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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Decreasing the Smoking Rate at EMMC Family MedicineCenter and Residency in Bangor, ME

Alex Coffman
Short-term Project
Maine's rate of adult current smoking is 20%, which is significantly higher than all other New England states (Connecticut 16%, New Hampshire 17%, Massachusetts 16%, Vermont 17%, and Rhode Island 17%). The national adult smoking rate in the US is 17.8%. An estimated 2,200 Maine adults die each year from their own smoking.
Chronic Pain Management with High Dose Opioid Medication

Joshua Cohen
Short-term Project
Chronic pain management with non-abuse deterrent high dose opioids is a necessary but dangerous practice. This project addressed physician opinions about this sensitive issue and audited patient records to assess documentation compliance with VT rules. The goal is to standardize communication and documentation in order to improve safety for patients, physicians, and the community at large.
Identifying Sleep Disorders and Proper Sleep Hygiene in School-Aged Children

Kathryn Colelli
Short-term Project
Sleep is a daily struggle for many people. Children in particular often suffer from sleep restriction and poor sleep hygiene. Poor sleep can have a negative impact on their physical, social and emotional health. Children in our community are rarely educated about sleep disorders or sleep hygiene. The goal of this project was to create a learning tool to help facilitate sleep education in children.
Obesity Intervention and Prevention

Bridget Ann Colgan
Short-term Project
Obesity is a prevalent health concern at Berlin Family Practice, with 41% of the patients seen in the past two years with a BMI greater than or equal to 30, many suffering from comorbid diseases of hypertension, diabetes, high cholesterol, and stroke. In an effort to assist patients in making lifestyle changes to improve nutrition, activity level, and weight loss, this project aims to incorporate the Vermont Department of Health's Weight and Health Profile into patient visits. Feedback from both practitioners and patients on how to improve and update this tool will be provided to Vermont Department of Health Physical Activity and Nutrition program in an effort to optimize its effectiveness and help patients with healthier eating, weight loss, and increased activity, thereby reducing incidence of obesity and associated comorbidities.
Increasing Provider Awareness Regarding Act 39 in Middlebury Vermont

Kyle F. Concannon
Short-term Project
Vermont passed the Patient Choice and Control at End of Life Act (Act 39) in 2013 and as knowledge of this law is increasing in the community more patients are requesting it. To address the need for further education, an educational pamphlet was produced and provided to practitioners in Middlebury Vermont, many of whom had patients request Act 39.
Education in Over the Counter Medications, for High School Freshmen

Ian Crane
Short-term Project
Over the medications offer numerous benefits, allowing short term treatment of symptoms, and reducing unnecessary Doctor’s visits for things like viral illness. Yet these medications also have potential for misuse. Roughly 10% of Danbury High School students abused OTC medications in 2013.
Bridging the Gap Between the Primary Care Physician and Accessible Resources for Patients with Mental Health Needs

Tracey DaFonte
Short-term Project
Mental illness and maintaining mental health is a significant problem in the world, the United States, and here in Vermont. The burden of mental illness can lead to disability, lost work productivity, and at its worst, suicide. Vermont ranks 14th in the United States for rates of death by suicide. Many people struggle every day with mental health needs from depression, anxiety disorders, ADHD, and more. The aim of this project was to create a mental health resource card that can be used in primary care offices to provide patients with information to get the help they need and attempt to increase the percentage of patients who address mental health issues with their primary care provider.
Burnout Prevention in Primary Care Providers

Dylan M. Devlin
Short-term Project
Burnout is a pervasive problem in primary healthcare. Mindfulness training has been shown in decrease symptoms associated with burnout and improve overall patient care. This project attempts to evaluate the rates of both burnout and mindfulness in healthcare workers within Rutland County, Vermont. A survey was distributed to both administrative and primary healthcare workers within the Community Health Centers of the Rutland Region system to determine if employees suffer from symptoms of burnout as well as their willingness to participate in mindfulness training.
Radon: The New Carbon Monoxide

Katherine M. Evans
Short-term Project
Radon is derived from breakdown of uranium naturally found in the environment all across the globe. Some geographic locations have higher levels of radon than others. Like carbon monoxide, radon is colorless and odorless. It is the second leading cause of lung cancer in the United States. Human exposure happens primarily via buildings: 1 in 8 Vermont homes exceed the recommended level. In Brattleboro, 1 in 5 homes exceed the recommended level, but between January 1993 and January 2014, the Vermont Department of Health received only 329 home testing kits from Brattleboro.
Provider Resources for Smoking Cessation Counselling

Pierre Galea
Short-term Project
Tobacco is still the leading cause of preventable death. The Vermont Department of Health has instituted smoking-related goals for "Healthy Vermonters 2020." One resource that is useful for providers who counsel patients to quit smoking is 802quits. Strategic utilization of this resource and implementation within the healthcare center, is invaluable for providers, and is an effective tool to reach patients and support them throughout their journey.
Lyme Disease Awareness in Downeast Maine

Justin L. Genziano
Short-term Project
Lyme disease is caused by the bacteria Borrelia burgdorferi and is transmitted by the deer tick (Ixodes scapularis). Lyme disease is endemic in the state of Maine with 1,399 probable and confirmed cases reported in 2014. The rate in coastal Hancock County has doubled since 2012, and has the third highest rate of infection in the state.

Medical providers in Hancock County have observed an increase in anxiety and concern about Lyme disease in the community, and have found that much of this is driven by hearsay or unreliable information from the internet. The goal of this project is to provide patients with concise and accurate information to help alleviate this concern.
Over the Counter Medication Education Approach

Gurpinder Gill and Ian Crane
Short-term Project
OTC meds are essential because they give the patient the ability to avoid an unnecessary visit to the doctor's office. They also allow the health care provider to better focus on those with more serious illnesses, and some patients do not have appropriate health care access and rely solely on non-prescription meds. However, patients who use OTC meds do have a tendency to underestimate the serious risks of these meds such as potential for abuse, toxicity, adverse effects, drug interactions, and the delay in seeking a physician's advice.
Determining Barriers to Oral Health Care in Bennington County

Taylor Goller MS-3
Short-term Project
Bennington County has some of the worst oral health outcomes in the state of Vermont. A survey was designed to assess current oral health problems, maintenance habits, and barriers to oral health services access. Results are preliminary.
Osteoporosis: Prevention, Screening, and Treatment in the Primary Care Setting

Jeanne T. Gosselin
Short-term Project
Osteoporosis, with its related fragility fractures, is largely a preventable disorder, not an inevitable part of aging. Through effective education, screening, and treatement in the primary care setting, it may be possible to curb the impending rise of osteoporosis and costly fractures as the population ages. A time-conserving patient education pamphlet on osteoporosis was developed for a family medicine practice in central Vermont. The educational intervention is sensitive to the time constraints of a busy practice and may provide a much needed foundation for osteoporosis education in the primary care setting.
Added Sugars: Educating the Public on New Guidelines

Michael A. Grant
Short-term Project
Added sugars are a non-nutritional source of calories found in many food products where people do not expect to find them. There is ongoing discussion of the healthy amount of added sugars to consume as well as new guidelines and labeling efforts. This project reviews the epidemiology of a small town in VT and considers ways to improve the awareness of added sugars and how to reduce the amount consumed by its residents.
Pediatric Tooth Care and Fluoride Exposure in Maine

Lucas Grover
Short-term Project
Maine is a large and rural state with limited access to fluoridated drinking water and consistent health and dental care. There is little information and guidance for parents regarding the importance of home pediatric dental care, early dentist visits, and home testing for fluoridated drinking water. Parents and primary care providers must engage in a dialog regarding proper tooth care to identify child specific risk factors that can lead to childhood caries and chronic tooth decay if not addressed early and aggressively.
Implementing Developmental Screening per AAP Guidelines

Douglas Handley
Short-term Project
"Fewer than half of the nation's pediatricians conduct systematic surveillance of young children's development… time and cost are among the barriers." Missing developmental delay leads to further attenuation of the problem and can lead to additional developmental problems. Developmental delay can often be corrected or treated to reduce the impact it has on the child. The AAP suggests "developmental surveillance" at every well child visit and standardized "developmental screening" at WCC 9 months, 18 months, and 24 or 30 month.
Development and Implementation of a Suboxone Therapy Group

David Hermel
Short-term Project
Implementing effective opiate detoxification is critical to the health and well-being of the Lewiston-Auburn area, which has the highest rate of admissions for substance abuse (especially non-heroin opiates) and mental health conditions in Maine. The number of Maine residents seeking treatment for prescription drug abuse topped the nation at 368 admissions per 100,000 residents in 2008.
Increasing Awareness of the HPV Vaccine

Jonathan M. Hernandez
Short-term Project
Increasing the public awareness and knowledge of HPV complications and prevention through vaccination is an effective intervention to increase vaccination rates and reduce overall public health cost and burden.
Improving Vaccination Rates at UVMMC Family Medicine, Berlin

Emily G. Jones
Short-term Project
Practitioners don't know current vaccination rates for their practice. Some current reported rates look incorrect, according to the Medical Director. Other reports show areas for improvement. One problem is that patients no longer in the practice remain in the system and decrease rates; another problem is that paper records were loaded manually by persons without medical training when the electronic medical record.
Substance Abuse Amongst High School and College Students

Herman Kalsi
Short-term Project
Substance abuse among young adults is hardly a new trend. About 50% of full-time college students binge drink or abuse prescription drugs, 25% of which meet the definition of having substance abuse or a dependence. That is three times the rate of the general population. Estimated overall total cost of substance abuse in US is $600 billion annually. Ease of access is a main contributor to drug abuse amongst college students.
Implications of Long-term Proton Pump Inhibitor Use: Promoting Step-Down Therapy for Management of Gastro-esophageal Reflux Disease in the Outpatient Setting

Sonam Kapadia
Short-term Project
Per the International Montreal Consensus, gastro-esophageal reflux disease (GERD) is defined as a "condition which develops when the reflux of stomach contents causes troublesome symptoms or complications". GERD is the most common disease of the gastrointestinal tract with an estimated prevalence affecting 20% of the Western population. According to the National Ambulatory Medical Care Survey, 38.53 million annual outpatient visits are related to GERD. The ABIM Foundation's "Choosing Wisely" initiative in collaboration with the American Gastroenterological Association draws attention to the evidence based recommendation: "For pharmacological treatment of patients with gastro-esophageal reflux disease (GERD), long-term acid suppression therapy (proton pump inhibitors or histamine2 receptor antagonists) should be titrated to the lowest effective dose needed to achieve therapeutic goals."
Barriers to recovery for Buprenorphine Patients in Bangor, Maine

Erin L. Keller and John McLaren
Short-term Project
Opiate addiction is a major public health problem in Maine. Addiction is a chronic disease with high relapse rates. A better understanding of the demographics and barriers to recovery in opiate addicted populations can help to improve the success of buprenorphine treatment programs.
Polypharmacy Management in a Rural Family Medicine Practice: View from Multiple Perspectives

Sarah Anne Kelso
Short-term Project
Polypharmacy is a growing problem in the United States. The elderly population is expanding, and the use of specialists to manage their healthcare is increasing. This project looks at the role of the primary care physician at a rural Family Medicine practice in reducing the risks of polypharmacy. The perspectives of patients and the local pharmacist were used to create an education tool about polypharmacy management within this community. Increased awareness of this issue and how it applies to patients within the practice were the results of this intervention.
Promoting Awareness of Hepatitis C in Burlington, Vermont’s Homeless Population

Catherine M. LaPenta
Short-term Project
Chronic Hepatitis C infection is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States. Most Hep C + patients are unaware that they are infected. Chronic HCV infection represents a huge public health and financial burden. While about 1% of the general U.S. population is HCV+, the prevalence is as high as 41.7% in some homeless populations in the U.S. Awareness of Hep C is low and Vermont’s homeless patients who are HCV+ are likely severely underdiagnosed and undertreated.