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Skin and Chronic Wound Care in Older Adults

Course Description | Faculty | Accreditation | General Information

Course Description

Acknowledgement: This module is supported by a grant from the Donald Reynolds Foundation.

Skin and chronic wound problems are common clinical challenges for physicians and trainees who provide care for older patients. Appropriate assessment and wound care management decisions require focused, specific knowledge of the unique characteristics of older patients’ skin and predisposition to chronic wounds. However, this topic is not routinely and adequately covered in most residency training curricula. This is unfortunate, as chronic wounds can be problematic not just for the patient, but also to facilities, as failure to heal or prevent them can lead to litigation and reimbursement issues. To address this challenge, we developed a web-based, interactive virtual patient program that aims to educate clinicians on the multi-modal management of skin and chronic wounds in geriatric patients. The module consists of five cases representing common clinical scenarios that highlight the principles of assessment and treatment of common chronic wound conditions: normal aging skin, skin tears, foot ulcers in persons with diabetes, venous stasis ulcers, and pressure ulcers. At the end of the module, the learner will be able to describe the normal changes of aging skin, identify risk factors for the development of chronic wounds, prevent skin tears and common types of chronic wounds, and compose a treatment regimen for these wounds. Videos, including how to properly dress a skin tear, perform compression wrapping, and probe and swab a chronic wound, are included. Questions are interspersed within each case and text feedback is provided to reinforce learning. References are provided with links to full PubMed abstracts.

Original Release: 2/18/2009
Most Recent Update: 9/29/2011
Termination Date: 9/29/2014

NUMBER OF CREDIT HOURS: The Harvard Medical School designates this enduring material for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 2 hours to complete.

COST: $40.00 for the average learner. Participants living in emerging nations receive a 50% discount or can register for free. See our International Pricing Page for details.


  1. To acquire knowledge and skills in common chronic wound care conditions in older adults.


  1. Describe the changes in skin that occur with normal aging.
  2. Identify risk factors for the development of chronic wounds.
  3. Prevent skin tears and common types of chronic wounds (including foot ulcers in persons with diabetes, venous stasis ulcers and pressure ulcers).
  4. Compose a treatment regimen for skin tears and common types of chronic wounds.


Registrants participate in the learning process by answering interactive multiple choice questions that are dispersed throughout the case presentation. You must answer a question correctly in order to continue through the course. If you answer a question incorrectly, you will be prompted to try again.

In order to earn credit, physicians must complete the entire educational activity before the termination date (see above). Non-physicians may register for the course but are not eligible for AMA PRA Category 1 Credits™. Instead, non-physicians will earn a certificate of participation after successfully completing the course before its termination date.


This internet enduring material is a case-based, interactive presentation comprised mainly of text, interactive questions, and images. A variety of media, including video clips, audio clips, and Flash animation, may be presented. Links to any necessary plugins are provided when necessary, but no plugins are required for general use of the CME website, and you may skip the multimedia presentation(s) within the course if you choose.

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Course Director
Dr. White-Chu chose to specialize in geriatric medicine due to the patients’ medical complexity and opportunity to provide quality care to those in need. After completing her internal medicine residency at Oregon Health & Science University in Portland, OR, Dr. White-Chu served as a primary care provider in a Program for All-Inclusive of the Elderly. She elected to move to Boston, MA for a two-year geriatric fellowship at Harvard Medical School. She quickly realized her geriatric background lent itself to a holistic approach to chronic wound care. Furthermore, she appreciated there was a lack of chronic wound care education for health professionals. She is an International Interprofessional Wound Care Course graduate and a graduate of the Harvard Macy Institute Program for Educators in the Health Care Professions. She has received a Geriatric Academic Career Award -- a five-year clinician educator award -- for her Interdisciplinary Curriculum in Chronic Wound Care for Older Adults.

The commercial entities with which I have relationships do not produce health-care related products or services relevant to the content I am planning, developing or presenting for this activity.

Course Contributor
Grace Huang, MD, is the Director of the Office of Educational Technology at the Carl J. Shapiro Institute for Education and Research, a joint venture between HMS and Beth Israel Deaconess Medical Center (BIDMC) in Boston. She also works as a hospitalist at BIDMC. She has spent a number of years designing web-based modules on clinical skills, including computer-based case simulations (“virtual patients”), physical diagnosis tutorials, interactive pathophysiology diagrams, and procedure-based instruction. She serves as a consultant to the Association of American Medical Colleges in their initiative to promote scholarship and sharing of educational materials through MedEdPORTAL. Her clinical research interest is in the impact of a formal hospital-based procedure service on complication rates among internal medicine residents.

Dr. Huang's spouse works at Pfizer, Inc., and she holds stock options and shares in the same company.

Course Contributor
Dr. Reddy is an Instructor of Medicine at Harvard Medical School and Medical Director of the Wound Healing Clinic at Hebrew Rehabilitation Center in Boston, MA. She is the past Director of the Wound Healing Clinic in the Division of Plastic Surgery at the Lahey Clinic in Massachusetts. Dr. Reddy completed Internal Medicine training in 1999, and Masters of Science in Clinical Epidemiology and subspecialty training in Geriatric Medicine at the University of Toronto in 2001, followed by a fellowship in Skin & Wound Healing in the Division of Dermatology at the University of Toronto 2001-2002, and was Faculty of the annual International Interdisciplinary Wound Care Course. Dr. Reddy is Assistant Editor of the Journal of Geriatrics and Aging, has published several papers on chronic wounds and textbook chapters, speaks frequently at educational events and has recently completed a book for patients and families on caring for chronic wounds.

The commercial entities with which I have relationships do not produce health-care related products or services relevant to the content I am planning, developing or presenting for this activity.

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Dr. Angela Catic, a geriatric clinician educator at Beth Israel Deaconess Medical School and Harvard Medical School, is the recipient of a Hartford Center for Excellence Research Fellowship Award and two Geriatric Academic Career Awards. She utilized these awards to develop multidisciplinary educational programs regarding the safety of elders during acute hospitalization. Particular areas of focus include pain management; delirium prevention and management; successful care transitions; and appropriate care of elders with advanced dementia.

Dr. Catic also co-directs ECHO-AGE, a tele-medicine educational program which trains long term care providers in the management of elders with dementia and associated behavioral issues. She holds a number of leadership roles including directing the Harvard Geriatric Medicine Fellowship program, leading the fourth year Harvard Medical School geriatric elective, and directing the educational component of the geriatric elective for internal medicine residents at Beth Israel Deaconess Medical Center.

The commercial entities which which we have relationships do not produce, market, re-sell, or distribute health care goods or services relevant to the content I am planning, developing, presenting, or evaluating for the activity.

Dr. Frank J. Domino is an Associate Professor and Family Medicine Clerkship Director at the University of Massachusetts Medical School. He was the Associate Editor for Family Medicine to the Up To Date medical database, and is currently the Editor in Chief of Lippincott, Williams and Wilkins’ "5 Minute Clinical Consult" series.

Dr. Domino’s major areas of focus include educating all levels of learners (students, graduate and post graduate) in a variety of subjects including Evidence Based Medicine, Sports Medicine, and common ambulatory controversies (Vitamin D Deficiency, Medical Ethics, Non-Pharmacologic Treatment of Depression and Anxiety). Dr. Domino’s areas of faculty development training include Problem Solving, Needs Assessment, Ambulatory Medical Ethics, Presentation Skills, and Fluency/Professional Development in the Medical Literature.

Dr. Domino has received numerous teaching awards, including multiple Outstanding Medical Educator Awards and the Outstanding Achievement "Star" Award for Curricular Contribution to the University of Massachusetts Medical School. Dr. Domino is the Family Medicine representative to Harvard Medical School’s Continuing Medical Education program "Current Clinical Issues in Primary Care" Pri-Med committee as well as the University of Massachusetts Medical School’s Continuing Education Committee. He is a regular contributor to and holds an appointment in the Community Faculty Development Center at the University of Massachusetts. His areas of clinical research include Vitamin D Deficiency, and the translation of medical research into practice.

Wolters Kuhler Publishing, Editor in Chief, 5 Minute Clinical Consult, Primary Care Medicine; no direct financial payment RxPalm, Incl., President; Medical Editing company

Richard Hodin MD is Professor of Surgery at Harvard Medical School and Attending Surgeon at the Massachusetts General Hospital. His clinical interests are in GI and Endocrine Surgery. He is Surgical Director of the MGH Crohns and Colitis Center and Chief of the MGH Endocrine Surgery Unit. Dr. Hodin runs an NIH-funded research laboratory that is focused on the gut mucosal barrier dysfunction that accompanies a variety of disease states, including starvation, IBD, and severe sepsis.

Reported no relevant financial relationships with commercial entities

Bio and Photo Coming Soon.

Reported no relevant financial relationships with commercial entities

Dr. Siobhan Ryan is an assistant professor in the Division of Dermatology, Department of Medicine of the University of Toronto. She works in the Wound Healing Clinic of Women’s College Hospital, Toronto Canada. Dr. Ryan is Chair of the Education Committee of the Department of Medicine of Women’s College Hospital and has been involved in the design of many continuing medical education programs related to both wound healing and dermatology.

Company: ARTEC Type of Relationship: Scientific Advisory Board (no renumeration) Content Area: Tissue Engineering Research Advice on Clinical Applicability Company: Astellas Pharma Candada, Inc. Type of Relationship: Clinical Trial Content Area: Psoriasis

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Course Planners
Dr. Sanjiv Chopra is Professor of Medicine and Faculty Dean for Continuing Medical Education at Harvard Medical School and Senior Consultant in Hepatology at the Beth Israel Deaconess Medical Center, Boston. In his role as Faculty Dean for Continuing Education, Dr. Chopra provides oversight and leadership of the Department and oversees the academic development of our programs. Dr. Chopra is an experienced clinician, researcher, and educator. In his research roles, he has served both as a principal investigator as well as co-investigator. He has more than 120 publications and five books to his credit, addressing topics in disease states, patient care, and leadership. Dr. Chopra’s teaching experience is extensive, and he has won numerous teaching awards for his work with medical students, residents and physicians. Currently, he directs and speaks at 10 multiday CME courses, nine of which are through HMS. For his full bio, please click here.

Reported no relevant financial relationships with commercial entities

Andi Long directs the Department of Continuing Education’s Distance Learning group, which offers a variety of online continuing medical education programs to health care professionals around the world. Andi develops strategies for new pilot programs and systematically rolls out new distance learning initiatives and has a leadership role in IT planning and other online processes for HMS DCE. She oversees the day-to-day operations of each distance learning activity and ensures ACCME compliance across all enduring programs. She has had the privilege of working with hundreds of Harvard Medical School Faculty members to develop high-quality, engaging online programs that physicians in more than 170 countries have taken part in. Andi earned her Ed.M. in Technology, Innovation, and Education from Harvard Graduate School of Education and graduated from Bridgewater State College with a degree in English. Her professional interests focus on teaching and learning with new technologies and online course development.

Reported no relevant financial relationships with commercial entities

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The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Harvard Medical School designates this enduring material for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 2 hours to complete.

Within 2 weeks of completing the course, you will receive your certificate via email.

Click the image to view a sample of the certificate

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General Information


Any computer running Windows, Mac OS, or Unix machines are supported.

Internet Connection
Your computer should be configured to access the Internet. A high speed internet connection may be required to view some of the large multimedia files.

Firefox or Internet Explorer 5.5 or higher are recommended. JavaScript and cookies must be enabled.

Some of the multimedia resources in this course require Apple Quicktime, RealMedia, or a Flash player. You will be prompted to download the appropriate plugin when necessary. No plugins are required for general use of the CME website, and you may skip the multimedia presentation(s) within the course if you choose.


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