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Akpinar Söylemez B, Akyol MA, Küçükgüçlü Ö, Özkaya Sağlam B, Gül B, İlçi N N, Işik AT. The impact of scenario-based aging simulation experience on empathy, attitudes toward and willingness to work with older adults in health sciences senior year students: A randomized controlled trial. Nurse Educ Pract 2024; 79:104066. [PMID: 39047458 DOI: 10.1016/j.nepr.2024.104066] [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: 05/08/2024] [Revised: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024]
Abstract
AIM This study was conducted to investigate the impacts of scenario-based aging simulation experience (SBASE) on students' empathy, attitudes toward and willingness to work with older adults. BACKGROUND Innovative teaching strategies such as SBASE have the potential to provide students with the essential skills required for working with older adults. DESIGN This study has a randomized controlled trial. METHODS This study was conducted in west of Turkiye with 120 health sciences senior year students (45 nursing students, 54 medicine students and 21 physical therapy and rehabilitation students) in 2022-2023. The students were randomly assigned to intervention or control group (IG-CG). The IG received SBASE. Pre- and post-tests (after intervention, 1 and 3 months later) were conducted. Data were collected using the descriptive characteristics form, Kogan's attitudes toward old people scale, basic empathy scale and willingness to work with elderly people scale. RESULTS The IG participants recorded statistically better scores regarding positive attitudes towards older adults, in terms of the group x time interaction (t: 2.521, p: 0.036). However, there was no significant difference in the variables investigated between the groups. CONCLUSIONS SBASE appeared to be effective in improving health sciences students' positive attitudes towards older adults. Health care providers should have a more positive attitude toward older adults to improve levels of care. DATA AVAILABILITY Data and supplementary material related to this article can be obtained from the corresponding author upon request.
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Affiliation(s)
- Burcu Akpinar Söylemez
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Inciralti, Izmir, Turkey.
| | - Merve Aliye Akyol
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Inciralti, Izmir, Turkey.
| | - Özlem Küçükgüçlü
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Inciralti, Izmir, Turkey.
| | - Bilgehan Özkaya Sağlam
- Internal Medicine Nursing Doctoral Programme, Dokuz Eylul University Institute of Health Sciences, Inciralti, Izmir, Turkey.
| | - Baran Gül
- Internal Medicine Nursing Doctoral Programme, Dokuz Eylul University Institute of Health Sciences, Inciralti, Izmir, Turkey.
| | - Nursen İlçi N
- Department of Physiotherapy and Rehabilitation Geriatric Physiotherapy, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Inciralti, Izmir, Turkey.
| | - Ahmet Turan Işik
- Department of Geriatrics, Faculty of Medicine, Dokuz Eylul University, Inciralti, Izmir, Turkey.
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Merchant RA, Ho VWT, Chen MZ, Wong BLL, Lim Z, Chan YH, Ling N, Ng SE, Santosa A, Murphy D, Vathsala A. Outcomes of Care by Geriatricians and Non-geriatricians in an Academic Hospital. Front Med (Lausanne) 2022; 9:908100. [PMID: 35733862 PMCID: PMC9208654 DOI: 10.3389/fmed.2022.908100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/09/2022] [Indexed: 12/19/2022] Open
Abstract
Introduction While hospitalist and internist inpatient care models dominate the landscape in many countries, geriatricians and internists are at the frontlines managing hospitalized older adults in countries such as Singapore and the United Kingdom. The primary aim of this study was to determine outcomes for older patients cared for by geriatricians compared with non-geriatrician-led care teams. Materials and Methods A retrospective cohort study of 1,486 Internal Medicine patients aged ≥75 years admitted between April and September 2021 was conducted. They were either under geriatrician or non-geriatrician (internists or specialty physicians) care. Data on demographics, primary diagnosis, comorbidities, mortality, readmission rate, Hospital Frailty Risk Score (HFRS), Age-adjusted Charlson Comorbidity Index, Length of Stay (LOS), and cost of hospital stay were obtained from the hospital database and analyzed. Results The mean age of patients was 84.0 ± 6.3 years, 860 (57.9%) females, 1,183 (79.6%) of Chinese ethnicity, and 902 (60.7%) under the care of geriatricians. Patients under geriatrician were significantly older and had a higher prevalence of frailty, dementia, and stroke, whereas patients under non-geriatrician had a higher prevalence of diabetes and hypertension. Delirium as the primary diagnosis was significantly higher among patients under geriatrician care. Geriatrician-led care model was associated with shorter LOS, lower cost, similar inpatient mortality, and 30-day readmission rates. LOS and cost were lower for patients under geriatrician care regardless of frailty status but significant only for low and intermediate frailty groups. Geriatrician-led care was associated with significantly lower extended hospital stay (OR 0.73; 95% CI 0.56–0.95) and extended cost (OR 0.69; 95% CI 0.54–0.95). Conclusion Geriatrician-led care model showed shorter LOS, lower cost, and was associated with lower odds of extended LOS and cost.
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Affiliation(s)
- Reshma Aziz Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- *Correspondence: Reshma Aziz Merchant,
| | - Vanda Wen Teng Ho
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Matthew Zhixuan Chen
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Beatrix Ling Ling Wong
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Zhiying Lim
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Natalie Ling
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Shu Ee Ng
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Amelia Santosa
- Division of Rheumatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Diarmuid Murphy
- Value Driven Outcomes Office, National University Health System, Singapore, Singapore
| | - Anantharaman Vathsala
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Nephrology, Department of Medicine, National University Hospital, Singapore, Singapore
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Chan CM, Ong MJY, Zakaria AA, Visusasam MM, Ali MF, Jamil TR, Aizuddin AN, Abdul Aziz AF. Assessment of dementia knowledge and its associated factors among final year medical undergraduates in selected universities across Malaysia. BMC Geriatr 2022; 22:450. [PMID: 35610579 PMCID: PMC9129895 DOI: 10.1186/s12877-022-03148-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background The elderly population in Malaysia are projected to reach almost one third of the total population by 2040. The absence of a National Dementia Strategy (NDS) in preparing the healthcare services for the ageing population is compounded by the lack of assessment of preparedness of future healthcare workers to manage complications related to ageing i.e., dementia. Studies in countries with NDS demonstrated lack of dementia knowledge among medical undergraduates. Hence, this study aimed to assess the knowledge on dementia among final year medical undergraduates in Malaysia and its associated factors, using the Dementia Knowledge Assessment Scale (DKAS). Methods This cross-sectional study, employed multistage sampling method to recruit final year medical undergraduates from eleven selected public and private medical institutions across Malaysia. Online self-administered measures were delivered to final year medical undergraduates through representatives of medical students’ society after approval from Deanery and institutional ethics board of participating universities. The measure collected demographic information, previous dementia exposure (i.e., formal or informal) and the 25-item Likert scale DKAS. Bivariate analysis and linear regression were conducted to confirm factors influencing dementia knowledge components. Results A total of 464 respondents from 7 universities participated in this study. Overall dementia knowledge among respondents with and without exposure, was low, with average score of 29.60 ± 6.97 and 28.22 ± 6.98, respectively. DKAS subscales analysis revealed respondents scored highest in care consideration subscale (9.49 ± 2.37) and lowest in communication and behaviour subscale (4.38 ± 2.39). However, only causes and characteristic subscale recorded significantly higher knowledge score among respondents with previous exposure (7.88 ± 2.58) (p =0.015). Higher knowledge of dementia was associated with previous formal dementia education (p=0.037) and informal occupational/working experience in caring for dementia patients (p = 0.001). Informal occupational/working experience (B = 4.141, 95% CI 1.748–6.535, p = 0.001) had greater effect than formal education (i.e. lectures/workshops) (B = 1.393, 95% CI 0.086–2.700, p = 0.037) to influence respondents’ knowledge on dementia. Conclusion Dementia knowledge among final year medical undergraduates is low. To improve dementia knowledge, Malaysian medical curriculum should be reviewed to incorporate formal education and informal occupational/working experience, as early as in undergraduate training to help prepare future healthcare providers to recognise dementia among ageing Malaysians.
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Affiliation(s)
- Chee Mun Chan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.,Class of 2021/2022, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Marjorie Jia Yi Ong
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.,Class of 2021/2022, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Adam Aiman Zakaria
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.,Class of 2021/2022, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Monikha Maria Visusasam
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.,Class of 2021/2022, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohd Fairuz Ali
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Teh Rohaila Jamil
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
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Clinical Pharmacists' Knowledge of and Attitudes toward Older Adults. PHARMACY 2021; 9:pharmacy9040172. [PMID: 34698246 PMCID: PMC8544685 DOI: 10.3390/pharmacy9040172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Although pharmacy literature suggests that pharmacists have a positive attitude towards older adults, there is a paucity of studies that have measured pharmacists’ knowledge or attitudes towards older people. The purpose of our study was to assess the knowledge and attitudes of hospital pharmacists toward older adults. Methods: An electronic survey was distributed over two months to clinical hospital pharmacists across the province of Alberta, Canada. The survey was composed of two validated tools, the Palmore Facts of Aging Quiz (PFAQ) and Kogan’s Attitude toward Old People Scale (KOPS). PFAQ is scored from 0 (poor knowledge) to 25 (high knowledge) and KOPS from 34 to 204, with higher than 119 indicating a positive attitude. Results: A total of 153 pharmacists completed the survey (response rate of 24%). The mean age was 39 (SD 10.8) years; the average years practiced was 15 (SD 11), and the majority of respondents (n = 65) reported that >50% of patients in their practice were geriatrics. The mean correct responses on the PFAQ were 18.8 (SD 2.6). KOPS had a mean score of 156.8 (SD 14), with only one pharmacist score falling below 119, indicating a negative attitude. There was a statistically significant, positive correlation between attitudes and knowledge (r = 0.38, p < 0.05), as well as the increasing age of the respondents (r = 0.18, p = 0.03). The remaining measured categories (i.e., gender, years of pharmacy practice) had no significant effect. Conclusion: Clinical hospital pharmacists in Alberta have a positive attitude toward geriatric patients, as well as a satisfactory knowledge of older adults.
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Effects of the Simulation Based Training Program on Attitudes of Nurses Towards Older Adults: A Quasi-Experimental Design Study. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2021. [DOI: 10.30621/jbachs.974288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Shi S, Lio J, Dong H, Jiang I, Cooper B, Sherer R. Evaluation of geriatrics education at a Chinese University: A survey of attitudes and knowledge among undergraduate medical students. GERONTOLOGY & GERIATRICS EDUCATION 2020; 41:242-249. [PMID: 29737957 DOI: 10.1080/02701960.2018.1468324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Despite widespread reforms in medical education across China, nationally there has been no mandate or movement toward systemically incorporating geriatrics into curricula. To what degree medical students are trained and have exposure to geriatric topics remains unclear. We surveyed 190 medical students during their final year of medical school at a Chinese medical university, graduating from reformed and also traditional curricula. The survey was comprised of a subjective assessment of attitudes and reported knowledge, as well as an objective assessment of knowledge via a multiple choice test. Student attitudes were favorable toward geriatrics, with 91% supporting the addition of specialized clinical experiences to the curriculum. Students generally reported low exposure to geriatrics, with no statistically significant differences between reform and traditional curricula. There was a statistically significant difference in performance on the multiple choice test between curricula but at a degree unlikely to be practically significant. Students had very favorable attitudes toward geriatrics as a field and specialty; however scored poorly on competency exams, with the lowest performance around diagnosis and treatment of specific geriatric conditions. Our results suggest that there is a need and desire for increased geriatric-oriented learning at Chinese medical schools.
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Affiliation(s)
- Sandra Shi
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jonathan Lio
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Hongmei Dong
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Ivy Jiang
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Brian Cooper
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Renslow Sherer
- Department of Medicine, University of Chicago, Chicago, IL, USA
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Jirau-Rosaly W, Brown SP, Wood EA, Rockich-Winston N. Integrating an Interprofessional Geriatric Active Learning Workshop Into Undergraduate Medical Curriculum. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120520923680. [PMID: 32548306 PMCID: PMC7271265 DOI: 10.1177/2382120520923680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE The aging population in the United States poses a substantial challenge to our health care system, and particularly affects the training of physicians in geriatric care. To introduce undergraduate medical students to a variety of clinical skills and concepts emphasized in geriatrics, we created an interprofessional geriatric workshop and examined changes in student perceptions of working in interprofessional teams, knowledge regarding geriatric concepts, perceptions of the pre-work material, and suggestions for curricular improvement to enhance the workshop for future students. METHODS Second-year medical students participated in a 4-hour workshop with tasks that emphasized activities of daily living, geriatric physical assessment, end-of-life discussions, Beers Criteria, and a home health assessment. Pre- and post-surveys were administered including the Students Perceptions of Interprofessional Clinical Education-Revised (SPICE-R) survey and a knowledge assessment. Student perceptions of pre-work and overall program assessment were captured after the workshop. Descriptive statistics and paired t tests assessed for significant differences. Emerging themes were analyzed using the Glaser constant comparative method. RESULTS Of the 186 medical student participants, 178 students completed the SPICE-R survey, demonstrating significant increases in students' perceptions of the value of interprofessional education (P < .001). In addition, 111 students completed the pre- and post-test for the knowledge assessment, demonstrating significant gains in geriatric concepts (P < .001). Overall, most students perceived the pre-work as useful and felt prepared to evaluate geriatric patients. Open-ended question analysis supported results, in which 34 students indicated that they felt most comfortable performing a home health assessment and emphasized the usage of the home health simulation. CONCLUSIONS Introducing medical students to a variety of geriatric assessments and concepts in an interprofessional environment early in their career positively influences their perceptions of working as an interprofessional team member to deliver comprehensive care to older adults.
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Affiliation(s)
- Wanda Jirau-Rosaly
- Department of Medicine, Medical College
of Georgia, Augusta University, Augusta, GA, USA
| | - Shilpa P Brown
- Department of Medicine, Medical College
of Georgia, Augusta University, Augusta, GA, USA
| | - Elena A Wood
- Department of Medicine, Medical College
of Georgia, Augusta University, Augusta, GA, USA
- Educational Innovation Institute,
Augusta University, Augusta, GA, USA
| | - Nicole Rockich-Winston
- Department of Pharmacology and
Toxicology, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Jaafari F, Delavari S, Bazrafkan L. Evaluation of the geriatric curriculum implemented at Shiraz University of Medical Sciences, Iran, since 2017: A qualitative study. F1000Res 2019. [DOI: 10.12688/f1000research.16040.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Recently, there has been an increase in life expectancy due to improvements in nutrition, health, and sanitation. The aim of this study was to evaluate the geriatric curriculum in the field of general medicine at Shiraz University of Medical Sciences (SUMS), Iran to improve the quality of services provided to this population in the community. Methods: This was a qualitative study. Six educational hospitals and ambulatory centers of Shiraz University of Medical Sciences participated in this study. Within these centers, 15 medical education faculty members and educational experts, 6 medical students, 6 elderly patients and 6 nurses working in the university related to the geriatric field were selected using purposive sampling. Data were gathered through semi-structured interviews, focus group discussion and field observations in the teaching hospital and ambulatory setting of SUMS from June 2017 to May 2018. Based on the qualitative research, the data underwent conventional content analysis and the main themes were developed from this. Results: Three main themes were extracted from the data: effective clinical education, geriatrics curriculum challenges and promotion strategies for geriatric medicine. Subcategories that emerged were a competent curriculum teacher, a challenging program, management of resources, promotion of the program, and the revision required in the curriculum, which were related to other concepts and described in the real-world situation of the geriatric curriculum in the university, as observed in field observations. Conclusions: This study identified three concepts as main themes that can be used to explain how to implement a geriatric curriculum in a medical university. The main contributing factor to different views of the participants was identified as the revision required to the curriculum for integrative care in a geriatric patient. This should be taken into consideration while planning any programs and decisions aimed at education of medical students on this topic.
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Hyer K, Jester DJ, Badana ANS, D'Aoust R, Robinson BE, Guerra L, Michael M, Molinari V, Schwartz A, Schocken D, Wills T, Wilson C, Andel R. Medical Faculty Beliefs: Self-Rated Importance and Confidence in Teaching Geriatrics Primary Care. J Am Geriatr Soc 2019; 67:576-580. [PMID: 30839109 DOI: 10.1111/jgs.15759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate and contrast 25 content areas essential to the primary care of older adults by medical faculty, thus identifying faculty beliefs and areas of possible improvement. DESIGN Using measures from the Healthcare Effectiveness Data and Information Set, the Consumer Assessment of Healthcare Providers and Systems, and Healthy People 2020, nine practicing clinical faculty identified 25 content areas essential to the primary care of older adults. SETTING A large academic health center in southeastern United States. PARTICIPANTS Eighty-two university medical faculty. MEASUREMENTS Faculty rated importance, knowledge, and confidence in teaching the 25 content areas on a scale from 1 (low) to 10 (high). Gap scores reflecting the difference in ratings for importance and confidence in teaching were calculated and assessed. The survey had high internal consistency within each of the three domains-Cronbach's α > .94. RESULTS The most important content areas were being able to explain details about patient's condition and taking medication clearly, followed by taking age-appropriate history. The three largest gaps were: "evaluating sensory impairment," "identifying and counseling at-risk drivers," and "evaluating cognition." The three smallest gaps were: "explaining prescribed medications," "explaining health conditions in easy-to-understand language," and "taking an age-appropriate patient history and performing a physical assessment." CONCLUSION Medical faculty were comfortable with topics reflecting primary care expertise but expressed less confidence with more specialized topics, such as sensory or cognitive impairment and driving. This may represent key areas for geriatrics training applicable to all those involved in education and training of future healthcare professionals. Integration of specialists (eg, neurologists, psychiatrists) may improve the geriatrics curricula. J Am Geriatr Soc 67:576-580, 2019.
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Affiliation(s)
- Kathryn Hyer
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
| | - Dylan J Jester
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
| | - Adrian N S Badana
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
| | - Rita D'Aoust
- Department of Acute and Chronic Care, School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Bruce E Robinson
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida.,Department of Geriatrics, Sarasota Memorial Hospital, Sarasota, Florida
| | - Lucy Guerra
- College of Medicine, University of South Florida, Tampa, Florida
| | - Melanie Michael
- College of Nursing, University of South Florida, Tampa, Florida
| | - Victor Molinari
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
| | - Amy Schwartz
- College of Pharmacy, University of South Florida, Tampa, Florida
| | - Dawn Schocken
- College of Medicine, University of South Florida, Tampa, Florida
| | - Todd Wills
- College of Medicine, University of South Florida, Tampa, Florida
| | - Cheryl Wilson
- College of Nursing, University of South Florida, Tampa, Florida
| | - Ross Andel
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
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Griffin A, Knight L, McKeown A, Cliffe C, Arora A, Crampton P. A postgraduate curriculum for integrated care: a qualitative exploration of trainee paediatricians and general practitioners' experiences. BMC MEDICAL EDUCATION 2019; 19:8. [PMID: 30612565 PMCID: PMC6322273 DOI: 10.1186/s12909-018-1420-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 12/05/2018] [Indexed: 05/09/2023]
Abstract
BACKGROUND Integrated care unites funding, administrative, organisational, service delivery and clinical levels to create connectivity, alignment and collaboration within and between care delivery and prevention sectors. It aims to improve efficiency by avoiding unnecessary duplication of resources. Consequently, implementing integrated care is increasingly important; however, there are many barriers and how we teach healthcare practitioners to work across systems is under-researched. This paper explores an innovative educational curriculum, the Programme for Integrated Child Health (PICH). METHODS The PICH involved an experiential learning approach supported by taught sessions on specific issues relevant to integrated care. A qualitative study was conducted by interviewing 23 participants using semi-structured one-to-one interviews. Participants included trainees (general practice, paediatrics) and programme mentors. Data was thematically analysed. RESULTS Results are coded under three main themes: integrated care curriculum components, perceptions of a curriculum addressing integrated care and organisational change, and personal and professional learning. The data highlights the importance of real-world projects, utilising healthcare data, and considering patient perspectives to understand and develop integrated practices. Trainees received guidance from mentors but, more crucially learnt from, with, and about one another. They learnt about the context in which GPs and paediatricians work and developed a deeper understanding through which integrated services could be meaningfully developed. CONCLUSIONS This study explored participants' experiences and can be taken forward by educationalists to design curricula to better prepare healthcare practitioners to work collaboratively. The emergence of integrated care brings about challenges for traditional pedagogical approaches as learners have to re-align their discipline-specific approaches with evolving healthcare structures. PICH demonstrated that trainees acquired knowledge through real-word projects and experiential learning; and that this facilitated integration, empowering doctors to become leaders of organisational change. However, there are also many challenges of implementing integrated curricula which need to be addressed, including breaking down professional silos and integrating resourceful healthcare. This study begins to demonstrate the ability of an integrated curriculum to support trainees to work collaboratively, but further work is needed to develop the wider efficacy of the programme incorporating other professional groups, and to assess its longer term impact.
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Affiliation(s)
- Ann Griffin
- Research Department of Medical Education, UCL Medical School, The Directorate, 74 Huntley Street, London, WC1E 6AU UK
| | - Laura Knight
- Research Department of Medical Education, UCL Medical School, Royal Free Hospital, Room GF/664, London, NW3 2PF UK
| | - Alex McKeown
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - Charlotte Cliffe
- Research Department of Medical Education, UCL Medical School, Royal Free Hospital, Room GF/664, London, NW3 2PF UK
| | - Arun Arora
- Manchester University, Oxford Rd, Manchester, M13 9PL UK
| | - Paul Crampton
- Research Department of Medical Education, UCL Medical School, Royal Free Hospital, Room GF/664, London, NW3 2PF UK
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