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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Attitudes and Beliefs on the use of Ambient Artificial Intelligence in a Family Medicine Practice: A Survey Study

Maxime Lapointe-Gagner
Short-term Project
Background: Since its implementation in 2023, Abridge has rapidly transformed family medicine practices across the UVM Health Network by facilitating documentation. However, there remains significant clinician apprehension regarding the utility and safety of this technology, preventing further adoption. Therefore, the aim of this study was to identify concerns and benefits held by family medicine clinicians regarding the use of Abridge.

Methods: Clinicians at the UVM-CVPH FM Center were invited to complete a survey about Abridge. The survey included modified elements adapted from Esmaeilzadeh (2020). Data was collected using Google Sheets. Respondents who are not permitted to use Abridge were excluded from analysis. Key themes were identified, and data was expressed as counts.

Results: 15 clinicians were approached (100% response rate). 11 clinicians were permitted to use Abridge and subsequently included: 5 attending physicians (80% early-career [< 10 yrs], 20% late-career [>30 years]), 4 residents (PGY-2/3), 1 NP, and 1 PA. 4 clinicians used Abridge. Users identified time saving, improved quality of time with patients, and reduced cost of care as benefits of its use. Users expressed concerns about unauthorized access to patient information, climate impact, and inaccurate documentation. Non-users, including all residents surveyed, (n=7) do not use the software due to time inefficiency, burdensome account set-up, poor note quality, and/or depersonalization of the encounter.

Discussion: Attitudes and beliefs surrounding Abridge starkly contrasted between users and non-users, especially regarding perceived time-saving benefits. Security concerns, climate impact, and poor note quality remain otherwise significant concerns.

Conclusion: Future training initiatives should emphasize efficient use of Abridge with emphasis on resident workflow, actionable security measures, and climate impact for potential users to make more informed decisions regarding its use.
Colorectal Cancer Screening Options Made Simple

Joon Young Lee
Short-term Project
Colorectal cancer (CRC) is a leading cause of death from cancer and one of the most common cause of cancers in men and women in the U.S. and worldwide. The USPSTF now recommends screening for CRC beginning at age 45. Studies have proven that increasing screening rates can significantly prevent new cases and reduce the number of deaths from CRC. Screening programs and outreach interventions have been successful in increasing patient participation rates and subsequently in reducing CRC incidence and mortality. This project aims to collect and utilize public recommendations and experiences to create a standardized communication in the electronic medical record in the form of a dot phrase as a method of intervention that provides express education on the available CRC screening tests to patients as a means of improving screening rate.
Generating Language for an Electronic Medical Record Patient Deliverable on Lifestyle Approaches to Migraine Prevention

Jonah Levine
Short-term Project
This project aimed to generate language on evidence based lifestyle modifications for migraine prophylaxis to be integrated into the Cerner EMR system at Central Maine Medical Center Family Medicine Residency such that it is made available for clinicians to deliver to migraine patients during an office visit.
Patient Education of Non-operative Management of Hip and Knee Osteoarthritis

Christopher Lin
Short-term Project
Arthritis is a group of diseases that causes joint pain and requires long-term management. 22.5 million adults in the U.S meet criteria for osteoarthritis. 92% of these patients see their primary care physician for OA. Yet, only 6-25% receive care from a specialist. As a result, there is significant patient confusion regarding diagnosis, prognosis, management, and prevention, as well as a lack of understanding of treatment options. Patients have consistently indicated the desire for more information delivered clearly from multiple sources of health information. More effective communication strategies and visual aids are required
Encouraging STI Testing in Clinton County

Jasmine Liu
Short-term Project
Promoting Muscle Health During GLP-1 Therapy Through Nutrition

Erin Manogaran
Short-term Project
The widespread use of GLP-1 receptor agonists for weight loss and metabolic disease management has raised concerns about unintended loss of lean muscle mass, often resulting from reduced overall caloric and protein intake. This decline in muscle mass may contribute to physical weakness, increased risk of falls, and greater susceptibility to other chronic conditions. To address this concern, a patient-centered weekly sample meal plan was developed in collaboration with the clinic dietitian, offering a starting point for individuals to set nutrition goals that support muscle preservation during GLP-1 therapy.
Comparison of the PHQ-9 and GDS-5 by Older Adult Patients in Middlebury, Vermont

Ryan Zarir Marawala
Short-term Project
This project examines the perspectives of older adult patients who provided their opinions on preference between the Public Health Questionnaire-9 (PHQ-9) and the Geriatric Depression Scale-5 (GDS-5). Twenty three patients aged sixty-five and older participated in the study, and sixteen of the twenty-three preferred the GDS-5. Reasons for this preference included ease of use, brevity, and being able to answer with "yes" or "no" rather than a Likert scale. These results point to a potential solution that screens older adults for depression while reducing their overall paperwork burden.
Minimizing Unnecessary Absences from Rural Early Childcare

Elizabeth Medve
Short-term Project
Access to rural childcare can be a significant challenge, and has a significant impact on early childhood development, parent and family employment, and the local economy. Previous studies have demonstrated childcare centers often unnecessarily exclude children from care for mild illnesses, many parents fear losing pay or their job when they stay home with a sick child. In this project, a pamphlet summarizing current guidelines for illness exclusion from childcare was developed for parents and staff at a rural childcare center, in conjunction with an educational session with the childcare director and staff and provision of full current guidelines.
Increasing Education Surrounding Proper use of Hormone Therapy for Menopausal Patients

Abigail M. Mercier
Short-term Project
This project intends to offer providers an easy way (via a smart phrase in Epic) to increase education in their menopausal patients about vaginal estrogen cream.
Making Exercise Accessible for All

Katina Messier
Short-term Project
Regular physical exercise is often suggested as an important modifiable factor to lessen the occurrence of conditions that are associated with a sedentary lifestyle such as obesity, diabetes, hypertension, and more. However, there is little education surrounding how to exercise, or how to modify movements to fit individual needs. This project serves to educate the public about the importance of exercise, provide movements for each major muscle group, and include modifications based on individual needs.
Dietary Fiber as a Means of Optimizing Health

Carlos Montejo
Short-term Project
More than 90% of the US population does not meet the recommended dietary fiber intake goal of 25-30g per day. Dietary fiber is an essential component of a well-rounded diet and is associated with reduced risk for cardiovascular disease, obesity, and type 2 diabetes mellitus (T2DM). Further, dietary fiber is linked with a reduced risk for colon cancer and has been found to alleviate constipation. Regionally, in Newport, VT, rates of cardiovascular disease, obesity among youth (grades 9-12), and T2DM were significantly higher when compared to the state average. This project aims to inform the community about the importance of incorporating fiber in their diet. Two individuals were interviewed in the Newport community and described the need for more information regarding dietary fiber. A tri-fold pamphlet was created to highlight the role of fiber in the body, how much fiber should be consumed daily, types of food sources rich in fiber, and price breakdowns of non-traditional fiber sources from local supermarkets. The results of this intervention have not been shown. With social determinants of health in mind, the desired outcome is for members of the community to become more conscientious about their diet and the role of dietary fiber in optimizing health outcomes.
Diabetes Prevention in High-Risk Populations

Petergaye Murray
Short-term Project
The American Diabetes Association estimated that the cost of diabetes care in the US in 2022 was $412.9 billion. With numerous patients being diagnosed with prediabetes, it was observed that these patients were underinformed about the necessary changes in diet and exercise needed to delay or prevent diabetes. Two interviews were conducted with professionals who work with diabetes, a pharmacist who providers nutrition counseling, and a physician who oversees the clinical management of diabetes. With their insights and information from nationally recognized resources such as the CDC and the American Diabetes Association, a mini-guide in preventing diabetes was created to disseminate to high-risk patients (patients with pre-diabetes) in clinical settings.
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.
Return to Play after Concussions: Advancing Patient Knowledge and Physician Comfort

Jai Narain
Short-term Project
Unsafe return to play after suffering a concussion can have significant long term consequences including prolonged or persistent concussion symptoms, increased risk of additional concussions and long term brain damage. Among those in youth sports, up to 38% of those who suffer concussions return to play the same day, displaying less symptom burden immediately following the concussion but statistically significant more burden of symptoms long term. The goal of this project is not only to allow medical professionals to have additional comfort and resources in guiding patients back from concussions, but also to give patients more understanding of the importance, stages and overall process of returning safely to activity.
Improving Language Accessibility in the Primary Care Setting

Nicki Nikkhoy
Short-term Project
This project seeks to increase language accessibility for patients from diverse cultural and linguistic backgrounds in the primary care setting. To do so, this project implemented "Point to your language" posters throughout the clinic to signify the availability of and encourage the use of interpreter services. This project found that these posters increased the use of interpreter services, and reduced the associated stigma and confusion of using an interpreter as a patient in the primary care setting.
Management of Low Back Pain in the Outpatient Setting

Casey Norton
Short-term Project
Anticholinergic Burden in New Milford

Maxwell Tyler Pendleton
Short-term Project
Patients in New Milford, Connecticut routinely report frequent use of prescription and over-the-counter medications that carry anticholinergic properties. Several of these medications have anticholinergic effects as a side effect and not as the primary drug class. A pamphlet was created using simple language and large text to provide accessible patient education to the population in New Milford that is at risk for adverse effects of common drugs that carry anticholinergic burdens.
Patient Guide to Managing Post-Meal Blood Sugar for Metabolic Health

Sarah Pfreundschuh
Short-term Project
Diabetes and prediabetes are highly prevalent metabolic conditions with significant public health and personal costs. Lifestyle modifications are widely recognized to play a key role in improving the management of such conditions and may prevent their progression. However, the conveyance of specific lifestyle modifications to patients with diabetes and prediabetes is often limited during standard primary care visits, and not all patients are able to meet with a Registered Dietician (RD) or Certified Diabetes Educator (CDE). Access to concise, generalizable educational materials that can easily be distributed to patients through the electronic medical record system is accordingly a valuable tool for primary care providers. This project involved collaboration with two local RDs, one of whom is also a CDE, to create one such educational material with simple tips for improving post-meal glucose control.
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.
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.
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.
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.
Improving Transition of Care: Supporting Patients After Hospital Discharge

Chloe Ruscilli
Short-term Project
Background/Purpose: Timely follow-up after hospital discharge is critical for patient outcomes, particularly among vulnerable populations, including Black, Hispanic, Medicaid, and low-SES patients. Many patients struggle to recall discharge instructions, and routine practices often lack clear guidance. At Newtown Primary Care, patients reported confusion about follow-up appointments, medication changes, and diagnoses. This project aimed to develop a simple, patient-centered handout to improve understanding and continuity of care.

Methods: Patients, family members, and primary care providers reviewed a structured discharge handout featuring organized instructions and medication instruction. Feedback on clarity, usability, and completeness was collected to assess its effectiveness in supporting post-hospital care.

Results: The handout was well-received. Patients and family members reported improved understanding and easier navigation of discharge instructions. Providers noted enhanced comprehension, particularly when complex conditions or multiple medications were involved.

Conclusion/Implications: Structured, patient-centered discharge materials can improve understanding and continuity of care. Expanding this approach to other hospital departments and tracking follow-up adherence could reduce preventable readmissions and associated healthcare costs.
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.
Screening for Adult ADHD in a Primary Care Setting

Harjas Sabharwal
Short-term Project
Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized as a condition that persists into adulthood, yet primary care providers often feel uncertain about diagnosing it due to symptom overlap with other psychiatric conditions and the absence of standardized tools. This project, conducted at New Fairfield Family Practice, aimed to improve provider comfort with adult ADHD diagnosis by introducing the World Health Organization’s Adult ADHD Self-Report Scale (ASRS-v1.1), an internationally validated screening tool. An educational intervention consisting of a slide presentation and integration of the ASRS-v1.1 into the electronic medical record was delivered to providers. Effectiveness was assessed with pre- and post-surveys measuring provider willingness to use the tool. Results demonstrated an increase in willingness from an average score of 0 (SD=0) pre-intervention to 9.5 (SD=0.71) post-intervention. This project underscores the value of integrating validated screening tools into primary care to address underdiagnosis of adult ADHD. Future directions include expanding provider education, creating accessible handouts for clinicians and staff, and strengthening referral pathways to behavioral health resources. These are small steps to address the significant personal and societal burden of untreated ADHD in adults.