Geriatrics (PGY-2)

Description of Rotation or Educational Experience

At Boulevard Temple nursing facility, residents provide continuity care to longterm and acute patients, and interact with multidisciplinary staff (nurses, physical and occupational therapists, social work case managers, dieticians) in the course of directing patient care. These clinical experiences are supplemented with didactic material during the Wednesday afternoon conference series, and during seminars provided by Dr. Beg while the residents visit Boulevard Temple nursing facility. These sessions include topics such as etiology and evaluation of falls, dementia, decubitus ulcer prevention and management, nutrition in the elderly, etc.

Patient Care

Goal

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:

Competencies

• Receive training to perform those clinical procedures required for their future practices in the ambulatory and hospital environments.
• Receive training that focuses on the core principles of Family Medicine: including Continuity of Care, Family-Oriented Comprehensive Care Experience, Family Medicine Center Experience, Patient Care Experience, FMC Continuity and Accessibility, Medical/Surgical Experiences, and Inpatient Experiences.

Objectives

By the end of the rotation the resident is expected to be able to:

• Perform complete physical examinations of elderly patients
• Manage health problems and other concerns of the older patient

Medical Knowledge

Goal

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to:

Competencies

• This rotation fulfills the family medicine-specific training and educational requirements for Care the Older Patient; providing educational experiences in both common and complex clinical problems of older patients.

Objectives

By the end of the rotation the resident is expected to be able to:

• Demonstrate a wide range medical knowledge and information relevant to the older patient.

Practice- Based Learning and Improvement

Goal

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning. Residents are expected to develop skills and habits to be able to :

Competencies

• Identify strengths, deficiencies and limits in one’s knowledge and expertise;
• Participate in the education of patients, families, students, residents and other health professionals, as documented by evaluations of a resident’s teaching abilities by faculty and/or learners

Objectives

By the end of the rotation the resident is expected to be able to:

• Recognize and adjust to the differences in medical care necessary in the treatment of older patients

Systems Based Practice

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:

Competencies

• Work effectively in various health care delivery settings and systems relevant to their clinical specialty
• Coordinate patient care within the health care system relevant to their clinical specialty

Objectives

By the end of the rotation the resident is expected to be able to:

• Demonstrate an enhanced understanding of the nursing home system and its potential use/value to other patients under resident care.

Professionalism

Goal

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:

Competencies

• Compassion, integrity, and respect for others
• Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation

Objectives

By the end of the rotation the resident is expected to be able to:

• Effectively coordinate the care of the older patient via close working relationships with nursing home staff and physicians.

Interpersonal and Communication Skills

Goal

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:

Competencies

• Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds
• Communicate effectively with physicians, other health professionals, and health related agencies

Objectives

By the end of the rotation the resident is expected to be able to:

• Develop and practice skills in communicating with the older patient, including firsthand experience in working through dementia, with stroke survivors, and other patients with communication challenges.

Teaching Methods

What teaching methods are you using on this rotation or educational experience?

• Didactic lecture
• Direct role-modeling and observation
• Precepting of direct patient care

Assessment Method (residents)

How do you measure the resident’s performance on this rotation or educational experience?

• Faculty evaluations of the rotator’s performance
• Real-time feedback during direct observation
• Resident is to generate self-observed behavior reports in each competency at least weekly over the course of this rotation.

Assessment Method (Program Evaluation)

How do you evaluate whether this educational experience is effective?

• Resident evaluation of rotation

Level of Supervision

How is the resident supervised on this rotation?

· Directly by attending physicians

Educational Resources

List the educational resources

• Relevant orientation materials are indicated and/or given at the beginning of the rotation and used throughout.

Resources and people residents have identified as useful, and encourage new rotators to become familiar with:

• Always keep your green cards with you (nursing home visit cards)
• Do not skip going to the nursing home, otherwise you will receive more pts
• Make arrangements for your nursing home pts if you are not able to be
• Call/inform Dr Beg if you are unable to make nursing home visits
• Take time to familiarize yourself with the charts at the nursing home
• Attend lectures on wound care, polypharmacy, and hydration.