Credits		3 credits
Coordinator/Primary Instructor		Dr. Estus (Dr. Hume & Dr. Eisenhower, co-coordinators)
Semester offered		Fall
Catalog Description		Broad issues in geriatrics including age-related physiologic changes, pharmacokinetics and pharmacodynamics, clinical assessment techniques, models of care, interdisciplinary teams, management of chronic diseases and drug therapy in older adults.
Estimated Enrollment		45 (P3 students or permission of instructors)

 

Detailed Course Description

Using diverse teaching techniques and active learning strategies, students will develop an understanding of age-related physiologic changes affecting pharmacokinetics and pharmacodynamics, assessment techniques for evaluating functional status as well as complex drug regimens, importance of interdisciplinary teams in the process of care, issues in evaluating evidence from clinical trials and recognition of the limitations of evidence-based practice in geriatrics.

Students will gain a broad understanding of clinical geriatrics that emphasizes a patient-centered approach to care and  in the management of complex drug therapy in older adults. Active, self-directed learning by students is a primary goal of this course.

 

Learning objectives upon completion of this course

1. Identify physiological changes in older adults that influence pharmacokinetic and pharmacodynamic parameters of  medications;
2. Demonstrate the use of common clinical assessment tools including Mini Mental Status Examination, Activities of Daily Living, Braden scale, etc;
3. Analyze the respective roles of different health professionals on interdisciplinary teams caring for older adults;
4. Discuss models of care for frail older adults including adult day care, assisted living, and nursing home;
5. Identify issues in communicating effectively with older adults and caregivers especially with respect to medication adherence;
6. Describe cultural competency and health literacy including their influence on working effectively with older adults and caregivers;
7. Evaluate the impact of common geriatric syndromes, their presentation, and management in older adults;
8. Develop an individualized drug regimen in medically complex older adults for achieving appropriate health outcomes.

 

Activities/Class Format

Early in the semester, there will be a focus on fundamental principles in geriatrics. Evaluating and discussing patient cases as well as group activities will be integrated throughout the semester to further the learning objectives. This course will incorporate problem-based learning approaches. Course faculty expect that all students will be proactive in their own learning especially regarding diseases, pharmacotherapy, and other issues that may not have been covered in the core curriculum of the Doctor of Pharmacy program.

In-Class Activities
Traditional lecture style format is minimized whenever possible. The small class size enourages participation and all students will be involved in class discussions. Sample in-class activities include: aging simulation, working with older adult assessment tools such as fall risk or MMSE with opportunities to assess actual older adult volunteers), patient interview techniques, choosing a nursing home, Medicare Part D formulary selection, health literacy tools, older adult patient volunteers visit to class, patient care conference, Book club and Film club discussions, Controversy presentations, many patient case discussions. There is frequent involvement with P4 students participating in geriatric rotations to provide input and facilitate discussion.

Site Visits
Students will visit local older adult care sites as part of class, sometimes meeting there instead of campus during class meeting time in order to participate in activities with the older adult volunteers. Activities in previous semesters have included: Film club, Wii® Wednesdays, tai chi, Investment Club, and Around the World travel series at South Bay Manor; Long-term care (LTC) pharmacy visit and consulting pharmacist opportunities at Omnicare.

Other opportunities include teaching computer skills to older adults or senior center activities. Last fall, the class was also involved with a Wii® Bowlathon and Wellness Fair at South Bay Manor. All of these activities occur with older adults and encourage intergenerational communication.

Adopt-a-Patient Project
Students, in groups of two, are partnered with an older adult volunteer from a local assisted/independent living facility. Students perform an initial interview early in the semester including medical history, brief physical assessment, medication review (including usage and storage), evaluation of fall risk, and fall risk assessment. Students “adopt” the patient, returning several times to visit and obtain updated information. Students discuss their de-identified patient issues with course faculty and with the class.

This activity counts for 20% of the course grade and components include: patient interview, SOAP note with prioritized problems identified, counseling points prepared addressing appropriate health literacy, discussion with Wellness Director and prepared discussion points, patient counseling session to review findings, and presentation of the final patient case to the class. P4 students are involved with this project for assistance.

Examinations
Two exams will be given during the semester. There is no final exam.

 

Grading
(Example from Fall 2008- subject to change)

Exam 1	15
Exam 2	15
Adopt-a-Patient project	25
Controversy Presentation	10
Book club scientific paper	30
Film club reflection	5
Total Points	100