Preparing a healthcare workforce for geriatrics care: an Interprofessional team based learning program.

BACKGROUND: Improving the care of older adults in our healthcare system involves teams working together. As the geriatrics population rises globally, health science learners need to be prepared to work collaboratively to recognize and treat common conditions in geriatrics. To enable workforce preparation, the Institute of Medicine and the National League for Nursing emphasize the need to implement interprofessional active learning activities for undergraduate healthcare learners at academic medical centers. METHODS: The Geriatrics Champions Program was a team-based learning activity created to meet this task. It was a 24-month program, repeated twice, that impacted 768 learners and 151 faculty from medicine, occupational therapy, physical therapy, nursing, social welfare, psychology, pharmacy and dietetics. Each class was intentionally divided into 20 interprofessional teams that met four times annually. Each session focused on one geriatrics domain. The objectives were centered around the specific geriatrics competencies for each health profession, divided into the eight domains written in the "American Geriatrics Society IM-FM Residency Competencies". Evaluation consisted of individual and team Readiness Assessment Tests (iRAT and tRAT). Surveys were also used to collect feedback using a Likert scale. Wilcoxon signed rank tests were used to compare iRAT and tRAT scores. Other analyses identified characteristics associated with tRAT performance group (Unpaired t-tests) and tRAT performance on the raw scale (Pearson correlation). Paired t-tests using a 7-level Likert Scale measured pre-post change in learner knowledge. RESULTS: Student tRAT scores were 30% higher than iRAT scores (p < 0.001). Teams were more likely to score 100% on the initial tRAT attempt if more team members attended the current session (p < 0.001), more health professions were represented by team members in attendance (p = 0.053), and the team had a better track record of past attendance (p < 0.01). In the post-program evaluation, learners felt this program was helpful for their career preparation in interprofessional geriatrics care. CONCLUSIONS: Learners understood that teams performed better than individuals in the care of older adults. Feedback from the learners and faculty was consistently positive and learners felt better prepared for geriatrics care. The program's benefits may extend beyond individual sessions.

Internal Medicine Clerkship ID Curriculum Flip: Will They Prefer to Pre-learn?

Varying pedagogical approaches of undergraduate medical education are utilized in clerkships to supplement bedside teaching. The flipped classroom mode, in which self-paced study precedes the in-person session, is often used in pre-clinical education. This shift allows time with the instructor to focus on guided application of pre-learned concepts. At our institution, the Internal Medicine Clerkship Infectious Diseases lecture was substituted to a flipped classroom with two pre-learning videos. Student satisfaction scores were higher for the flipped classroom and comments were more negative for the traditional lecture. This suggests that senior medical students favor flipped classroom pedagogy despite pre-learning requirements.

Patient Perspectives of Rural Kansas Maternity Care.

INTRODUCTION: Pregnant women in rural areas face a unique set of challenges due to geographic maldistribution of obstetric services. The perspectives of rural Kansas women were sought regarding experience of birth and satisfaction with maternity care. METHODS: Medical student research assistants facilitated discussion groups and structured interviews in rural Kansas communities distributed throughout the state with women who had an uncomplicated delivery in the last 24 months. Participants were recruited via convenience sampling from clinic medical records and appointments over a two-to-three-week period. Guiding questions were used to facilitate discussion. Survey instruments were used to gather information about satisfaction with maternity care. Data for qualitative and quantitative analysis was aggregated using Rural Urban Commuting Area (RUCA) codes. RESULTS: Fourteen groups with 47 total participants completed the survey and discussion. Participants came from large rural, small rural, and isolated areas in Kansas as described by RUCA Code Four Category Classification. Survey results indicated that satisfaction with maternity care in participants' home county was significantly higher in small rural and isolated compared to large Rural RUCAs. Qualitative analysis results showed positive experiences related to doctor characteristics, relationship with doctor, doctor's involvement with care, alternative labor options, and distance convenience. Negative experiences were related to doctor bedside manner, doctor not there until delivery, and staff related complaints. CONCLUSIONS: Kansas women in small rural and isolated RUCA codes appeared to be more satisfied with care.