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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Development of Guidelines for Refugee Screening at CMMC Family Medicine Residency, Lewiston, Maine

Catherine Hayes
Short-term Project
Lewiston Maine has the second highest number of refugees in the state of Maine, with 191 total intakes in 2015. Refugee populations face unique health concerns, and providing care for refugees requires education and development of a specialized skill set. This project provided a reference for clinic providers to assist with medical intake screening visits for refugees.
Williston, VT: Increasing the Awareness of Hypertension Implications and Sequelae

Tinh Thanh Huynh
Short-term Project
Hypertension is the most common reason for health office visits in the US and for the use of prescription drugs. Many patients fail to truly understand the diagnosis of high blood pressure and the various health consequences that comes with poor regulation such as cardiovascular disease, stroke and renal disease. This project was aimed to increase patient education on the implications of hypertension and its complications.
Suboxone Treatment in Caribou, ME: Evaluating Barriers and Engaging with Mid-Level Providers

Michael Ialeggio
Short-term Project
The Medication Assisted Recovery (Suboxone) program in Caribou, ME was started in 2004 as a cooperative endeavor by Aroostook County Mental Health Center and "Pines Health Servies". Since its inception, the program has experienced provider attrition. This project aimed to evaluate barriers to becoming and remaining a provider of Opiate Replacement Therapy, and to engage and inform local mid-level providers who will soon be eligible to become providers under the Comprehensive Addiction and Recovery Act passed in July 2016.
Broadening perspectives on the management of chronic pain

Daniel Ianno
Short-term Project
Complementary and alternative treatments are often overlooked when managing patients with chronic pain. Given the prevalent problem of prescription opioid abuse, narcotics should be avoided in the treatment of chronic pain if possible. When appropriate, practitioners should ensure patients have explored a wide variety of pain relief therapies prior to initiation of narcotics for the treatment of chronic pain. Increasing awareness and understanding of complementary and alternative therapies among practitioners and patients will hopefully help to mitigate the perceived need for narcotics in the treatment of chronic pain.
Injury Prevention in Adolescent Female Athletes in Western Connecticut

Allicia Imada
Short-term Project
Sports are the leading cause of injury in adolescents and can have long-term psycho-social and physical consequences especially in adolescent females. To increase knowledge and awareness of injuries and injury prevention in adolescent female athletes a short workshop was presented to 56 adolescent field hockey players who improved by 31.1% correct on knowledge based surveys from information in the talk and took home pamphlets. Hopefully in the future the workshops can be expanded to other athletes and sports, and specific information about injury prevention programs that have been shown to decrease injury rates an be shared with the community.
Improving Annual Influenza Vaccination Through Patient Education

Benjamin Jorgensen
Short-term Project
Influenza, commonly called the flu, is a seasonal respiratory virus which circulates each year and causes mild to severe illness which can lead to hospitalization and even death. Despite the advent of the flu vaccine during the Second World War, flu-related illness is the 8th leading cause of death in the United States. Each year the severity of flu in the United States is affected by many factors including characteristics of the circulating virus, timing of the season, how well the vaccine matches the season’s active strains of virus, and vaccination rates. The annual vaccination rates remain low despite public awareness of the illness and the vaccine. Therefore, educational material is a necessary step toward supplying patients with information regarding the need for, effectiveness, safety, and availability of influenza vaccines.
Chronic Pain Management: Local Resources and Education

Colby Russell Kearl
Short-term Project
Many patients with chronic pain are not aware of many treatment options and local resources available to them. Local providers know these resources, but often are not able to convey such vital information to patients due to time constraints. Educational handouts are often provided to patients allowing them to take time outside the clinical encounter to explore other options and resources.
Regulating Kids' Meals to Combat Childhood Obesity

Y-Lan Khuong
Short-term Project
Obesity is an epidemic crossing genders, ages, socioeconomic status, geography, and race/ethnicity. In Vermont, 11.3% of 10 to 17-year old are considered obese, thereby increasing risk for numerous health issues. One contributing factor is an increased tendency to eat away from home. This project aims to provide qualitative evidence regarding response to policy setting nutritional standards for kids' meals in Vermont restaurants.
Calcium Supplementation

Jani M. Kim
Short-term Project
Calcium supplementation is recommended for patients with osteopenia or osteoporosis to prevent further bone density loss. However, recent studies have shown associations between high calcium supplementation and increased cardiovascular disease and kidney stones. This study looks into current recommendations for calcium supplementations in light of these new findings.
Improving Pediatric Oral Health through the Primary Care Physician

Sarah King
Short-term Project
Dental health is an important part of pediatric growth and development. Childhood dental caries represent the most common childhood disease, more than four times as common as asthma and seven times as common as hay fever. In the state of Vermont in 2009-2010, 34% of children in grades 1-3 had a history of dental caries. Furthermore, patients of low socioeconomic status, racial or ethnic minorities and patients with disabilities bear a much greater burden of pediatric dental caries. This project aimed to improve pediatric oral health at Milton Family Practice through an educational handout, and to provide resources for finding a dentist, particularly for patients with Medicaid insurance or who are uninsured.
Test Your Knowledge: STI Questionnaire and Education

Talia Kostick
Short-term Project
Project aims to improve education concerning sexually transmitted infections (STIs) in the teenage patient population of Springfield Health Center Family Practice. Teenage patients were found to only cite pregnancy prevention, and not STI prevention, when asked by medical providers why they should use condoms.
Addressing Transportation Barriers to Healthcare in Windham County, VT

Susannah Kricker
Short-term Project
Limited access to transportation presents a significant barrier to obtaining health care for residents of Windham County, Vermont. This project, created in collaboration with the community health team at Grace Cottage Hospital in Townshend, VT, offers a comprehensive outline for a transportation assistance program in the region. It takes a multifaceted approach to overcoming barriers created by financial constraints and limited transportation resources.
Accessible Contraceptive Education in VT

Alyssa Kwok
Short-term Project
Trying to understand options for contraception can be challenging given the myriad of complex options. Providers at CHCB requested a tool with a user-friendly format that takes the varying health literacy of their diverse patient population into account. It needed to contain key features such as efficacy, pros, cons, and usability. The goal of the tool is to be a visual aid for providers that will assist them in helping patients make informed decisions about contraception.
The Urologic Referral: from the patient's perspective

Troy R. Larson
Short-term Project
Nearly 20 million visits to an Urologist occur annually in the U.S. Most urologic providers are older males. Although the most common patient seeing an Urologist is an older male, a significant number of patients do not fit within these demographics. The field of Urology entails discussion and treatment of personal and sensitive health issues, thus some patients may prefer or would be most comfortable with their physician to process similar like qualities.
The Importance of Collecting an Accurate Family Medical History

Danielle T. Leahy
Short-term Project
Family medical history has been recognized as an important non-modifiable risk factor for many chronic diseases including cardiovascular disease, diabetes, and even several types of cancer. However, a number of studies have shown that patients’ recall of their family history is often inaccurate and missing important information such as family members’ age at onset or diagnosis of a disease. Additionally, there is substantial variation regarding how often family physicians are actually obtaining FMH during visits. Patients’ understanding of the importance of obtaining an accurate FMH and even their perception of familial risk of common chronic diseases is also highly variable based on personal experiences and education.

Therefore, to assist physicians in acquiring a more accurate and detailed family medical history from patients it would appear that patients need to be educated on why collecting this information is an important part of understanding of their own health and risk for developing diseases. In addition, patients should be given the opportunity and the tools necessary to gather their family medical history prior to the scheduled visit with their physician, allowing the patient more time to have a conversation about health history with their family members. The purpose of this project was to design and implement an educational handout about the importance of collecting an accurate family medical history in addition to creating a form for patients to record their family medical history.
Confronting Barriers to Exercise in Patients with Chronic Health: Community Health improvement project in the Lewiston/auburn Area Concerns

Marie R. Lemay
Short-term Project
The CDC recommends at least 150 minutes of moderate-intensity aerobic activity every week, but most individuals with chronic disease do not reach this goal despite its numerous health benefits. Research has shown that scheduled exercise programs and exercise partners help individuals to sustain their exercise goals. Using this premise of group mentality individuals affected from cancer at the Dempsey center and patients attending CMMC’s diabetes group in Lewiston ME were polled about exercise self –efficacy and barriers to exercise. Subsequently, a one-time walking event was offered to the diabetes group and a phone-tree was introduced to one yoga class at the Dempsey Center in an attempt to encourage commitment to exercise.
Transportation as a barrier to access to care in Bangor and the surrounding Penobscot County area

David A. Leon and David A. Leon
Short-term Project
The focus of this project was to assess issue with transportation as a potential barrier to accessing health care in Bangor, Maine. This pilot project involved interviews with community members and providers, as well as evaluated the needs in terms of transportation for accessing primary care. Research regarding this need was conducted through anonymous patient surveys, conducted by the author, and was used to guide the recommendations for future interventions that would address transportation issues in Bangor and the Penobscot County area.
Increasing Provider Understanding: Somalian Population of Lewiston-Auburn

Christina Litsakos
Short-term Project
The Somalian refugee population of Lewiston, Maine has grown in size since 2001 and continues to flourish in this once struggling city. Increasing provider understanding of this unique population will help foster the delivery of optimal primary care to minority patients. As one of the core values of family medicine, understanding our patients beyond their illness is paramount to providing quality health care.
Optimizing Transitional Care Management

Mary Katherine LoPiccolo
Short-term Project
Since the institution of the Transitional Care Management billing codes by the Centers for Medicare and Medicaid Services in 2013, primary care practices nationwide have worked to meet expectations and provide high-quality care to patients upon discharge from hospitalization. In St. Albans, Vermont, the complexity of preparing for successful transitions of care has challenged family medicine providers and supporting staff. Thus, this project sought to provide a structured process by which the primary care team may communicate with inpatient staff, the patients, and each other and collect information required to ensure smooth transitioning of the patient back into the setting of their "medical home."
Skin Cancer Prevention

Jameson T. Loyal
Short-term Project
The state of Vermont has one of the highest incidences of skin cancer, and in particular melanoma, in the entire country. In fact, melanoma is the fifth most common cancer diagnosed in Vermont. The purpose of this project is to determine the impact of skin cancer on the state of Vermont and to develop a patient-centered educational brochure in which to educate patients on skin cancer and ways to prevent it. Through interviews with subject experts it is clear that one of the best ways to prevent skin cancer is through education. The informational brochure on skin health met a need in the family medicine clinic. Moreover, a survey was created to determine patients’ knowledge on the topic of skin cancer as well as to determine the effectiveness of the brochure. Finally, an abbreviated version of the brochure as well as a skin lesion history and description form was created for the electronic medical record.
Improving Breastfeeding Support at a Multi-Service Federally Qualified Health Center

Elisabeth P. Lucas
Short-term Project
A student project exploring how breastfeeding is addressed among different patient care teams in a federally funded clinic and using Electronic Health Record data to determine patient needs. Future recommendations included.
Improving patient understanding of low back pain in the primary care setting

Xiaoyu Lu
Short-term Project
Low back pain (LBP) is the most common type of pain reported by U.S. adults across all age groups and is the leading cause of disability worldwide. Up to 80% of individuals will experience LBP at some point in their lives. 411 patients ages 20-98 were seen over a one-year period for LBP at Castleton Family Health Center in Rutland County, Vermont. Patients and providers both saw a benefit to having educational materials on LBP in the office.
Chronic Pain: Decreasing Dependence on Opioids

Derek Luzim
Short-term Project
An estimated 100 million Americans suffer from chronic pain. A substantial number of them have been prescribed opioid medication for pain management. Evidence has accumulated that opioid medication is inefective for long-term pain control, and that it is associated with increased risk of overdose and accidents, diversion, dependence and misuse. Doctors are increasingly attempting to reduce levels of opioid use in their patients, and some patients with chronic pain are reluctant to decrease their use. This project aimed to provide information to both doctors and patients about this issue.
Addressing Language Barriers When Working With New American Patients

Molly A. Markowitz
Short-term Project
According to the Office of Refugee Resettlement, between the years of 1989-2013, 6310 refugees have settled in Vermont. Studies have found that when non-English speaking patients receive professional interpreting services, there is an increase in the recommendation of preventive health services and a decrease in the investigative tests utilized. Currently at UVMMC, there isn't an easy and accessible way for healthcare providers to obtain health information in different languages for patients. Thus, the aim of this project was to create an easy and accessible way for healthcare providers to access health information in different languages and then promote its utilization.
Incorporation of Advance Directive Discussions in Annual Wellness Visits

Stephen M. Maurer
Short-term Project