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Chao CT. Literacy for Frailty among Undergraduate Medical Education: An Under-Recognized Opportunity to Improve Geriatric Care. Aging Dis 2024; 15:1482-1486. [PMID: 37815896 PMCID: PMC11272203 DOI: 10.14336/ad.2023.0925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Our society is aging much faster than it was before, and this phenomenon demands concerted action to optimize geriatric care. Presentations, clinical features, and management decision making are distinct between older adults and the general population, and to enhance care quality, there remains unmet needs for undergraduate geriatric education. Among all geriatric syndromes that clinically matter, frailty is particularly instrumental, serving as the overarching phenotype that connects other geriatric conditions and predisposes individuals to adverse outcomes. However, understandings for frailty, or "literacy for frailty" is often poor among healthcare professionals, and misidentification, terminology confusion, and uncertainty surrounding the care of frail older adults, are not uncommon. This lack of frailty literacy undoubtedly contributes to the suboptimal geriatric care patients receive. We therefore propose a rationally designed, concise, and structured program for eliciting medical students' motivation for understanding frailty during their undergraduate period. Our increasing-frailty-literacy program includes 7 modules, accommodating the terminology, integrative pathogenesis, epidemiology of frailty, appropriate screening and identification tool selection, prognostication and patient communication, and individualization of treatment strategies. In combination with digital technologies and hands-on practice opportunities, we believe that our curriculum can promote medical students' learning efficacy for frailty and improve geriatric care for the current generation.
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Affiliation(s)
- Chia-Ter Chao
- Nephrology division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Nephrology division, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
- Graduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, Taiwan.
- Center of Faculty Development, National Taiwan University College of Medicine, Taipei, Taiwan.
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Mohd Tohit NF, Haque M. Preparing the Younger Generation for an Aging Society: Strategies, Challenges, and Opportunities. Cureus 2024; 16:e64121. [PMID: 38983672 PMCID: PMC11231670 DOI: 10.7759/cureus.64121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2024] [Indexed: 07/11/2024] Open
Abstract
The global demographic landscape is experiencing a monumental shift as populations age, driven by advances in healthcare and declining birth rates. This transition underscores the need to prepare the younger generation to navigate and contribute effectively to an aging society. This manuscript comprehensively reviews strategies to equip younger generations with the requisite knowledge, skills, and empathy to support an aging population. This study identifies critical challenges and opportunities in fostering intergenerational solidarity and understanding through an extensive analysis of existing literature and innovative educational programs. The review highlights the importance of early education, community engagement, and policy interventions in bridging the generational divide. Additionally, it explores the role of technology and digital media in facilitating awareness and empathy among young people. Key findings suggest that incorporating aging-related content into educational curricula, promoting volunteerism, and implementing supportive policies can significantly enhance the younger generation's readiness to support an aging society. The manuscript concludes with recommendations for future research and practical steps for educators, policymakers, and community leaders to foster a more inclusive and age-friendly environment. By preparing the younger generation today, we can build a more cohesive and supportive society for tomorrow.
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Affiliation(s)
- Nor Faiza Mohd Tohit
- Department of Community Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, MYS
| | - Mainul Haque
- Karnavati Scientific Research Center (KSRC), School of Dentistry, Karnavati University, Gandhinagar, IND
- Department of Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
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Moll-Jongerius A, Langeveld K, Tong W, Masud T, Kramer AWM, Achterberg WP. Professional identity formation of medical students in relation to the care of older persons: a review of the literature. GERONTOLOGY & GERIATRICS EDUCATION 2024; 45:424-437. [PMID: 37170948 DOI: 10.1080/02701960.2023.2210559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
With the growing population of older persons, medical students have to be well prepared for older persons' health care during medical school. Becoming a doctor is an interplay of building competencies and developing a professional identity. Professional identity formation of medical students is a relatively new educational concept in geriatric medical education. This review aims to explore the concept of professional identity formation of undergraduate medical students in relation to the care of older persons. Twenty-three peer-reviewed studies were included and summarized narratively. Patient-centeredness, caring and compassion, collaboration and holistic care are characteristics of the doctor's professional identity in relation to the care of older persons. Participating in the context of older persons' health care contributes to the becoming of a doctor in general. In this context, the building of relationships with older persons, participating in their lives and role models are important influencers of professional identity formation. Furthermore, the perceptions and expectations medical students have of future doctoring influence their feelings about the care of older persons. To prepare medical students for older persons' health care, professional identity formation seems to be a relevant educational concept.
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Affiliation(s)
- Annemarie Moll-Jongerius
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Kirsten Langeveld
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Wing Tong
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Tahir Masud
- Department of Health Care for Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Anneke W M Kramer
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Parizian-Steinberg N, Benyamini Y, Weiss-Gal I. Factors Associated with the Intention to Work with Older Adults Among First Year Social Work Students in Israel. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:588-604. [PMID: 38590186 DOI: 10.1080/01634372.2024.2339972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
This study examined a model based on the Terror Management Theory and the Theory of Planned Behavior (TPB) to identify factors associated with social work students` intention to work with older adults. A cross-sectional study with a sample of 375 first-year Israeli social work students was undertaken. Attitudes, subjective norms and perceived behavioral control were directly associated with this intention. Contact with older adults was related to anxiety about older adults, which along with anxiety about self-aging, was related to the TPB constructs. The model explained 63% of the variance of the students` intention to work with older adults.
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Affiliation(s)
| | - Yael Benyamini
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Idit Weiss-Gal
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Kupis R, Perera I, Targowski T, Gąsowski J, Piotrowicz K. Is geriatric medicine teaching homogeneous? The analysis of geriatric medicine courses at Polish undergraduate medical programmes. Eur Geriatr Med 2024:10.1007/s41999-024-01004-y. [PMID: 38898185 DOI: 10.1007/s41999-024-01004-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE We aimed to analyse the characteristics of geriatric courses offered to undergraduate medical students in higher educational institutions (HEIs) in Poland. METHODS We searched the official websites of the HEIs offering the medical degree programmes and directly contacted the dean's offices and HEIs representatives to retrieve the relevant information. The documents were analysed for course content, teaching methods, duration, and recommended texts. We also checked the obtained curricula for the reference to of the learning objectives related to geriatric medicine, selected from the currently endorsed Polish educational standards (ES) provided by the Ministry of Science and Higher Education. RESULTS Geriatric medicine courses were obligatory at all included HEIs (n = 19), but the courses differed in structure and content. The courses varied in duration from 11 to 60 h and were primarily lecture based. Simulation was utilized at only one HEI and e-learning at two institutions. Out of 315 learning objectives, we acknowledged only 9 as geriatric. They were not always found in all curricula. Two HEIs included self-described learning objectives in their curricula. Across all HEIs, a total of 29 recommended texts (published between 1995 and 2021) were identified, including 2 English-language texts. CONCLUSION Geriatric medicine was a mandatory subject for medical students of the included HEIs. However, there was a lack of uniformity in the offered courses. This leaves room for the development of a unified undergraduate geriatrics curriculum to effectively address diverse geriatric issues across Europe. The importance of this matter is highlighted by demographic trends and workforce challenges.
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Affiliation(s)
- Robert Kupis
- Department of Medical Education, Centre of Innovative Medical Education, Jagiellonian University Medical College, Kraków, Poland
| | - Ian Perera
- Department of Medical Education, Centre of Innovative Medical Education, Jagiellonian University Medical College, Kraków, Poland
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Targowski
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
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Sieber C, Petrovic M, Masud T, Benetos A, Martin FC, Maggi S, Strandberg TE. A European perspective on the challenges of healthcare for older adults. Eur Geriatr Med 2024; 15:1-2. [PMID: 38194051 DOI: 10.1007/s41999-023-00913-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Affiliation(s)
- Cornel Sieber
- Kantonsspital Winterthur, Klinischer Bereich A, Brauerstrasse 15, Postfach 834, 8401, Winterthur, Switzerland
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Tahir Masud
- Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham, UK
| | - Athanase Benetos
- Department of Geriatrics, University Hospital of Nancy, Université de Lorraine, Nancy, France
| | | | | | - Timo E Strandberg
- University of Helsinki and Helsinki University Hospital HUS, 00290, Helsinki, Finland.
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Tomkow L, Thomson A. Beyond the biomedical: an evaluation of the introduction of social gerontology into a postgraduate geriatric medicine education program. Eur Geriatr Med 2023; 14:1369-1372. [PMID: 37796376 PMCID: PMC10754721 DOI: 10.1007/s41999-023-00864-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023]
Abstract
Geriatric Medicine education tends to adopt a biomedical lens, despite the practice of Geriatric Medicine involving the comprehensive assessment of the functional, psychological, and social aspects of older people's lives. In this commentary, we describe the delivery of a Social Gerontology education program for Geriatric Medicine trainees in the Northwest of England. Education in Social Gerontology-a field that focuses on how social, cultural, economic, and environmental factors shape the lives of older adults-is thought to mitigate against ageism, a pervasive and multifaceted form of discrimination. We describe the rationale for, and context of, the program delivery, before presenting an overview of trainee's feedback. Thematic analysis of feedback centered around three main themes: knowledge acquisition, change in clinical practice, and enjoyment of the sessions. Trainees (n = 20) reported enjoying the sessions, with 100% likely to recommend to peers. The focus on underserved groups, the novel content of the sessions, which were not taught elsewhere, and the non-medical perspective of the speakers were described as particularly valuable. By sharing our approach and reflecting on the early success of the program, we argue for an increased focus on Social Gerontology in Geriatric Medicine education.
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Affiliation(s)
- Louise Tomkow
- Humanitarian and Conflict Response Institute, University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M15 6JA, UK.
| | - Alexander Thomson
- Salford Care Organisation, Northern Care Alliance and University of Salford, Salford, UK
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van Poelgeest E, Seppala L, Bahat G, Ilhan B, Mair A, van Marum R, Onder G, Ryg J, Fernandes MA, Cherubini A, Denkinger M, Eidam A, Egberts A, Gudmundsson A, Koçak FÖK, Soulis G, Tournoy J, Masud T, Wehling M, van der Velde N. Optimizing pharmacotherapy and deprescribing strategies in older adults living with multimorbidity and polypharmacy: EuGMS SIG on pharmacology position paper. Eur Geriatr Med 2023; 14:1195-1209. [PMID: 37812379 PMCID: PMC10754739 DOI: 10.1007/s41999-023-00872-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023]
Abstract
Inappropriate polypharmacy is highly prevalent among older adults and presents a significant healthcare concern. Conducting medication reviews and implementing deprescribing strategies in multimorbid older adults with polypharmacy are an inherently complex and challenging task. Recognizing this, the Special Interest Group on Pharmacology of the European Geriatric Medicine Society has compiled evidence on medication review and deprescribing in older adults and has formulated recommendations to enhance appropriate prescribing practices. The current evidence supports the need for a comprehensive and widespread transformation in education, guidelines, research, advocacy, and policy to improve the management of polypharmacy in older individuals. Furthermore, incorporating deprescribing as a routine aspect of care for the ageing population is crucial. We emphasize the importance of involving geriatricians and experts in geriatric pharmacology in driving, and actively participating in this transformative process. By doing so, we can work towards achieving optimal medication use and enhancing the well-being of older adults in the generations to come.
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Affiliation(s)
- Eveline van Poelgeest
- Section of Geriatric Medicine, Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
- Aging and Later Life, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Lotta Seppala
- Section of Geriatric Medicine, Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Aging and Later Life, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Gülistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey
| | - Birkan Ilhan
- Division of Geriatrics, Department of Internal Medicine, Liv Hospital Vadistanbul, Istanbul, Turkey
| | - Alpana Mair
- Effective Prescribing and Therapeutics, Health and Social Care Directorate, Scottish Government, Edinburgh, Scotland, UK
- Edinburgh Napier University, Edinburgh, UK
| | - Rob van Marum
- Aging and Later Life, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Elderly Care Medicine, Amsterdam University Medical Centers, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Graziano Onder
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marília Andreia Fernandes
- Department of Internal Medicine, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Antonio Cherubini
- Geriatria Accettazione geriatrica e Centro di Ricerca per l'invecchiamento IRCCS INRCA, Ancona, Italy
| | - Michael Denkinger
- Agaplesion Bethesda Clinic Ulm, Institute for Geriatric Research, Ulm University, Geriatric Center Ulm, Ulm, Germany
| | - Annette Eidam
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Angelique Egberts
- Department of Hospital Pharmacy, Franciscus Gasthuis & Vlietland, Rotterdam, Schiedam, The Netherlands
| | - Aðalsteinn Gudmundsson
- Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
| | - Fatma Özge Kayhan Koçak
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
| | - George Soulis
- Outpatient Geriatric Assessment Unit, Henry Dunant Hospital Center, Athens, Greece
- Hellenic Open University, Patras, Greece
| | - Jos Tournoy
- Department of Geriatric Medicine, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium
- Department of Public Health and Primary Care, KU Leuven Biomedical Sciences Group, Leuven, Belgium
| | - Tahir Masud
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Martin Wehling
- Clinical Pharmacology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nathalie van der Velde
- Section of Geriatric Medicine, Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Aging and Later Life, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Nawaz I, Fatima A, Manan MR. Geriatric medicine as an undergraduate curriculum competency in medical schools. Eur Geriatr Med 2023; 14:1411-1412. [PMID: 37856047 DOI: 10.1007/s41999-023-00876-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023]
Affiliation(s)
- Iqra Nawaz
- Quaid-e-Azam Medical College, Bahawalpur, Pakistan.
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Ramos-Zúñiga R, González-Rios JA. The Role of an Exoskeleton Simulation of Senescence in Health Sciences Education. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2023; 2023:3148896. [PMID: 37283813 PMCID: PMC10241574 DOI: 10.1155/2023/3148896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 06/08/2023]
Abstract
Background Education in the formation of human capital in health constantly presents challenges. New tools in the emerging contexts may strengthen empathic attitudes. We developed an educational intervention that included a senescence simulator and assessed its impact on perception and attitudes in healthcare students. Methods A cross-sectional comparative study was conducted that assessed acquired knowledge and self-perception using a semistructured survey administered before and after the demonstration and intervention using the simulator and reported the experience through the role of the patient and caregiver. The data were analyzed statistically to identify the demographic characteristics and differences between the groups of students. The data were analyzed statistically to identify the demographic characteristics and differences between the groups of students in the responses pre-post intervention, using statistical software (IBM SPSS Statistics 26.0). Results Of the 256 participants surveyed before the intervention, 93.8% described cognitive deterioration as a significant disability and 53.1% considered the health system to be inadequate in meeting the needs of older individuals. Only 59.8% stated that the current academic training meets the educational requirements for the care of the elderly. In total, 98.9% of the participants reported that the simulator changed their perception by increasing their empathy. In total, 76.2% showed greater sensitivity to older adults and 79.3% reported that the experiential learning consolidated their professionalizing perspective. Among the younger participants (aged 18-20 years), sensitivity and reorientation toward pursuing an associated graduate degree were higher after the intervention (p=0.01). Conclusions Educational strategies, such as the senescence simulator, offer an experiential intervention that strengthens the knowledge and attitudes toward older individuals. During the pandemic emergency, it proved to be a useful educational strategy in consolidating caring behavior as a hybrid educational tactic. The senescence simulation enabled the participants to widen their educational and professional schemes to encompass the care of the older population.
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Affiliation(s)
- Rodrigo Ramos-Zúñiga
- Translational Neurosciences Institute, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Jorge A. González-Rios
- Translational Neurosciences Institute, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, Mexico
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Lilamand M, Vrillon A, Gonzales-Marabal L, Sindzingre L, Götze K, Boddaert J, Pautas E, François-Fasille V, Dumurgier J, Paquet C. Lumbar puncture training with healthcare simulation improves self-confidence and practical skills of French medical residents in geriatrics. Eur Geriatr Med 2023:10.1007/s41999-023-00769-y. [PMID: 36976436 DOI: 10.1007/s41999-023-00769-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE To assess the skill level and self-confidence of medical residents in geriatrics with regard to conducting the lumbar puncture (LP) procedure and to study the potential benefits of training with simulation and virtual reality. METHODS First, a questionnaire survey was conducted among all French residents in geriatrics in the Paris area to assess their knowledge and self-confidence regarding the practice of LP in older adults. Second, we set up a simulation LP training session combined with virtual reality (3D video) training for selected respondents of the first survey. Third, we performed post-simulation survey for the attendees of the simulation training. Finally, a follow-up survey was conducted to examine the change in self-confidence and the success rate in clinical practice. RESULTS Fifty-five residents responded to the survey (response rate = 36.4%). The importance of mastering LP was fully recognized by the residents in geriatrics (95.3%), so most of them (94.5%) advocated for the need for additional practical training. Fourteen residents took part in the training (average rating = 4.7 on a 5-point scale). Simulation was regarded by 83% of the respondents as the most useful tool for their practice. We observed a significant pre/post-training mean improvement in self-estimated success of 20.6% (Wilcoxon matched-pairs signed-rank W = - 36, p = 0.008). The post-training success rate of the residents in real-life clinical practice was good (85.8%). CONCLUSION Residents were aware of the importance of mastering LP and requested additional training. Simulation may represent a major driver to improve their self-confidence and practical skills.
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Affiliation(s)
- Matthieu Lilamand
- Department of Geriatrics Hôpital Lariboisière Fernand-Widal, AP-HP.Nord Université Paris Cité, Paris, France.
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France.
- Université Paris Cité, INSERM, UMRS 1144, Paris, France.
| | - Agathe Vrillon
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
- Université Paris Cité, INSERM, UMRS 1144, Paris, France
| | | | - Louise Sindzingre
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Karl Götze
- Department of Geriatrics Hôpital Bretonneau, AP-HP.Nord Université Paris Cité, Paris, France
| | - Jacques Boddaert
- Department of Geriatrics Hôpital la Pitié Salpêtrière, AP-HP, Sorbonne Université, INSERM, UMR 1135, Paris, France
| | - Eric Pautas
- Department of Geriatrics Hôpital la Pitié Salpêtrière, AP-HP, Sorbonne Université, INSERM, UMR 1135, Paris, France
- Department of Geriatrics Hôpital Charles Foix, AP-HP, Sorbonne Université, Ivry-sur-Seine, France
| | - Véronique François-Fasille
- Department of Geriatrics Hôpital Lariboisière Fernand-Widal, AP-HP.Nord Université Paris Cité, Paris, France
| | - Julien Dumurgier
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Claire Paquet
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
- Université Paris Cité, INSERM, UMRS 1144, Paris, France
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12
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Almarwani M. Does Ageism Exist Among Multidisciplinary Rehabilitation Students? Predictors of Attitudes Toward Older Adults. J Multidiscip Healthc 2023; 16:181-189. [PMID: 36714237 PMCID: PMC9875585 DOI: 10.2147/jmdh.s398994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/12/2023] [Indexed: 01/21/2023] Open
Abstract
Background With the growing population of older adults, the demand for health rehabilitation services has rapidly increased. Like many countries around the world, the older population in Saudi Arabia is increasing. Tackling ageism has powerful provenance for uncovering and changing the dynamics of contemporary aging in Saudi Arabia. This study examined the attitudes toward older adults and the potential predictors influencing these attitudes among multidisciplinary health rehabilitation students. Methods A total of 293 health rehabilitation students completed an online survey with a mean age of 21.1± 1.3 years. The survey included data about demographic and geriatric-related characteristics, attitudes toward older adults (UCLA-GA), knowledge of aging (FAQ) and aging anxiety (AAS). Results Most participants were female (70.3%), with 53% of the students specializing in physical therapy. The average score of attitudes toward older adults was 3.43 (0.40). The predictors of attitudes toward older adults were knowledge of aging (β = 0.34, p < 0.0001), living with older adults (β = 0.12, p = 0.02) and the importance of contact (very important, β = 0.31, p = 0.04). Conclusion These results provide further evidence to support that ageist attitudes among students can be overcome by enhancing knowledge of aging and promoting positive contact with older adults. With the demographic shift in Saudi Arabia, we propose that there is a great need for establishing a competency-based geriatric education and strategies to enhance positive contact with older adults.
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Affiliation(s)
- Maha Almarwani
- Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia,Correspondence: Maha Almarwani, Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Kingdom of Saudi Arabia, Email
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13
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Stuck AE, Masud T. Health care for older adults in Europe: how has it evolved and what are the challenges? Age Ageing 2022; 51:6931745. [PMID: 36529998 PMCID: PMC9760902 DOI: 10.1093/ageing/afac287] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Indexed: 12/23/2022] Open
Abstract
Geriatric medicine has evolved to an accepted specialty in 23 European countries. Despite much heterogeneity of postgraduate geriatric curricula, European societies have succeeded in defining a common core curriculum with a list of minimum training requirements for obtaining the specialty title of geriatric medicine. Geriatricians play a leading role in finding solutions for the challenges of health care of multimorbid older patients. One of these challenges is the demographic shift with the number of adults aged 80 years and older in Europe expected to double by 2050. Although geriatric units will play a role in the care of frail older patients, new care models are needed to integrate the comprehensive geriatric assessment approach for the care of the vast majority of older patients admitted to non-geriatric hospital units. Over the last few years, co-management approaches have been developed to address this gap. Innovative models are also in progress for ambulatory care, prevention and health promotion programs, and long-term care. Efforts to implement geriatric learning objectives in undergraduate training, and the generation of practice guidelines for geriatric syndromes may help to improve the quality of care for older patients.
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Affiliation(s)
- Andreas E Stuck
- Address correspondence to: Andreas E. Stuck, Geriatrics University Department, Inselspital, Freiburgstr. 46, CH 3010 Bern, Switzerland. Tel: +41 31 632 78 30; Fax: +41 31 632 69 42. E-mail:
| | - Tahir Masud
- Healthcare of Older People, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK,Medical Research Council and Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Nottingham, UK,National Institute for Health and Care Research Nottingham Biomedical Research Centre for Musculoskeletal Disease theme, Nottingham, UK
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14
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Kokorelias KM, Leung G, Jamshed N, Grosse A, Sinha SK. Identifying the areas of low self-reported confidence of internal medicine residents in geriatrics: a descriptive study of findings from a structured geriatrics skills assessment survey. BMC MEDICAL EDUCATION 2022; 22:870. [PMID: 36522619 PMCID: PMC9756669 DOI: 10.1186/s12909-022-03934-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Currently, no standardized methods exist to assess the geriatric skills and training needs of internal medicine trainees to enable them to become confident in caring for older patients. This study aimed to describe the self-reported confidence and training requirements in core geriatric skills amongst internal medicine residents in Toronto, Ontario using a standardized assessment tool. METHODS This study used a novel self-rating instrument, known as the Geriatric Skills Assessment Tool (GSAT), among incoming and current internal medicine residents at the University of Toronto, to describe self-reported confidence in performing, teaching and interest in further training with regard to 15 core geriatric skills previously identified by the American Board of Internal Medicine. RESULTS 190 (75.1%) out of 253 eligible incoming (Year 0) and current internal medicine residents (Years 1-3) completed the GSAT. Year 1-3 internal medicine residents who had completed a geriatric rotation reported being significantly more confident in performing 13/15 (P < 0.001 to P = 0.04) and in teaching 9/15 GSAT skills (P < 0.001 to P = 0.04). Overall, the residents surveyed identified their highest confidence in administering the Mini-Mental Status Examination and lowest confidence in assessing fall risk using a gait and balance tool, and in evaluating and managing chronic pain. CONCLUSION A structured needs assessment like the GSAT can be valuable in identifying the geriatric training needs of internal medicine trainees based on their reported levels of self-confidence. Residents in internal medicine could further benefit from completing a mandatory geriatric rotation early in their training, since this may improve their overall confidence in providing care for the mostly older patients they will work with during their residency and beyond.
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Affiliation(s)
- Kristina Marie Kokorelias
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Suite 475 - 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, Ontario, M5S 1A8, Canada
| | - Grace Leung
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, Ontario, M5S 1A8, Canada
| | - Namirah Jamshed
- Division of Geriatric Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Anna Grosse
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Suite 475 - 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada
| | - Samir K Sinha
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Suite 475 - 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada.
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, Ontario, M5S 1A8, Canada.
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, USA.
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15
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van Poelgeest EP, Seppala LJ, Lee JM, Bahat G, Ilhan B, Lavan AH, Mair A, van Marum RJ, Onder G, Ryg J, Fernandes MA, Garfinkel D, Guðmundsson A, Hartikainen S, Kotsani M, Montero-Errasquín B, Neumann-Podczaska A, Pazan F, Petrovic M, Soulis G, Vankova H, Wehling M, Wieczorowska-Tobis K, van der Velde N. Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey. Eur Geriatr Med 2022; 13:1455-1466. [PMID: 36319837 PMCID: PMC9722796 DOI: 10.1007/s41999-022-00702-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE To provide an overview of the current deprescribing attitudes, practices, and approaches of geriatricians and geriatricians-in-training across Europe. METHODS An online survey was disseminated among European geriatricians and geriatricians-in-training. The survey comprised Likert scale and multiple-choice questions on deprescribing approaches and practices, deprescribing education and knowledge, and facilitators/barriers of deprescribing. Responses to the survey questions and participant characteristics were quantified and differences evaluated between geriatricians and geriatricians-in-training and between European regions. RESULTS The 964 respondents (median age 42 years old; 64% female; 21% geriatricians-in-training) were generally willing to deprescribe (98%) and felt confident about deprescribing (85%). Despite differences across European regions, the most commonly reported reasons for deprescribing were functional impairment and occurrence of adverse drug reactions. The most important barriers for deprescribing were patients' unwillingness, fear of negative consequences, lack of time, and poor communication between multiple prescribers. Perceived risk of adverse drug reactions was highest for psychotropic drugs, nonsteroidal anti-inflammatory drugs, cardiovascular drugs, and opioid analgesics. Only one in four respondents (23% of geriatricians and 37% of geriatricians-in-training) think education in medical school had sufficiently prepared them for deprescribing in clinical practice. They reported that their future deprescribing activities would probably increase with improved information sharing between various prescribers, deprescribing recommendations in guidelines, and increased education and training. Approximately 90% think that a paradigm shift is required for prescribers and patients, increasing focus on the possible benefits of deprescribing (potentially) inappropriate medications. CONCLUSIONS Based on the outcomes of this survey, we recommend investing in improved inter-professional communication, better education and evidence-based recommendations to improve future patient-centered deprescribing practices.
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Affiliation(s)
- Eveline P van Poelgeest
- Department of Internal Medicine Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands.
| | - Lotta J Seppala
- Department of Internal Medicine Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
| | - Jihoo M Lee
- Graduate School of Communication Science, University of Amsterdam, Amsterdam, The Netherlands
| | - Gülistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey
| | - Birkan Ilhan
- Division of Geriatrics, Department of Internal Medicine, Sisli Hamidiye Etfal Training and Research Hospital, University of Medical Sciences, Istanbul, Turkey
| | - Amanda H Lavan
- Mercers Institute of Successful Ageing, St James's Hospital, Dublin, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Alpana Mair
- Effective Prescribing and Therapeutics, Health and Social Care Directorate, Scottish Government, Edinburgh, Scotland, UK
| | - Rob J van Marum
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
- Department of Elderly Care Medicine, Amsterdam University Medical Centers, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, Netherlands
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Odense Deprescribing Initiative (ODIN), Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Marília Andreia Fernandes
- Department of Internal Medicine, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Doron Garfinkel
- Center for Appropriate Medication Use, Sheba Medical Center and Deputy Head, Homecare Hospice, Israel Cancer Association, 55 Ben Gurion Road, 5932210, Bat, Yam, Israel
| | - Aðalsteinn Guðmundsson
- Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Marina Kotsani
- Université de Lorraine, CHRU-Nancy, Pôle (Maladies du Vieillissement, Gérontologie et Soins Palliatifs), Nancy, France
| | | | | | - Farhad Pazan
- Clinical Pharmacology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - George Soulis
- Outpatient Geriatric Assessment Unit, Henry Dunant Hospital Center, Athens, Greece
- Hellenic Open University, Patras, Greece
| | - Hana Vankova
- Cooperatio 34 - Internal Disciplines, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martin Wehling
- Clinical Pharmacology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Nathalie van der Velde
- Department of Internal Medicine Section of Geriatrics, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
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