During my geriatrics rotation, I completed two site evaluations with Arti, PA-C from NYPQ. These evaluations were very informative as I presented patient cases and was tested on pharmacology cards that I created based on medications frequently encountered in my rotation. Each evaluation session was structured to encourage active learning and peer collaboration.
In my first evaluation, I presented a case involving a patient with a chronic cough, which we were investigating as a potential result of pneumonia or an exacerbation of congestive heart failure. After I shared my case, Arti assessed my pharmacology knowledge by reviewing the drug cards I had prepared. Following our individual presentations, Arti led a group discussion on a new case, which was a patient presenting with diarrhea. As a group, we worked through the steps of formulating a comprehensive workup. This interactive approach was highly beneficial, and I believe incorporating case discussions like these are valuable for all participants in the evaluation.
In my second evaluation, I presented another case, this time involving a patient for whom the geriatrics team was consulted on the internal medicine floor. This case was particularly memorable because it involved a patient with a history of recent falls. We conducted a thorough cognitive and neurological evaluation, which led us to consider several differential diagnoses, including various types of dementia and conditions like normal pressure hydrocephalus. The patient exhibited significant changes in cognition, memory, personality, ambulation, and coordination, making the case both complex and emotionally challenging due to the noticeable deterioration in their condition. This experience really showed me the diagnostic power of the physical exam in narrowing down differentials before ordering any additional labs or imaging.
As part of the second evaluation, I presented a research article comparing the efficacy of the Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) for diagnosing mild cognitive impairment. I chose this paper to introduce my peers to the MoCA, as MMSE is typically emphasized in school, yet other tools like MoCA can offer valuable insights into cognitive function.
To conclude the evaluation, Arti shared a set of multiple-choice questions with us, which we completed as a group. This activity was not only engaging but also excellent practice, as it reinforced key concepts and challenged us to think critically. I am grateful for the supportive and collaborative environment Arti fostered, which made each session a rewarding learning experience.
