Program Coordinator: Diana Galindo, MD

Faculty: Diana J. Galindo, MD, Kerry-Ann Miller, MD 
Location: Cleveland Clinic Florida outpatient at Weston and Sunrise Health and Rehabilitation Center (skilled nursing home).

Duration: 4 weeks
Availability: Year round
No. of Students: 1
Time: Full time

Description

Medical students in Geriatric Medicine to include exposure to inpatient services on older person admitted to Sunrise Health and Rehabilitation Center, a skilled nursing facility also in Sunrise and outpatient geriatric assessment at the Cleveland Clinic Florida outpatient department. The curriculum incorporates recommendations made by the American Geriatrics Society, the American College of Physicians, and the Society of General Internal Medicine. The rotation focuses on comprehensive care of the frail and older persons with chronic problems and with acute exacerbations of those problems and usually affecting their functional status. There are also permanent residents of the nursing home that will need health maintenance and evaluation during their rotation.

Goals

  1. To prepare resident to perform a comprehensive medical evaluation of frail and older persons with an acute illness and to determine the effect of chronic diseases on rate of recovery and maintenance of functional ability.
  2. To gain expertise in the evaluation and management of common and challenging geriatric syndromes, e.g. dementia, depression, delirium, urinary incontinence, gait disorders with falls, immobility, failure to thrive, pain disorders and functional decline which are commonly neglected in the frail and older persons residing at the nursing homes or undergoing rehabilitation at the hospital.
  3. To achieve the skills of effective communication with the older person.
  4. To be familiar with the psycho-social needs of the older person.
  5. To master a basic working knowledge of aging physiology and pharmacology.
  6. Explicit knowledge of geriatric syndromes and common geriatric problems.
  7. To become familiar with resources such as adult day care centers, assisted living facilities, skilled nursing facilities and rehabilitative services for the frail elderly.

Educational Content

Medical history and physical examination will be performed on new patients and all patients being followed at the clinic and the nursing home. Medical student will prepare a detailed history of the present illness, summarize the pertinent past medical history as well as focus on pertinent functional status e.g. activities of daily living, instrumental activities of daily living, social support, nutritional status, neuropsychiatric illnesses and any sensory deficits. Formal presentation will be made in a case that will be presented to the attending physicians on the last week of the rotation (usually the last Monday at 12 noon). Specific lectures on various geriatric syndromes and geriatric assessments will be given to the medical student.

Principal Educational Materials

Standard medical text books, relevant articles from peer reviewed medical literature, medical grand rounds, individual one on one teaching and computer guided literature searches will be the principal educational material used for this course.

Evaluation

Standard medical student evaluation will be reviewed with the resident at the end of the rotation. The results of this evaluation will be forwarded to the Program Director of Internal Medicine Department.

This curriculum has been reviewed by me as well as the faculty involved with this rotation. This has been distributed to the staff in my section who is involved with Internal Medicine Resident education. Each medical student will receive a copy of this curriculum before beginning the rotation. In an effort to continually improve the content of this curriculum, changes may be made throughout the academic year based on the feedback from the medical students, residents and staff.