Aging & Integrated Medicine Scholars Track (AIMS)

(PDF - Outline of AIMS Program)

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.

Name and department of faculty member who will direct this track

Elizabeth Harlow, MD, Assistant Professor

1)    What are AIMS educational objectives?

Upon completion of the Aging and Integrated Medicine Track, the student will be able to:

a)    Describe and perform with supervision the management of chronic, complex, and multiple illnesses in older patients.

b)    Communicate effectively with older patients and their families utilizing accommodations for culture and educational level.

c)    Assist patients in establishing goals of care and priorities

d)    Effectively function across sites and venues of care;

e)    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.)

2)    How will student achievement of those objectives be assessed?

a)    Completion of assigned activities, rotations and tutorials

b)    "Capstone project," i.e. Paper or poster on geriatric issue or research published or presented at regional or state meeting

c)    Completion of geriatric pre-and post-tests for M3 clinical rotation

d)    Evaluation by mentors and geriatric faculty

How will this track supplement the current medical school curriculum?

See tables below.

ACTIVITIES IN   ADDITION TO REQUIRED MEDICAL SCHOOL CURRICULUM

Activity

Required or Optional

Time Required

Comments

M-1

Aging Interprofessional Group (AIG)

Required

3 hours/semester max

Required to attend minimum 2 AIG meetings &/or activities/year

Preceptor experiences with mentor# or other geriatric faculty (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. Steve Bonasera or other appropriate researcher.

(for more information go to;

College of Medicine Student Summer Research Scholarship oMedical Student Training in Aging Research (MSTAR)

Meet with faculty during January of 1st year to identify aging research   interest; submit proposal to Medical Student Training in Aging Research (MSTAR or COM Scholarship) 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, learn unique clinical skills for   evaluating the elderly and prepare for Rural Clinical Block experience.(see below for more)*

ACTIVITIES IN   ADDITION TO REQUIRED MEDICAL SCHOOL CURRICULUM

Activity

Required or Optional

Time Required

Comments

M-2

Aging Interprofessional Group (AIG)

Required

3 hours/semester max

Required to attend minimum 2 total AIG meetings &/or activities

Preceptor experiences with mentor# or other geriatric faculty (as part of LCE clinical preceptor activity)

Required

5 visits per semester

Focus: increased knowledge of geriatric syndromes and conditions.  Refine H&P skills, reporting,   documentation and presenting skills.

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 case conference, resident presentations and other Geriatric division activities that would satisfy the requirement to assist attendance.

ACTIVITIES IN   ADDITION TO REQUIRED MEDICAL SCHOOL CURRICULUM

Activity

Required or Optional

Time Required

Comments

M-3

M3 ambulatory medicine rotation (Selective during Internal Medicine Block)

Required

3 weeks

 

Meeting with mentor on capstone project

Only required if capstone   project is not completed or progressing slowly

One hour monthly

 

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 Journal club dates and times 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 case conference, resident presentations and other Geriatric division activities that would satisfy the requirement to assist attendance.

ACTIVITIES IN   ADDITION TO REQUIRED MEDICAL SCHOOL CURRICULUM

Activity

Required or Optional

Time Required

Comments

M-4

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"

 

Aging Interest Group

Required

3 hours per year

Exceptions: 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

4   hours per year

Students will be alerted of case conference, resident presentations and other Geriatric division activities that would satisfy the requirement to assist attendance.

Poster presentation of capstone project or approved research at EMET research fair

Required

Research fair occurs on the Wednesday or Thursday prior to match day in March (this presentation alone does not satisfy   capstone requirement of AIMS program)

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

 

End-of-life care "Hands-On Experience."

IMED-728

(A Hospice and Palliative care rotation)

Optional

One   month

Activities include;

-Core lectures and readings include

-Work with community based Hospice team

-Work with Hospice Medical Director

-Participate in the Hospice and Palliative Care Team at Omaha VA Medical Center
-Perform oral presentation by the student on end-of-life care

The AIMs scholar must   complete 1 the following rotations

(However, the scholar is encouraged to do as many as they   can)

Rotation

Time Required

Activities

Geriatric Sub internship

IMED-709

One month

(VA inpatient based rotation. Availability will vary from year to year. Check   with Travis if you are interested)

-function   as an intern under direct supervision of supervisory resident and attending   physician.

Attending-William   Lyons, MD

End-of-life care "Hands-On Experience."

IMED-728

One   month

Activities-as described above under "End-of-life care "Hands-On   Experience."

IMED-728

Outpatient   Geriatrics "The Complete Geriatric Experience."

IMED-744.

One month

Rotation   activities;

-Geriatric   assessment clinics (GEM-VA) and (GAC-University)

-Home-Based   Primary Care visits (HBPC)

-Inpatient VA Hospice and Palliative Care team consults & rounds and HPC clinic.

-Skilled Nursing Facility (both Rehabilitation and Long Term Care)

-Geriatric Primary Care Clinics in the Patient Centered Medical Home

-Health promotion and disease prevention in the Home Instead Center for Successful   Aging in the Engage Wellness Program)

*AIMS Geriatric Clinical Skills “Boot Camp”.

  1. A single day clinical experience instructed by geriatric faculty
  2. Upon completion the scholar will be able to;
    1. Describe completion history and physical
    2. Apply unique aspects of taking a history from a geriatric patient
    3. Perform the unique aspects of examining a geriatric patient
    4. Perform a neurologic exam that combines the unique aspects for geriatric patients
    5. Perform cognitive testing (MMSE & MOCA)
    6. Perform a functional screen
    7. 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. Additionally, other activities sponsored by the Geriatric Division, can satisfy the requirement, which include; research conferences, most difficult case conference, and geriatric resident or fellows presentations.

# Faculty mentor; all AIM scholars will be assigned to a specific geriatric faculty mentor. Every attempt will be made to match the scholar with the mentor’s skills and interests that would best benefit the scholar. However, regarding clinical work, due to conflicting schedules, the student should expect to also spend part of their precepting clinical time with other geriatric faculty during their AIMS preceptor clinical  training.

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.

Please describe the interdisciplinary nature of this 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.

Interprofessional Activities

Year

Activity

Disciplines

M-1/M-2

Preceptorship   Experiences

Social work, Pharmacy, Nursing

Physical/Occupational Therapy

Home-based primary care

Social work, Pharmacy, Nursing, Dietary

Physical/Occupational Therapy

Nursing home care

Socialwork, Pharmacy, Nursing

Physical/Occupational Therapy

Aging Interest Group

Physician Assistants, Pharmacy

Nursing, Physical therapy, COPH

M-3

Ambulatory medicine rotation

(Geriatric Assessment Clinic)

Social work, Pharmacy, Psychology, Psychiatry, Nursing

Aging Interest Group

Physician Assistants, Pharmacy

Nursing, Physical therapy, COPH

M-4

Inpatient Sub Intern

Social work, Pharmacy, Physical therapy, Occupational therapy, Speech therapy, Nursing

Aging Interest Group

Physician Assistants, Pharmacy

Nursing, Physical therapy, COPH

Palliative care rotation

Social work, Pharmacy, Chaplaincy

Nursing

Outpatient geriatrics

Social work, Pharmacy, Nursing, Physical therapy, Occupational therapy, Speech therapy, Palliative Care Nurses, Chaplain

How will students be selected for this track?
Selection; based on students one page letter of interest, interviews, background and performance in medical school to date.

What is the maximum number of students who may participate in this track?
4 students per year, maximum total 12.

What benefits or recognition will students receive for completing this track?

Aging and Integrated Medicine Scholars (AIMS) Track

Faculty Contact
Elizabeth Harlow, MD, Assistant Professor
986155 Nebraska Medical Center
Omaha, NE 68198-6155
Email: evandenb@unmc.edu

AIMS & Education Programs Coordinator
Travis Weyant

986155 Nebraska Medical Center
Omaha, NE 68198-6155
Phone: 402-559-9364
Email: tweyant@unmc.edu