Geriatrics

Aging & Integrated Medicine Scholars Tract (AIMS)

     

Why study Aging? People over the age of 65 are the fastest-growing segment of the population in America. They are the most challenging and also the most interesting and satisfying population to care for. Students who complete the AIM track will be ahead of their peers in their ability to diagnose and manage the care of this population.

Why "Integrated" medicine? Care of the aging requires clinicians to integrate knowledge and from a variety of specialties (e.g., medicine, psychiatry, rehabilitation) into treatment plans. This discipline coordinates care across several venues (e.g., outpatient, inpatient, home) The AIM track will emphasize interdisciplinary care, assisting patients and families in setting goals for care, and decision making in the face of multiple and complex illness.

  1. Name and department of faculty member who will direct this track
    Ed Vandenberg, M.D., CMD

    a.  What are AIMS educational objectives?  
              Upon completion of the Aging and Integrated Medicine Track,the student will be able to:
      1. Describe and perform with supervision the management of  chronic, complex,and multiple illnesses in older patients.
      2. Communicate effectively with older patients and their families utilizing accommodations for culture and educational level.
      3. Assist patients in establishing goals of care and priorities.
      4. Effectively function across sites and venues of care.
  2. Confidently care for hospitalized and community dwelling older people throughout the spectrum of health (from healthy independent people to those approaching the end-of-life.)

b.  How will student achievement of those objectives be assessed?

a. Completion of assigned activities, rotations and tutorials
b. Paper or poster on geriatric issue
c. Completion of geriatric pre-and post-tests for M3 clinical rotation
d. Evaluation by mentors and geriatric faculty

           c.  How will this track supplement the current medical school curriculum?
                See table below.

Activities in addition to required medical school curriculum

ACTIVITY

REQUIRED OR OPTIONAL

TIME REQUIRED

COMMENTS

M-1

      
Aging Interest Group Required 3 hours/semester max Required to attend 2 of 3 total AIG  meetings
Preceptor experiences with mentor (as part of LCE clinical preceptor activity) (includes clinic, hospital, nursing home, home visits) Required 5 visits per semester Additional focus beyond the required experiences will be; unique aspects of geriatric history and physical exam and geriatric disease identification.
Clinical Aging Research
(one avenue to complete Capstone Project)		 Optional

Summer Medical Student Research
Program with Dr. Brenda Keller or Dr. Steve Bonasera,  for more information go to: http://info.unmc.edu/indexedres.html
MSTAR
http://www.afar.org/research/funding/mstar

 

 Meet with faculty during Feb of 1st year to identify aging research interest; submit proposal to Medical Student Research Program during Feb of 1st year; Complete research project summer between 1st and 2nd years and during remaining medical school years as needed.
Journal Club* Attend one in spring M1 semester Two hours per semester

 
AIMS
Geriatric Clinical Skills "Boot Camp"		 Required 1 day (immediately follows end of school year, usually in early May before RCB) The scholar will refine their H & P skills for evaluating the elderly and prepare for Rural Clinical Block experience. (see below for more)*

M-2

      
Aging Interest Group Required Maximum 3 hours per semester Required to attend 2 of 3 total AIG  meetings
Preceptor experiences with mentor or geriatric faculty (as part of LCE clinical preceptor activity) (includes clinic, hospital, nursing home, home visits) Required 4 visits per semester
(this will need to be a minimum of four visits unless one of the geriatric visits is to underserved areas)		 Focus:  geriatric syndrome and conditions.  Includes home visit experience.  Follow a patient longitudinally in nursing home or ALF.
Journal Club** Attend two per semester Four hours per semester Students will be alerted of each monthly Journal club to assist attendance.
Case conference*** Attend two per semester Two hours per semester

 

 Students will be alerted of each monthly conference to assist attendance.
Lunch with
Geriatric Fellows		 One time-M2 One time during medical school,
preferred second-year		 Provide opportunity for students to explore what it's like to do a geriatric fellowship

M-3

      

ACTIVITY

REQUIRED OR OPTIONAL

TIME REQUIRED

COMMENTS
M3 ambulatory medicine rotation Required 3 weeks

 
Meeting with mentor on capstone project Required (if capstone project is not completed or progressing slowly) One hour monthly

 
Aging Interest Group Optional; but continued participation encouraged   Student off campus or demands of clerkship prohibits participation.
Journal Club** Required; 1 per year, however highly encouraged to attend additional Journal Clubs 3 hours per year; by attending Journal Club while on the M3 Geriatrics Ambulatory Medicine Rotation Students will be alerted of each monthly Journal Club to assist attendance.
Case conference*** Required; 3 per year additional attendance encouraged but optional 3 hours; completed while on the M3 Geriatrics Ambulatory Medicine rotation, additional attendance encouraged but optional Students will be alerted of each monthly conference to assist attendance.

 

M-4

      

ACTIVITY

REQUIRED OR OPTIONAL

TIME REQUIRED

COMMENTS
Geriatric inpatient Sub-intern Required 4 weeks

 
Capstone project completion

 

 

 Required
(if student has not initiated a Capstone project by M4, this month would be required to assist them in comple­tion)		 1 month to prepare abstract for national meeting presentation/ manuscript

Options include;

-Senior selective (M ID-716) "Science of Geriatrics"

-Palliative Care rotation with end of rotation paper/poster/presentation 
Aging Interest Group Required 3 hours per year Exceptions: often student off campus or demands of clerkship prohibits participation.
Journal Club** Required to attend 4 per year 8 hours per year Students will be alerted of each monthly Journal club to assist attendance.
Case conference*** Required to attend 4 per year 8hours per year Students will be alerted of each monthly conference to assist attendance.
Poster presentation of capstone project or approved research at EMET research fair Required Research fair occurs on the Wednesday prior to match day in March All costs of poster production and clerical support are provided by the geriatrics division. Posters previously formatted for presentations elsewhere would be allowed.  
Senior selective
(M ID-716) "Science of Geriatrics		 Optional One month

 
Palliative Care rotation

 

 Optional One month

 

* AIMS Geriatric Clinical Skills “Boot Camp”.

  1. A two day clinical experience instructed by geriatric faculty
  2. Upon completion the scholar will be able to;
         a. Perform a complete history and physical
         b. Apply unique aspects of taking a history from a geriatric patient
         c. Perform the unique aspects of examining a geriatric patient
         d. Perform a neurologic exam that combines the unique aspects for geriatric patients
         e. Perform cognitive testing (MMSE & MOCA)
          f. Perform a functional screen
         g. Write up a history and physical and SOAP progress note

** Journal Club; meets monthly, usually second Tuesday of the month, 5:30 p.m., At the Home Instead Center, second floor meeting room.  Food provided.  Schedule will be sent to the AIMS scholar monthly
*** Case Conferences; meets weekly on Monday, 12 p.m.-1 p.m. at the Home Instead Center, third floor meeting room.  Excellent clinical discussion.  Topics are cases physicians and fellows are trying to solve and need discussion and advice. No food provided.

c) How will this track provide students with opportunities for interaction with a faculty mentor?
    All precepting activity in M1/M2, M3 and M4 rotations involve direct contact with and supervision by geriatric faculty. Additional interactive times will occur during case 
    conferences, Journal club, and direct mentoring sessions by faculty.

d) Please describe the  interdisciplinary training during the AIM track. Which departments and sections  
    will be involved?
    Geriatrics as a specialty, highly utilizes interdisciplinary care (see below). The students during the activities in the center column will have direct contact with following disciplines 
    in the right-hand column.

INTERDISCIPLINARY ACTIVITIES 

Medical School Year

Activity

Disciplines
M1/M-2

 

 
  AIMS Geriatric Clinical Skills “Boot Camp” Social work
Pharmacy
Nursing
Neuropsychology
Geriatric Psychiatry
  Preceptorship Experiences Social work
Pharmacy
Physical/Occupational Therapy
Nursing

 

 Home-based primary care Social work
Pharmacy
Occupational Therapy
Nursing
Dietary

 

 Nursing home care Social work
Pharmacy
Occupational Therapy
Nursing
Physical Therapy
  Aging Interest Group Physicians Assistants
Pharmacy
Nursing
Physical Therapy
M-3 Ambulatory medicine rotation
(Geriatric Assessment Clinic)		 Social work
Pharmacy
Psychology
Psychiatry
Nursing
  Aging Interest Group Physicians Assistants
Pharmacy
Nursing
Physical Therapy
M-4 Inpatient Sub-Intern Social work
Pharmacy
Nursing
PT
OT
Speech Therapy
  Aging Interest Group Physicians Assistants
Pharmacy
Nursing
Physical Therapy

 

 Palliative Care rotation Social work
Pharmacy
Chaplaincy
Nursing

 e) How will students be recruited and selected for this track?
     Aging Interest Group, M1 lectures by geriatric faculty, mass e-mail in September to M-1's.
     Selection; based on students one page letter of interest, interviews, background and performance in medical school to date.

    i) What is the maximum number of students who may participate in this track?
       4 students per year, maximum total 8. 

5.  What resources will be needed for this track and who will provide them?

      a) Faculty time

          i) Director and mentors

Most of the faculty time for these rotations is already dedicated.  Additional time will be required for precepting (if faculty
are not already doing this), time will be needed for individual meetings, and capstone project.

     b) Administrative and Clerical Support 

  Director time and clerical support will be integrated into the Geriatric Section organization. There are National, 
  UNMC and Geriatric Section resources of funding student research.

     c) Other costs

         i) Identify any other resources needed for this track

            The Geriatric Section will provide funding for attendance at national meeting to present poster.

3. What benefits or recognition will students receive for completing this track?
          - Additional certification on their transcript.
          - Acknowledgment at their graduation ceremony
          - A plaque and acknowledgment at the annual April Senior companion/AIG end of the year party
          - Acknowledged in their Dean’s letter
          - Successful completion of AIM will provide strong, personal letters of recommendation from their Geriatric 
            Mentors.
          - Presentation of capstone project research  poster at M4 EMET research fair
          - An all expense paid trip to national geriatric meeting to present poster 

For more information go to; geriatrics.unmc.edu  click on education,  then click on Medical Students, then click on Aging and Integrated Medicine Scholars (AIMS) Track

Coordinator: Jackie Whittington  email
402-559-6117 

Faculty contact: Dr. Ed Vandenberg
                         981320 Nebraska Medical Center
                         Omaha, NE 68198-6155
                         402-559-7514  email