start prescribing gender affirming hormone therapy. This project aimed to assess existing access to gender affirming care and identify areas for improvement and support to enhance accessibility to care in northern New York

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  Day 1 of Type 2 Diabetes Mellitus: A Patient-Centered Educational Tool

  Isaac E. Sellinger

  Short-term Project

  Type 2 diabetes mellitus (T2DM) presents an overwhelming diagnosis for many patients, with a significant burden of education, lifestyle modification, and medical management required from day one. In Clinton County, NY, diabetes prevalence remains high, with disproportionately elevated rates of diabetes-related mortality and preventable hospitalizations compared to state averages. To address these gaps, a two-page, accessible, and actionable educational handout and accompanying clinical workflow tools for patients newly diagnosed with T2DM was developed. These materials were designed to integrate seamlessly with the existing after-visit summary (AVS) process at Champlain Valley Physicians Hospital Family Medicine Center. The project emphasizes small, achievable lifestyle changes, locally available resources, and goal-setting strategies to enhance patient engagement and build motivational inertia. Early implementation has shown that these tools are simple, well-received by providers, and practical for clinical integration. Future directions include assessment of long-term impact on patient outcomes, expanded patient feedback integration, and adaptation for use in other chronic disease management pathways.

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  New food for thought: Promoting updated concussion management guidelines

  Ian A. Strohbehn

  Short-term Project

  Many in the general public are only aware of outdated concussion management strategies which emphasize strict rest. These strategies may delay healing and increase incidence of post-concussion syndrome. Current guidelines recommend early return to light physical activity which can shorten time to recovery.

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  Supporting School Behavioral Health in the New Mainer Population

  Eunice Suberu

  Short-term Project

  This project addresses the growing youth mental health crisis in Lewiston-Auburn, Maine, with a focus on refugee and immigrant adolescents. The intervention involved creating a culturally informed emotional regulation guide for middle and high school students. The guide was shaped through conversations with healthcare providers, youth, and community organizations, and aims to equip students with practical strategies to manage emotions and seek support. This work highlights the importance of trauma-informed, culturally competent approaches to behavioral health in school and community settings.

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  Improving Access to Halal Groceries in the Norwalk Area: A Community-Based Nutrition Resource

  Zaymee Z. Syeda

  Short-term Project

  This project aims to increase awareness of culturally appropriate, affordable, and health-conscious grocery options for low-income and immigrant communities in Norwalk, Connecticut. By identifying SNAP-eligible stores that offer halal meat and healthy food choices, the project provides tailored guidance for navigating nutrition with dietary restrictions and chronic disease risks in mind.

  Outreach included conversations with local store staff, food pantry coordinators, and shelter kitchen managers. The final resource is a printable guide with evidence-based ratings to support diabetes-friendly, heart-healthy, and weight-conscious choices

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  Hormone Therapy Education and Patient Empowerment in Menopause

  Claudia Tarrant

  Short-term Project

  This project focuses on evidence-based education for patients going through menopause who are interested in learning more about symptomatic treatment options using menopausal hormone therapy. Many patients going through menopause are unaware that there are generally safe and effective treatments to help manage their symptoms. The goal of this project was to create patient centered, evidence based resources to help empower patients going through menopause and navigating treatment options.

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  Weight Management and Knee Osteoarthritis: A Practical Approach for Primary Care Patients

  Adam B. Thompson

  Short-term Project

  Knee osteoarthritis (OA) is a leading cause of disability, with obesity being the most significant modifiable risk factor for its progression. Weight loss has been shown to substantially reduce knee joint load, yet knee pain often limits physical activity, creating a challenging cycle. In Connecticut, 21.3% of adults have arthritis, and obesity rates have risen to 30%. The high cost of knee OA management, including knee replacements, underscores the need for preventive strategies to reduce financial and healthcare burdens. A one-page pamphlet was developed to provide evidence-based guidance on weight management and knee OA, incorporating recommendations from peer-reviewed literature and the American Academy of Family Physicians (AAFP). The pamphlet was distributed at a primary care clinic in New Canaan, Connecticut, offering information on beneficial exercises and local community resources for weight management. The pamphlet was made readily available to patients and well received by clinic staff. While direct patient feedback was limited, the intervention ensured that educational materials were accessible to those seeking guidance on weight management in the setting of knee OA pain. Future interventions should incorporate structured patient feedback, extend the distribution period, and expand availability to additional clinics and community centers.

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  Providing Vaccine Education to Immigrant and Refugee Populations in Bridgeport, CT

  Lauren Tien

  Short-term Project

  The population of refugees, immigrants, and migrants (RIM) across the United States is under vaccinated. Under vaccination puts the individual and community at risk for preventable communicable diseases.

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  Guiding Steps for Accessing Mental Health Care Resources in Danbury CT

  Alex Tran

  Short-term Project

  My work aims to offer easy to access resources for accessing mental health care in Danbury and Newtown, CT. It is aimed at newcomers to therapy, but is especially targeted as elderly patients who find navigating the system unfamiliar. By providing a rack card with basic information and scannable QR code with detailed steps, we hope to make this process less intimidating for patients in the area. Information was gathered from local therapists in the region and patient interview on what steps that found challenging or vague.

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  Gun Safety in Lewiston Maine FMR Clinic

  Ryan Trus

  Short-term Project

  Community project to help improve safe gun storage in Lewiston Maine

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  Addressing Polypharmacy in Older Adults in Primary Care

  Genevieve T. Wakeman

  Short-term Project

  Polypharmacy is a common problem affecting older adults, leading to increased medication burden, risk of falls and negative health outcomes, hospitalizations, and mortality. This community project attempts to improve medication management in older adults without increasing provider burden. A brief checklist was created to be included in provider note templates, prompting a consult with a clinical pharmacist if the patient meets criteria. Results have yet to be studied.

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  Expanding Access to Affordable Nutrition through Shelf-Stable Recipes in Brandon, Vermont

  Shannon M. Wasley

  Short-term Project
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  Access to Weight Loss Services in Western CT

  Zachary E. Wheeler

  Short-term Project
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  Marijuana Use with Prescription Medication: Patient Education

  Oliver Young

  Short-term Project

  Marijuana use in Vermont has increased in recent years across all patient populations, but there is little understanding of the effects of marijuana use on medications. Vermont has the highest percentage of marijuana use in the country, and Windham county is among the highest in the state. Marijuana is metabolized by CYP450 enzymes in the liver, which are also responsible for metabolizing many other medications like SSRIs, benzodiazepine, blood thinners, opioids, beta-blockers, statins, and seizure medications. Marijuana can increase side effects and decrease the effectiveness of medications, which may be dangerous. The wide variety of medications, including the most prescribed medication in the US (statin), paired with the common use of marijuana means there is likely overlap in the populations who use both. This project aimed at educating patients at Grace Cottage Hospital in Townshend, VT, about risks of marijuana with prescriptions with the hope that it start conversations between patients and providers. Results of the project have yet to be studied.

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  Mole Patrol: Identifying Skin Cancer Risk Factors and Suspicious Lesions Documentation with a Smart Phrase

  Amir Zafaranian

  Short-term Project

  Introduction

  Skin cancer, specifically melanoma, is highly prevalent in Vermont. The state has the third-highest incidence rate of melanoma in the U.S. More relevant to the South Burlington Family Medicine Clinic is that Chittenden County has the fourth-highest age-adjusted incidence rate for melanoma in the state of Vermont and is unfortunately rising in comparison to the national average. This problem can likely be explained by a predominantly white and aging population, outdoor leisure, and poor sun protection in the winter months. Vermont is a rural state with all, but one county considered rural, and that a recent study found 88% of rural counties in the United States don’t have practicing dermatologists, the access to dermatologists for prevention through education and detection of skin cancers is limited. Therefore, primary care physicians are often tasked with these responsibilities. The project focused on the AHEC Core Principle of Medical Practice Transformation to support documentation and record keeping of skin cancer risk factors and documentation concerning lesions.

  Methods

  I developed an Epic smart phrase to be utilized in the primary care setting for documentation during preventative care or focused skin concern visits. This phrase outlines several key risk factors, as published by the Journal of the American Academy of Dermatology and noted by local Vermont dermatologists, and a checklist for information regarding skin cancer prevention for patient counseling. A survey was simultaneously distributed to the clinic’s providers at South Burlington Family Medicine for evaluation of effectiveness and feedback.

  Results

  2 providers responded, and 1 found it “very helpful.” Both providers perform focused skin exams in their practice. For the biggest challenges in dermatology referrals, they both identified long waits and limited access for their patients. One provider found it helpful to list risk factors during a visit.

  Discussion

  While this study only captured one clinic during a brief period, it highlights the importance of skin cancer detection in primary care, especially during a time when access to dermatology is difficult. Keeping in mind Vermont’s prevalence of life-threatening melanoma diagnoses, it is more important than ever to support primary care physicians in the surveillance and education of skin cancers.

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  Addressing Mental Health and Intentional Self-Harm in Afghan Patients

  Muhammad H. Zeb

  Short-term Project

  Refugee and immigrant populations in the United States are at an elevated risk for a variety of mental health challenges. Post-traumatic stress, social isolation, experiencing racism, and elevated unemployment are among the correlates of increased mental health risks, including self-harming and suicidal behaviors. Among other factors, recent Afghan refugees or immigrants may encounter these issues due to the limited experience and resources available for healthcare providers working with them. To support healthcare providers in delivering care that is evidence-based and culturally appropriate, an educational resource was developed for identifying and then providing initial care for the mental health needs of the Afghan population. Following a literature review, multiple experts in working with Afghan patients (psychiatrists, other mental health providers, and primary care physicians) were interviewed about providing assessment and treatment services for this population. This information was consolidated to create an educational resource that can be delivered as a self-directed E-Learning module to be broadly distributed. The expectation is that these materials will support healthcare and other providers in their efforts to deliver high-quality, culturally informed mental health care for the Afghan refugee population.

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  Improving Mental Health Accessibility in South Burlington

  Leena R. Ziane

  Short-term Project

  Individuals in South Burlington continue to face difficulties accessing mental health services. Common barriers such as cost, wait time, and lack of cultural competence contribute to this difficulty. Exacerbation of mental health directly correlates to physical health. This project aims to address these barriers by developing a comprehensive handout highlighting available mental health resources counteracting each of these barriers and promoting inclusivity of diverse needs.

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  Elder Care Resources – Chittenden County

  Julie Adelman

  Short-term Project