Passport to Therapy

Abstract

Abstract Introduction In 2010, a set of geriatrics competencies were outlined for internal medicine and family medicine residency programs to help guide their curriculum. These competencies include ability of internal medicine and family medicine residents working on inpatient services to work in conjunction with other healthcare providers (e.g., social work, case management, nursing, physical therapy) to recommend appropriate services based on clinical needs, social and financial resources, and the patient's eligibility for community-based services on discharge from hospital. The residents should also be able to screen older adults for risk for falls in both inpatient and outpatient settings, and be able to institute appropriate corrective measures. This resource was initially designed for geriatrics fellows at Cleveland Clinic, and adapted for internal medicine residents rotating through geriatrics to help them learn about different types of therapies, identify patients who may benefit from them, and understand how patients progress in their goals in these therapies. Methods In collaboration with the rehabilitation department at Montefiore Rehab, we have been doing this activity for the past 3 years. The learners spend a half-day in the rehabilitation department of a skilled rehab facility. They go through stations set up by the instructing therapists and observe patients participating in therapy. Results The residents at our institution enjoy the opportunity to visit a rehab facility, interact with therapists and patients, and observe therapies being performed on actual patients. They have graded the occupational therapy and adaptive equipment sessions as a very useful learning experience. They have graded the physical therapy station as a less interactive learning experience, and suggested hands-on experience at physical therapy sessions and the possibility to observe gait training and muscle strengthening exercises on non-surgical patients. They have also expressed interest in observing a swallow evaluation being performed on patients. Discussion This activity is designed for internal medicine residents who rotate through geriatrics every month at Cleveland Clinic. They spend a half day in rehabilitation department of a skilled rehab facility. They go through stations set up by the instructing therapists as described above, and observe patients participating in therapy. They experience the nursing home environment, see patients progressing in therapy, and learn about gait and balance assessments, use of assistive devices, roles of physical, occupational and speech therapies. They enjoy this experience immensely.

Keywords

• Resident Education
• Geriatrics
• Rehabilitation
• Accidental Falls
• Falls