1. 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

2. 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

3. 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

4. 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

5. 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

6. 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.

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

8. Nutrition Curriculum Review

9. Nutrition Confidence Over the Year Pre and Post Clerkship

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

11. Smoking Cessation Curriculum Review

12. Confidence with Tobacco Cessation Pre and Post Clerkship

13. 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

14. 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.

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

16. Substance Abuse Curriculum Evaluations

17. Pain Meds Over the Year Pre and Post Clerkships

18. Gait Assistive Equipment

19. 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

20. 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

21. Successes: Curriculum Ratings
Scale of 1-4

22. 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

23. 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?

24. 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