1
|
Lapteva ES, Ariev AL, Tsutsunava MR, Arieva GT. Comprehensive Geriatric Assessment—Resolved and Unresolved Issues (Review). ADVANCES IN GERONTOLOGY 2021. [DOI: 10.1134/s207905702104007x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
2
|
Raff AC. Great nephrologists begin with great teachers: update on the nephrology curriculum. Curr Opin Nephrol Hypertens 2021; 30:215-222. [PMID: 33229909 DOI: 10.1097/mnh.0000000000000676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight developments and opportunities in the nephrology curriculum from the basic science foundation years through teaching medical students, residents and fellows in the clinical realm. RECENT FINDINGS Teaching skills are a vital tool for nephrologists both to promote excellent patient care and attract talented learners to the field. Exposure to dynamic and inspiring nephrologists is one of the main factors given by students and residents for selecting a career in nephrology. Nephrology teaching, including case discussions, problem-based learning, team-based learning and flipped classrooms, provides motivating active learning for medical students and is equally effective for didactics in graduate medical education. Avenues for teaching in the clinical realm include the microskills framework, bedside teaching and grounding in evidence-based medicine. Areas of growth include blended nephrology/subspecialty fields as well as social media applications. SUMMARY Medical education is a satisfying and exciting area of growth in the field of nephrology. The recent literature provides a framework for best practices in active learning as well as providing numerous examples of educational interventions and innovations. In addition, this field is ripe for further development and scholarly activity.
Collapse
Affiliation(s)
- Amanda C Raff
- Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| |
Collapse
|
3
|
Subramaniam A, Tiruvoipati R, Lodge M, Moran C, Srikanth V. Frailty in the older person undergoing elective surgery: a trigger for enhanced multidisciplinary management - a narrative review. ANZ J Surg 2020; 90:222-229. [PMID: 31916659 DOI: 10.1111/ans.15633] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/17/2019] [Accepted: 11/19/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND The ageing of our society has led to increasing numbers of older people requiring elective surgical procedures. Preoperative frailty is a strong predictor of adverse post-operative outcomes. This review aims to summarize the evidence for interventions aimed at improving outcomes in frail older people who may undergo elective surgery. METHODS Articles published on perioperative management of frailty between 1 January 1970 and 31 May 2019 were searched using PubMed and EMBASE. RESULTS We identified very few studies investigating such interventions, such as comprehensive geriatric assessment, prehabilitation (alone or as a multicomponent strategy) and other multicomponent interventions. Administration of a comprehensive geriatric assessment was shown to be associated with reduced mortality, fewer complications and shorter length of hospital stay, and may be best targeted towards those who are identified as frail for resource efficiency. Multicomponent interventions including prehabilitation may be associated with improved outcomes, but the evidence base for these needs to be strengthened. CONCLUSION Establishing multidisciplinary collaborative services to provide person-centred models of care should be considered for older people presenting for elective surgery, particularly in those with greater preoperative frailty. Further large-scale studies should focus on implementing and evaluating such multicomponent models of care.
Collapse
Affiliation(s)
- Ashwin Subramaniam
- Department of Intensive Care, Frankston Hospital and The Bays Hospital, Melbourne, Victoria, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Ravindranath Tiruvoipati
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care, Frankston Hospital and Peninsula Private Hospital, Melbourne, Victoria, Australia
| | - Margot Lodge
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Aged Care, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia
| | - Christopher Moran
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Aged Care, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia
- Department of Medicine, Peninsula Health, Melbourne, Victoria, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, Victoria, Australia
| | - Velandai Srikanth
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, Victoria, Australia
- Acute Care of the Elderly, Menzies Institute for Medical Research, Hobart, Tasmania, Australia
| |
Collapse
|