Diary of an MSTAR Student
Diary of an MSTAR Student

The MSTAR Program encourages medical students to consider a career in academic geriatrics by providing summer research and training opportunities. Follow these students as they journey through new experiences in the lab, classroom, and clinic.  Click here to read entries from previous years.

Diary of an MSTAR Student: Courtney Maloney

Oct 19
12:07 pm

Diary of an MSTAR Student: Courtney Maloney View MoreBACK

Posted by Gemma Martinelli


Courtney Maloney, 2015 UC San Diego MSTAR Student

 

After taking a small group course in undergrad on aging, death, and dying, I became interested in the subject of aging and working with elders. Between my sophomore and junior I founded Bears for Elder Welfare (the Bear being the UC Berkeley’s mascot) a student-run organization dedicated to educating the campus and wider community on issues in aging and volunteering with the local elder community.

Entering medical school I wanted to further pursue my interest in aging so I am so grateful for this opportunity to participate in geriatrics research through the Medical Student Training in Aging Research (MSTAR) program at UC San Diego.

My MSTAR project took place at Senior Behavioral Health (SBH), a voluntary in-patient psychiatry unit at University of California San Diego Medical Center- Hillcrest, in Downtown San Diego. I worked with Ipsit Vahia, MD, geriatric psychiatrist and Director of Research for SBH.

Our project aims to identify whether and how iPads can be used as a tool to improve psychiatric care by reducing behavioral symptoms and antipsychotic medication use. The primary goals are to establish if iPad applications can be used to control patient’s behavior, and if so what types of applications are most effective, and for which conditions. We aim to collect quantitative data (iPad-use logs, behavioral PRN medication logs, mental status testing, and demographic information.) We also aim to collect qualitative information in a narrative form, to develop case studies that may guide iPad use in the community.

One of my favorite aspects about this project is the amount of one-on-one-time I get with the patients. Rounds at Senior Behavioral Health begin at 9:00 AM on Mondays, Wednesdays and Fridays. As a rising 2nd year student with limited clinical experience just being able to absorb rounds has been a great learning experience. In the early afternoon my work with the patients really begins. There are 70+ apps on the iPad available for patients to use. I go into the “living room” of the unit and see if any patients would be interested in using the iPad with me, sit with them, help them choose an app, and help them use the app as much or as little as they would like.

One of my most memorable patients, lets call her “Jane” had a primary diagnosis of psychosis. She also had a history of stroke and was missing teeth which both contributed to dysarthria. One of my primary difficulties working with Jane was learning to understand her. I would ask if she would like to use the iPad with me or what type of app she would like to use and I would often have difficulty understanding her answer. I have even tried having her write out her response, but unfortunately that has not much success either.

In the end I decided to try the “pond” app with her. This app mimics an interactive koi pond. When you touch the water, it ripples and the fish swim in the other direction. You can add lily pads, fish, and dragonflies, which all contribute to the serene milieu of this app. I sat with the patient and demonstrated how to use it, moving my finger on the screen as the water rippled. Jane’s mouth opened into an “o” and her eyes widened. I added two orange fish and she made a sound of pure delight. I held the iPad out to her telling her she could try as well, but she just watched in rapt attention as I added more fish and ripples to the pond. After some time I would ask if she would like to keep going, and we would continue until she would shake her head and verbally signify that she was done. I used the pond app with Jane twice, both to a good reaction, but after hearing a tip from a staff member that she liked Elvis music I decided to try something new. I first played “Hound Dog” and Jane smiled and danced in her wheelchair, bobbing her head and arms to the music as a nurse joined in. We played songs and danced until Jane grew tired. These types of interactions have been my favorite aspect of the project, as I enjoy spending time with the patients.

Currently and even once I complete my full-time work on this project and get back to school, I will be mostly involved in the “writing” aspect of this project. I am working on both a peer-reviewed type of manuscript and an iBook targeted to the general public, to help guide iPad use in the larger community.

I have treasured this summer as an MSTAR student and all the opportunities it has afforded me, both as an opportunity to learn more about geriatrics, psychiatry, and clinical medicine as a whole and also for the privilege to be able to just sit down with patients, (with an iPad or not!) and spend my day with them.

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