1. Medical Students as Teachers in Extended Care (MedTEC): Development of an interdisciplinary teaching program for medical students
Amanda Lathia, MD, MPhil
Cleveland Clinic Lerner College of Medicine
Center for Geriatric Medicine

2. Needs Assessment Medical students on geriatric rotation
Lacked formal training in levels of care
Struggled with differentiating care levels
Unable to identify appropriate levels for patients

3. Program Goals Develop knowledge, attitudes, and skills necessary to:
Identify appropriate levels of care for older adults in the outpatient and inpatient settings

4. Program objectives The learner will be able to:
List the levels of post acute and extended care
Differentiate specific care levels
Define components of successful transitions

5. Program Context 3rd year medical students Required month long rotation
Family medicine/geriatric medicine
1 day at a facility offering long term, assisted living, and skilled nursing care

6. Program Structure Informal group discussion on levels of care
Tour of facilities- assisted living, skilled nursing, long term care, and clinical dementia unit
Preparation for in-service
In-service for facility staff
Patient interviews

7. Discussion on levels of care

8. Student led in-service

9. Tools Levels of care pocket card
post-acute and long term care settings
Informational pamphlet for patients

10. Program Assessment Pre and post program surveys
Demographic information
Multiple choice knowledge test
Self-efficacy/attitude scale
Program feedback
Administered using REDCap
Evaluate changes in self-efficacy/attitudes and knowledge
REDCap is a secure, web-based application for building and managing online surveys and databases.

11. Confidence in care of hospitalized elders
confident in my ability to provide appropriate care for older adults in the hospital.
confident in my ability to provide appropriate care for older adults in the outpatient setting.
knowledgeable about the different levels of post-acute and extended care in the community.
knowledgeable about the discharge process and how to determine the most appropriate disposition for each patient upon discharge from the hospital.
Personal contact with the post-acute care physician prior to hospital discharge is necessary.
Question Key
Confidence in care of hospitalized elders
Confidence in care of elders in outpatient setting
Knowledge of levels of care
Knowledge of discharge process and ability to determine appropriate disposition
Importance of personal contact with post-acute care physician

13. Future directions Assessment of program outcomes
Use of students’ patient logs
Identify appropriate level of care for patients seen in clinic
Feedback from preceptors
Long term follow up
Use of control group
Expansion of program to other trainees

14. Conclusions MedTEC Unique educational approach
Improves knowledge of levels of care
Improves attitudes/self-efficacy
Model program
model for building physician competency on managing medical and psychosocial conditions in different settings of care.

15. Acknowledgements Barbara Messinger-Rapport, MD, PhD HRSA, GACA
Montefiore nursing facility
Donald W. Reynolds FD~AGE Program
Duke University mini-fellowships
Mitchell Heflin, MD, MHS
Sandro Pinheiro, PhD