GERIATRICS

For Students Geriatric Clerkship Requirements (3rd Year)
•	Geriatric Syllabus
•	Required Booklist
•	Evaluation Forms; Clinical encounter log, procedure logs
•	Comprehensive H&PE
Geriatric Rotation Sites & Faculty
•	Meet the Geriatric Faculty
•	Geriatric Site-Specific Instructions
Geriatrics Fellowship and Career Information
•	Geriatrics Fellowships & Careers
•	Geriatric Web Links and Resources
For Faculty
•	Faculty Development and CME Program
•	Useful Faculty Development Links (go to Quick Links)
•	Clinical Faculty Application
•	Preceptor Evaluation of Students

 

 

 

 

 

 

Geriatrics Syllabus

Chairs:

Virginia Campus: Richard T. Williams, M.D., M.S. (rwilliams@vcom.vt.edu) Interim Chair

Carolinas Campus: Edward Warren, M.D. (ewarren@carolinas.vcom.edu)

Rotation Credit Hours: 4

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Goals

The primary goals for the geriatric rotation are three fold. First, to enjoy a fruitful and fulfilling career the physician must look forward to awaking each day, proceeding forward with the outlook that each day is a gift with many rewarding, challenging and personal growth experiences. Secondly the continual addition of knowledge is necessary to provide excellent patient care and personal life long growth fulfillment. Third each task must have a measurable goal or marker that the task was successfully completed. With the above thoughts the goals for the geriatric rotation is to: provide and enjoyable experience with significant addition of medical knowledge that culminates with the successful completion of the final geriatric exam.

For more detailed information about your rotation, click on the headers below. If there is anything I can assist you with, please let me know.
Richard T Williams M.D., M.S.
VCOM  Geriatrics Acting  Department Chair

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Rotation Description

During the third year geriatrics rotation, students expand their knowledge of Geriatric Medicine conditions and gain the ability to apply this knowledge in the clinical setting. The curriculum is taught through VCOM TV on-line lectures, on-line case modules and presentation, assigned readings, grand rounds, and through one-on-one student-preceptor experience in caring for patients in the clinical setting.  The Core Geriatric Medicine Competencies that are to be gained in the third year are found below.

Clinical Setting in Which Rotation Occurs
The practice of geriatric medicine occurs in the outpatient office setting, in long-term care facilities and in the inpatient setting.  Due to the variety of practice opportunities and formats in geriatric medicine, students should review their specific site instructions for a more detailed description of their specific practice setting.

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Requirements for Completion

Required Textbook

Kane: Essentials of Clinical Geriatrics 6e.  (Available in electronic format on the VCOM Library) The specific reading assignments in this textbook have been designed to correspond to the core clinical topics for the rotation and can be found below under the “Clinical Modules – Required Curriculum.”

Requirements for Successful Completion of the Geriatrics Rotation

1. Attendance according to VCOM and preceptor requirements (student handbook)

2. Completion of all Clinical Modules in the Required Curriculum

3. View required geriatrics videos [+]

1. Videos are found on VCOM TV (http://vcomtv.vtls.com/vital/access/manager/Login)
2. Up to 2 questions on the end of rotation exam will come from each video
   • Dermatological Condition in the Elderly
     Soheir Boshra, MD, FAAFP, Fellowship Director, Carilion Clinic
   • Maintaining Health After 70
     Karol Gordon, DO, CAQG, CMD
   • Nutrition and Aging
     Kathy Hosig, PhD, MPH, RD
   • End of Life Care
     Don Bivins, MD, Medical Director, Good Samaritan Hospice
   • Anti-Aging
     Richard Williams, MD, Interim Department Chair, Geriatrics
     Associate Professor, Geriatrics and OMM
     Edward Via College of Osteopathic Medicine - Virginia Campus
   • Peri-operative Care in the Elderly
     Aubrey Knight, MD, CMD, Section Chief, Geriatrics, Carilion Clinic
   • Vitamin D Deficiency
     Richard Williams, MD, Interim Department Chair, Geriatrics
     Associate Professor, Geriatrics and OMM
     Edward Via College of Osteopathic Medicine - Virginia Campus
   • Community Response to Elder Abuse and Elder Abuse Prevention
     Janet Brennend, Elder Abuse Prevention Specialist , New River Valley Agency on Aging
   • ARMD and Glaucoma
     Richard Williams, MD
     Associate Professor, Geriatrics and OMM
     Edward Via College of Osteopathic Medicine - Virginia Campus

4. Procedure Log

5. Rotation Evaluations:

• Student Site Evaluation. Students must complete and submit at the end of rotation.
• Preceptor Evaluation form
  • It is the student's responsibility to ensure that all clinical evaluation forms are completed and submitted online or turned into the Site Coordinator or the Clinical Affairs Office at the completion of each rotation. Students should inform the Clinical Affairs Office of any difficulty in obtaining an evaluation by the preceptor at the end of that rotatio

6. Successful completion of the end-of-rotation written exam.
The geriatric end-of-rotation exam questions will be derived directly from the specific objectives presented in each of the below modules.

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Clinical Modules - Required for Completion

The geriatric curriculum is delivered through the 21 following modules which cover the core topics and clinical conditions most commonly practiced in geriatric medicine.  Each of the following topics has specific learning objectives and is accompanied by an assigned reading in the text as well as an online case.  Some topics may also have an accompanying VCOM TV lecture and PowerPoint presentation.  The geriatric end-of-rotation exam questions will be derived directly from the specific objectives presented in each of the below modules. Thus success on the exam will require that students complete all module assignments, including reading, viewing of online videos and review of any accompanying cases or presentations. 

1. Acute Delirium [+]

2. Constipation and fecal impaction  [+]

3. Contractures  [+]

4. Dehydration [+]

5. Dementia and Cognitive Decline [+]

6. Diverticular Disease [+]

7. Elder Abuse [+]

8. Fever [+]

9. Hypothyroidism [+]

10. Multiple Myeloma [+]

11. Osteoporosis and Fracture [+]

12. Pain [+]

13. Parkinson's [+]

14. Polymyalgia Rheumatica [+]

15. Polypharmacy [+]

16. Pressure Ulcers [+]

17. Stroke [+]

18. The Musculoskeletal Examination in the Elderly [+]

19. Urinary Incontinence [+]

20. Sensory Impairment in the Elderly [+]

21. OMM Core Curriculum Assignments [+]

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Clinical Performance Objectives

While the end-of-rotation exam is derived from the didactic curriculum and objectives described above in the “Clinical Modules – Required Curriculum” section, the end-of-rotation evaluation completed by your geriatric preceptor is based on clinical core competencies.  These core competencies reflect student performance in 6 key areas: communication, problem solving, clinical skills, medical knowledge, osteopathic medicine and professional and ethical considerations.  Your end-of-rotation evaluation from your preceptor will be based directly on your performance in these 6 core competencies as described below.  

1. Communication - the student should demonstrate the following clinical communication skills:
1. Effective listening to patient, family, peers, and healthcare team
2. Demonstrates compassion and respect in patient communications
3. Effective investigation of chief complaint, medical and psychosocial history specific to the rotation
4. Considers whole patient: social, spiritual & cultural concerns
5. Efficiently prioritizes essential from non-essential information
6. Assures patient understands instructions, consents & medications
7. Presents cases in an accurate, concise, well organized manner
2. Problem Solving – the student should demonstrate the following problem solving skills:
1. Identify important questions and separate data in organized fashion organizing positives & negatives
2. Discern major from minor patient problems
3. Formulate a differential while identifying the most common diagnoses
4. Identify indications for & appliy findings from the most common radiographic and diagnostic tests
5. Identify correct management plan considering contraindications & interactions
3. Clinical Skills - the student should demonstrate the following problem solving skills:
1. Assesses vital signs & triage patient according to degree of illness
2. Perform good auscultory, palpatory & visual skills
3. Perform a thorough physical exam pertinent to the rotation
4. Osteopathic Manipulative Medicine - the student should demonstrate the following skills in regards to osteopathic manipulative medicine
1. Apply osteopathic manipulative medicine successfully when appropriate
2. Perform and document a thorough musculoskeletal exam
3. Utilize palpatory skills to accurately discern physical changes that occur with various clinical disorders
4. Apply osteopathic manipulative treatments successfully     
5. Medical Knowledge – the student should demonstrate the following in regards to medical knowledge
1. Identify & correlate anatomy, pathology and pathophysiology related to most disease processes
2. Demonstrate characteristics of a self-motivated learner including demonstrating interest and enthusiasm about patient cases and  research of the literature
3. Are thorough & knowledgeable in researching evidence based literature
4. Actively seek feedback from preceptor on areas for improvement
5. Correlate symptoms & signs with most common diseases
6. Professional and Ethical Behaviors - the student should demonstrate the following professional and ethical behaviors and skills:
1.   Is dutiful, arrives on time & stays until all tasks are complete      
2. Consistently follows through on patient care responsibilities
3. Accepts & readily responds to feedback, is not resistant to advice
4. Assures professionalism in relationships with patients, staff, & peers
5. Displays integrity & honesty in medical ability and documentation
6. Acknowledges errors, seeks to correct errors appropriately
7. Is well prepared for and seeks to provide high quality patient care
8. Identifies the importance to care for underserved populations in a non-judgmental & altruistic manner

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