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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Rutland City Public School At Risk Youth Mentorship

Michael J. Marallo
Short-term Project
This after school program’s purpose is to address the unique challenges of Rutland, VT Middle/High School students with multiple psychosocial risk factors (as determined by comparison to the ACE questionnaire) through mentorship, health and life skills education, and by guiding the development of positive coping skills. Activities will allow for self-expression outside of the classroom in a safe environment. Focus will be placed on assisting paraeducators and teachers with meeting goals that are appropriate for each individual student.
Teaching Value-based Care: A Framework for a Family Medicine Resident Clinic

Alexander W. Marchese
Short-term Project
Milton Family Practice is home to the University of Vermont’s Family Medicine residency program. As efforts to improve the value of health care increase, graduate medical education accreditation organizations may begin to reward and penalize residency programs based on their commitment to teaching and providing value-based care. Residency programs currently lack a clear strategy to prepare residents to assess and deliver value-based care. In this presentation, I present the VALUE Framework (Patel, Davis, & Lypson 2012) for the University of Vermont Family Medicine residency program to teach residents to assess and deliver value-based care for their patients during preceptor sessions.
Breast Density Notification: A Primary Care Summary

Nicole Lin Mendelson
Short-term Project
On January 15^th, 2017 Vermont Senate Bill 157 took effect requiring healthcare facilities that perform mammography to provide patients information that identifies their individual breast tissue classification. 40-50% of women fall into the category of having increased breast density. Increased breast density reduces the sensitivity of mammography and increases the chance that cancer will not be detected. Additionally, women who have dense breasts are at an increased risk for developing breast cancer. Supplemental screening provides an opportunity to increase detection of breast cancer, but comes with an increased rate of false positives. With this new law in place, there is a need to educate primary care physicians on the risks and benefits of available supplemental screening technologies so that they may appropriately counsel patient that wish to proceed. This project resulted in an educational document and presentation to primary care physicians at Berlin Family Practice with the aim of raising awareness about the topic, providing education on the screening options/counseling patients, and providing a forum to discuss how patients will be affected.
Addiction Recovery Support: Connecting Primary Care Providers and Community Resources

Amber J. Meservey
Short-term Project
Addiction to drugs and alcohol is a pervasive problem throughout Vermont and the U.S., and only a fraction of those needing help receive it. The vast majority of admissions to substance abuse treatment programs do not come from healthcare providers, who report a lack of preparedness in managing addiction screening and referrals. Recognizing that Family Medicine Providers are likely to be caring for many patients struggling with substance abuse, this project aims to improve provider familiarity with local resources. In particular, this project focuses on promoting long-term retention in self-help group programs, as these have been demonstrated to be the most approachable form of help for many presenting in the primary care setting.
Talking To Your Teens About Pregnancy

Sergio Andres Munoz
Short-term Project
Teen parents are at risk for a variety of adverse life outcomes. The rate of low birth weight and premature delivery is higher among teen mothers than the average population. Teen pregnancy and birth are major contributors to lower educational achievement and income as they are less likely to graduate High school and college, leading to increased rates of poverty among teen mothers. This project aims to educate parents of at risk teens on how to approach the topic with their kids and to provide them with a list of online sources to aid in the process.
Radiation Risks and Safety

Hyunsoo Joshua No
Short-term Project
Patient and physician requests for the use of X-Rays, CTs, and other radiation-producing medical imaging are increasing in the US. Both public and physician awareness of radiation knowledge is limited. Studies suggest that the general public is not concerned about exposure to ionizing radiation from medical procedures due to the widespread notion that healthcare professionals have received extensive training in the radiation principles and are competent in minimizing risk. Pamphlets providing simplified information, available for both providers and patients, may provide as an effective intervention to help educate both physicians and the public about radiation risks and safety.
Promoting Awareness of the Opioid Epidemic in Rural Vermont

Kathleen Olson
Short-term Project
Vermont is in the middle of an opioid epidemic. Heroin use fatalities are on the rise and the number of people in treatment for opioid use disorder in Rutland County has tripled in recent years. Despite this widespread problem, community members of Rutland County feel that there is reluctance to talk about opioid misuse and lack of awareness. This project aims to bring awareness, provide resources, and encourage people struggling with opioid use disorder to seek treatment.
Aging Well: Informing Seniors About Local Resources Throughout The Aging Process

Sravana Paladugu
Short-term Project
A large portion of the Franklin County population is elderly and above the age of 60. They have many unique socioeconomic barriers to healthcare that add to the difficulty of maintaining independence in the community. This has been a burdensome public health cost for not only this community but for Vermont as a whole. The goal of this project was to inform local seniors of services provided by Age Well VT that could enable them to stay at home for longer. This was carried out by designing an Age Well VT handout that could be easily read and utilized by elderly patients at the Fairfield Street Health Center.
Opioid Prescribing: New Vermont Regulations for Providers

Lloyd Patashnick
Short-term Project
Opioid abuse is serious problem in Vermont with an estimated yearly health cost of $38 million. In 2015, 28% of Windham county residents were prescribed opioids. In order to combat the ongoing crisis of opioid prescription abuse, the State of Vermont will implement new prescribing regulations which will take effect in July, 2017. To ensure compliance with these new regulations, health care providers need to be educated to allow for a seamless transition in patient care.
Barriers to Affordable Prescriptions in Rural Vermont

Niketu P. Patel
Short-term Project
This project aimed at understanding why people in Rutland County, Vermont struggle with buying medications for their health. The project implemented and proposed several methods to help the population of Rutland area better adapt to the growing cost of prescriptions via $4 medication lists, rebates, samples, etc.
Promoting Antibiotic Stewardship

Saurabh Patel
Short-term Project
Antibiotics are not always prescribed optimally in the outpatient setting for common respiratory illnesses. Providers also spend time reiterating the same facts to patients about antibiotics and why their use is not warranted for their common cold symptoms. By providing a visual aid that can capture the attention of patients and present concise, easy to retain facts, we may lessen the amount of time providers spend counseling. At the same time, we are able to get patients to contribute to the fight against antibiotic overuse, antimicrobial resistance, and healthcare associated infections.
Adolescent Sex Education

Carolyn Payne
Short-term Project
This project identified a significant need for adolescent sex education and curriculum development in Vermont and the United States. A comprehensive sex education presentation was developed, reviewed by experts in the field, and piloted at The Boys and Girls Club of Burlington. Subjective results were positive and future strategies to teach students, evaluate effectiveness, and expand impact were developed.
Marijuana Use Counseling During Pregnancy

Adam Petchers
Short-term Project
Penobscot County, Maine has among the highest rates of marijuana use in the country, and Maine has recently voted to legalize recreational use of marijuana. Research has shown that pregnant women frequently seek out and are dissatisfied with information regarding the safety of marijuana use during pregnancy. We surveyed Family Medicine providers at the Center for Family Medicine at Eastern Maine Medical Center in Bangor Maine regarding their counseling of pregnant patients on the topic of marijuana use. From the results, we created an information sheet to aid providers in marijuana use counseling with pregnant women.
Sports Injury Prevention in Danbury, CT

Cori Polonski
Short-term Project
Sports Injuries, especially overuse injuries, cause a significant amount of morbidity and public health cost, especially for young athletes. Importantly, many of these injuries can be prevented with proper training and some novel approaches to warm-up and training. To address this concern, I worked with Orthopedic Specialists of CT and the athletic trainers at Danbury High School to come up with some educational materials for patients on effective ways to prevent sports medicine injuries.
Rural Teens and Stress

Morgan R. Pratt
Short-term Project
Stress is significantly associated with risk taking behavior and increasing depression/anxiety among teens. There is no shortage of stressors experienced within the teenage years.This project's aim is to create a pamphlet that can be available for teens in rural Vermont. It will contain apps for healthy lifestyle, stress, mood, mindfulness as well as local help line numbers for teens in crisis and signs and symptoms of anxiety and depression.
Narrative Medicine: Improving Patient Care and Shifting Office Culture

Yazen Qumsiyeh and Julia Shatten
Short-term Project
Chronic pain and depression are both prevalent in the Unites States and often co-exist in the same population. According to the literature, there is no consensus between providers as to the best practice of treating chronic pain and concomitant depression. Narrative Medicine, a medical model that uses a patient’s illness narrative to make meaning of their disease, allows patients to tell their stories of chronic pain and other important aspects about their life, while it helps providers better understand patients’ experiences with pain. This project will assess the current culture and attitudes of providers treating chronic pain conditions at the Center for Family Medicine at Eastern Maine Medical Center. It will also assess their current understanding of Narrative Medicine and the Northwestern Life Story Interview. We found that providers who dread visits with patients with chronic pain conditions are more likely to feel less confident when treating those patients.
Connecting Seniors in Franklin County Vermont to Community Resources

Autumn Reilly
Short-term Project
Vermont currently has the second oldest population in the country and the elderly population is continuing to increase. Senior citizens define aging successfully as having good health, strong friendships, and being able to participate in activities. In order to meet the needs of seniors it is important to find ways to better connect them with available community resources. The aim of this project was to create a pamphlet of community resources available to seniors in Franklin County, Vermont to aid in connecting them to community involvement and support.
Breast Cancer Screening - Helping Patients Choose

Fran Riley
Short-term Project
Breast cancer imaging has been covered broadly in the lay press. Many questions have been raised in the past few years, which bring confusion to patients in terms of risks vs benefits. In addition, new research shows dense breasts to be a significant risk factor to developing breast cancer, warranting additional modalities. All of this requires the patient to have an understanding of the risks versus benefits so they can choose what's best for them. This project creates an information brochure for patients, using numbers to give patients objective perspective to inform their decision.
Preventing Falls in the Elderly

Rebecca Robbins
Short-term Project
Falls are the leading cause of fatal and non-fatal injuries for older Americans, leading to 27,000 deaths every year and almost 3 million emergency room visits. Many view falls as just part of getting older; however fall risk can be significantly diminished through appropriate screening, education and community programs. Through literature review and talking to members of the local community, I learned about how fall risk is assessed along with what education and programs are provided for those at increased risk of falling. This project sought to educate patients about simple steps that can be made to decrease their fall risk and to educate providers about screening tools available to assess fall risk and how to work with patients who have an increased risk of falling.
Indirect Approach to Intimate Partner Violence

Jasmine Y. Robinson
Short-term Project
Discussing Intimate Partner Violence can be difficult, and has many barriers. An indirect approach to speaking with patients about domestic violence, whether is is sexual, physical, emotional or financial can be achieve with patient's trust in a physician if they withhold judgement.
Identification of Barriers to Organ Donation: A Primary Care Interventional Approach

Brittany L. Rocque MSc
Short-term Project
Organ transplantation provides a potentially life saving intervention for patient with end-organ failure as well as substantial cost-benefit with relation to Medicare expenditure. Despite the advantages of transplantation, deceased organ donors are in short supply and many patients die or lose quality years while awaiting transplantation. Registered organ donor rates are relatively low in our opt-in system being 52% nationwide and only 44% in Vermont, which is below the >50% per state goal. Non-organ donor patients were given and informational brochure and surveyed regarding their attitudes and beliefs toward organ donation.
Assessing Transportation Hurtles in Lamoille County, VT

Brian J. Rosen
Short-term Project
Rural areas are often characterized by low population densities, and large distances between available services and the population they serve. Lack of transportation in these areas makes access to services even more challenging. Access to primary healthcare was listed as the number one concern for patients in 2015 Copley Hospital Service Area (Lamoille County) and lack of suitable transportation was a major reason for this lack of access. The primary purpose of this project was to assess the medical transportation options for patients without appropriate transportation in Lamoille county, and to produce a flyer educating the patients about their options. The second goal was to educate the providers at Morrisville Family Health Care about the transportation struggles their patients face.
Primary Care to the Rescue, Again! Autopsy and the Death Certificate

Emily E. Ryan
Short-term Project
An pre and post testing, an educational module, a presentation, and a dot phrase were developed to improve providers' knowledge of the hospital autopsy and the correct completion of death certificates.
Recognizing Depression in Elderly Patients

Maia Sakradse
Short-term Project
Recognizing depression in elderly patients can be challenging. Lack of awareness of mental health issues amongst elderly patients, ideas that depression is a normal part of aging, and confusing symptoms of depression as symptoms of other conditions are just a few of the challenges. Providing patient information about the signs and symptoms of depression in older patients may help encourage patient to talk to their doctors about depression.
Concussion

Kasra Sarabakhsh
Short-term Project
Concussions are very common, especially among young athletes and students. Most patients are encouraged to rest and avoid activities that are physically and cognitively demanding. However, there is not much education regarding alcohol use after a concussion and its detrimental effects on brain recovery.