Mary Lindholm Frank Domino Robert Baldor Judy Savageau Karen Rayla A Little Help From Our Friends! Interdisciplinary Teaching to Address Obesity, Tobacco, Substance Abuse and Gait Assistive Devices in Family Medicine Clerkship Mary Lindholm Frank Domino Robert Baldor Judy Savageau Karen Rayla

Objectives Review the components of our curriculum addressing obesity, substance abuse, smoking cessation and gait disorders Review these curricula's evaluations from 2 years of 3rd year students Discuss successes and areas of difficulty Share best practices for integrating interprofessional education to better teach healthy living

Family Medicine at UMass 5 week clerkship 4 “core” sessions of case-based discussion around virtual McQ family Additional sessions cover: motivational interview with an SP, communicating with a pharmacist and a grocery store tour ~ 19 Days with community based preceptor

Components of Healthy Living Curriculum Web Based Tutorials in: Motivational Interviewing Obesity Education Dietary Counseling Methods Exercise options Smoking Cessation via Lung Age Nutrition videos Gait assistive devices

Opportunities for Interprofessional Learning Dietician leads grocery store tour focusing on reading food labels and advising Mike McQ who has HTN, hyperlipidemia, and is a meat and potato man Psychologist takes MI to the next level beyond 1st year curriculum and is followed by SP session allowing practice in MI Pharmacist answers questions about his role in narcotic prescribing

McQ Curriculum Mike McQ-55 yo male referred by the safety manager at work for bp of 165/100. Active at work but no regular exercise. Smokes 1 ppd and not ready to quit, drinks a couple of six packs on the weekend, eats mostly meat and potatoes.

Nutrition Curriculum Online modules Grocery store tour/Nutritional videos which address label reading MI training for dietary counseling

Nutrition Curriculum Review

Nutrition Confidence Over the Year Pre and Post Clerkship

Smoking Cessation On line module on smoking intervention MI session with psychologist and standardized patient addressing smoking Lung age monitor module and instruction

Smoking Cessation Curriculum Review

Confidence with Tobacco Cessation Pre and Post Clerkship

Substance Abuse Curriculum Assigned readings address the scope of the problem and responsible use of medicine for pain Case based discussion of John McQ Pharmacist question and answer session

McQ Curriculum John McQ=35 yo male who hurt his back moving furniture. Unplanned 3rd child just born. An extra scotch at night is helping him deal with his stress Given Percocet by the ER for back pain. Pain is improving but would like to have some on hand in case he needs it again. Pharmacy also called to let you know he is receiving temazepam from several different providers.

Pharmacy Session (Sample topics discussed) Physician Monitoring Program (PMP) Provider/pharmacist communication Med disposal Pharmacists liability Refusal to prescribe

Substance Abuse Curriculum Evaluations

Pain Meds Over the Year Pre and Post Clerkships

Gait Assistive Equipment

Obstacles Lung Age Meters-are they a scare tactic? Coordination of dietician/grocery store tour Student prep Cost/grant support Increasing narcotics abuse Lung age meters: expensive, require sharing and returning. Generally preceptors aren’t using them, so students are shy about using them A lot of on line curriculum/reading that doesn’t get done

Despite effort, opioid deaths still climbing in Mass Despite effort, opioid deaths still climbing in Mass. Boston Globe 10/21/15 Growing epidemic across the country Governor Baker proposes legislation to address problem in MA Mandated curriculum

Successes: Curriculum Ratings Scale of 1-4

Successes Enhancing student knowledge, especially in the area of pain med prescription and narcotic abuse Increasing knowledge of other professionals and how we can work together to help patients with difficult problems Decreases burden on community preceptor a small amount? All the interprofessionals have been enthusiastic teachers, often continuing to teach beyond funding

Audience Discussion How have you incorporated interprofessionals in your curriculum? Any innovative teaching methods around lifestyle modification or substance abuse? Funding ideas for these pieces?

Summary Family medicine plays a vital role in teaching about lifestyle modification, and pain medication Using psychologist, dieticians and pharmacists enhances the curriculum and opens learners eyes to the roles these professionals play in our patients lives