Medical Students as Teachers in Extended Care (MedTEC)



Medical Students as Teachers in Extended Care (MedTEC)

Background:

Members of the medical community frequently have inadequate knowledge of the different sites and levels of care in the community to which older adults are discharged from the hospital. This is partly due to the fact that medical school curriculum frequently does a poor job in disseminating knowledge and experience in these areas. As a result, many students acquire insufficient knowledge and understanding of levels of care. This can greatly impact the care of older adults and contributes to the problem of unsafe care transitions that frequently occurs amongst this population and often leads to readmissions to the hospital.

Goals:

Students will develop the knowledge, attitudes, and skills necessary to improve transitions of care for older adults and to provide appropriate care to older adults in the community.

Objectives:

At the end of the program, the learner will be able to:

1. List the levels of post-acute and extended care

2. Differentiate specific levels of care

3. Define transitions of care

4. Articulate ways to improve transitions of care

5. Differentiate

a. Inpatient (acute) rehab vs. skilled rehab

b. Long term acute care vs. inpatient rehab

c. Subacute vs. skilled nursing

d. Assisted living vs. long term care

6. Teach geriatric principles and other topics relevant to the care of older adults in post-acute and extended care to interdisciplinary facility staff members.

7. Identify a learning need of a patient and utilize a patient-centered teaching approach to address that need.

Program format and guidelines:

This is program will take place on the 2nd Monday of the Family Medicine/Geriatrics block from 8am to 5pm at Montefiore nursing home and skilled nursing facility.

1. Pre-program survey/test will be emailed to each student at the beginning of the FM/Geriatrics month.

2. Please arrive at Montefiore (1 David Meyers Parkway, Beachwood, OH, 44122, 216-360-9080) at 8am on the second Monday of the FM/Geriatrics block. Meet Dr. Lathia in the lobby by the fish tank.

3. We will gather together and informally talk about post-acute and extended care levels and transitions of care.

4. Then we will tour the facility- both long term care units and skilled nursing units, and the rehabilitation wing

5. Each student will be given 1 hour to talk with either a skilled patient or a long term resident. Ask the patient/resident about their experiences. For skilled patients- ask about the transition from hospital to SNF, their experiences while at SNF, and their goals for discharge. For long term care residents- ask how they came to live in a nursing home, their experiences while living at Montefiore, and their goals. Each student should also discover a learning need of the patient- can be any medical topic or question that the patient would like to learn about, preferably a topic relating to geriatric medicine. If there is time, also try to find the patient/resident’s chart, peruse it briefly, and note the medication regimen.

6. We will reconvene at the end of the morning for lunch. You can bring a bagged lunch. There is also a café (non-kosher) available within the facility where lunch can be purchased if desired. We will discuss your experiences with the patients.

7. In the early afternoon, we will talk briefly about principles of teaching to patients and to interdisciplinary staff members. If an in-service session is planned in the afternoon for staff members, students will be given materials to help prepare for the session.

8. Students will conduct (under guidance of Dr. Lathia) a brief (10-15 minute) in-service session for facility staff on a topic relating to the care of older adults.

9. If time permits, students will have the opportunity to carry out 1 or 2 additional exercises including 1. tour of other levels of care (assisted living, adult day care), 2. complete the “Passport to Therapy” exercise with physical and occupational therapists, and/or 3. meet again with their patients to provide education/counseling.

10. We will reconvene at the end of the afternoon to debrief on the day’s experiences

11. Students will be asked to complete the post-program survey/test online.

For any questions or concerns, please email Dr. Amanda Lathia at lathiaa@ or pager 216-444-4000, 84773

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