Welcome to the Geriatric Medicine Clerkship

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Welcome to the Geriatric Medicine Clerkship


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Course Overview

During the 2-week Geriatrics Clerkship, students will actively participate in the ongoing, daily care of older patients who have a wide variety of acute and chronic illnesses and abnormal physical findings. Each student will be paired with a primary geriatric physician mentor who will provide clinical teaching and ongoing feedback to the student. Additionally, each student will be responsible for his or her own panel of patients at a skilled nursing facility.  Throughout the clerkship students will work with a variety of geriatric focused health professionals as part of the interdisciplinary care team. This includes nurse practitioners, therapists, certified nursing assistants, and social workers. It is expected that throughout the course of the 2-week clerkship students will be involved with and responsible for admission assessment, discharge planning, ongoing care and management, writing orders, and working with families.

Student will also actively participate in a series of case based clinical skills workshops. These sessions will provide students with needed instruction and practice of skills pertinent to the care of older adults. The timing of the workshops will also allow ample time for students to practice their developing skills at their clinical sites. As with all other clerkships, students and faculty will use a Clinical Skill Passport to assist teaching and learning of several geriatric focused skills. Faculty will use this tool to guide teaching and feedback to students, and students will use the Passport to track their learning needs more effectively.

Course Goals

This clerkship will provide the students with:
1.  A fundamental knowledge of the demography, pharmacology, biology, and physiology of aging
2.  The ability to distinguish age related changes from pathology
3.  An overview of the psychosocial, economic, cultural, ethical, and health policy issues influencing aging and health care for older adults
4.  The components of a comprehensive and multidisciplinary assessment of older adults and their social support system
5.  An understanding of how common health problems in older adults can have atypical presentations
6.  An understanding of the various clinical settings and services offering care to the elderly, how to access these services and factors that affect utilization of these types of care.

Learning Objectives

At the end of this clerkship the student will be able to:

1.  Perform medication reconciliation and consistently identify potential drug-drug interactions, drug-disease interactions, duplication of pharmacologic action, and potentially inappropriate medications in the elderly.
2.  Calculate the creatinine clearance in an elderly patient and dose renally cleared medications accordingly.
3.  Identify and correctly stage a pressure ulcer.
4.  Perform and interpret the following tests
               mental status examination
               functional gait assessment
               geriatric depression screening
5.  Demonstrate the proper use of common assistive devices for gait instability.
6.  Compare and contrast the presentations of delirium and dementia.   Generate a differential diagnosis for each
7.  Outline strategies for delirium prevention in at risk individuals.
8.  Analyze case presentations and identify red flags that potentially signify elder abuse.  Demonstrate a knowledge of available community resources to assist physicians in helping individuals and families affected by elder abuse.
9.  Develop an appropriate pain management strategy for an elderly individual with moderate to severe pain.
10. Demonstrate an understanding of the connection between the physiologic changes of aging and the potential for atypical presentation of disease in the elderly.
11. Obtain, record, and present histories and physical examinations on geriatric patients
12. Select appropriate diagnostic tests and studies with special consideration given to risks, benefits, and goals of care.
13.  Appreciate common ethical dilemmas that arise in the care of geriatric patients, the complexity of such dilemmas, and some of the tools appropriate for approaching such dilemmas.