Case mapping of geriatrics: Looking beyond age in skills laboratories.

BACKGROUND AND PURPOSE: Development of competencies related to care of older adults is necessary in pharmacy education. Skills laboratories as an essential part of the curriculum represent an important setting to teach geriatrics. The purpose of this research was to describe geriatrics cases in skills/simulation activities of an undergraduate pharmacy program. EDUCATIONAL ACTIVITY AND SETTING: A retrospective review of one academic year of skills laboratories from the pharmacy program at the Faculty of Pharmacy of University of Montreal was performed. Sessions including cases aged ≥65 years were selected. Content was extracted for characteristics relating to the patient, health, medications, and care context. A framework including geriatric considerations such as geriatric syndromes, frailty status, and potentially inappropriate medications was developed for data collection. FINDINGS: In total, 210 patient cases were extracted. Older adults (≥ 65 years) were represented in 51 cases (24%), with 8 cases (4%) aged ≥80 years. Geriatric syndromes were documented in 8%, functional status in 10%, and mobility in 12% of the cases. The median number of comorbidities and medications were 4 and 7, respectively. Regarding polypharmacy, only 10 cases had >10 medications, and none had >15 medications. Potentially inappropriate medications were found in 47% (n = 24) of the cases but were addressed in only 14% (n = 7) cases. SUMMARY: This mapping of skills laboratories highlights gaps in geriatrics content. Inclusion of the oldest patients and geriatrics issues were incorporated in a minority of cases and lacked many characteristics essential for geriatrics care.

The value proposition for geriatrics.

In response to some of the challenges that have been articlulated about the future of Geriatrics, we describe a more positive view and value proposition for the field. Health professionals with specific training in Geriatrics are a natural fit for a variety of roles in value-based care (VBC) programs and health systems. These roles include serving as educators for primary care health professionals and specialists in person-centered care of older adults, serving as consultants on geriatric conditions and syndromes in a co-management model of care, becoming effective leaders in VBC programs and health systems, and conducting quality improvement initiatives to build on the evidence-base for the management of common conditions in the older population. We further recommend that VBC programs and systems support Centers of Excellence or Institutes to implement these strategies within and Age-Friendly, learning system approach.

Using Assisted Living Communities to Enhance Nursing Student Attitudes Toward Older Adults.

PURPOSE: The older adult population continues to increase, resulting in greater use of health care resources. Nurses will be at the forefront of providing competent care to this population, but many nurses do not wish to work with the aged population after graduation. The current study sought to explore whether the addition of a clinical shift at an assisted living community promoted positive attitudes by nursing students toward older adults and exposed them to healthy aging. METHODS: Students (N = 70) in a required undergraduate course at a large university in the West received clinical experience at local assisted living communities in which they independently interviewed a resident and provided an educational session to residents. RESULTS: Students, communities, and clinical instructors had a positive experience in this clinical, finding it rewarding and meaningful and a mechanism for observing healthy aging. CONCLUSION: The incorporation of a clinical experience at an assisted living facility into a stand-alone gerontology course created a positive shift in nursing student attitudes toward older adults, dispelled myths and stereotypes, and was reported to be a meaningful experience. [Journal of Gerontological Nursing, 50(2), 11-15.].

Incentivizing Students to Learn More About Gerontological Practice.

Enticing students to expand their knowledge of aging-related issues and careers can be fraught with challenges. Intrinsic and curricula-related factors associated with pursuit of aging-related careers have been identified, but little evidence exists demonstrating the effectiveness of external factors at motivating students to learn more about gerontological practice. This brief report presents findings from a survey of 214 students enrolled in at a single university in the mid-west to assess how likely they would be motivated to learn more about aging by twelve possible incentives with additional opportunities to write in other thoughts. Credit toward required field work, financial incentives such as stipends, scholarships, tuition waivers, and raffles were the most frequently mentioned incentives. Some variation was noted based on race/ethnicity, age, and program of study. Themes emerging from other suggestions provided by students included curricula enhancements, employment incentives, and the suggestion that nothing could entice some students. Findings can be used by scholars in program development and funding requests.

Survey of pharmacy students to assess attitudes toward a career in older adult care.

INTRODUCTION: In the United States, the older adult population is growing faster than the geriatrics-trained healthcare workforce. The primary objective of this study was to determine the top factors that increase or decrease pharmacy student interest in seeking a career in geriatrics. METHODS: A 23-item survey was disseminated to 611 first- through fourth-year pharmacy students. Participants were recruited from two public schools of pharmacy in the United States from February through September 2022. Surveys were administered during class or distributed via email and websites for required courses. Participation was voluntary, and responses were anonymous. Descriptive statistics, independent-samples t-tests, Fisher's exact test, and analysis of variance were used for analysis. RESULTS: A total of 210 responses were received. Respondents were evenly split between somewhat or extremely interested and somewhat or extremely disinterested in geriatrics. Among those interested, the top factors driving interest were past positive experiences with older adults, interest in deprescribing, and perceived need for geriatrics-trained providers. Among those not interested, the top three factors discouraging interest were emotional impact of death and end-of-life care, disinterest in geriatric syndromes, and perception of inadequate exposure to geriatrics within the curriculum. CONCLUSIONS: In order to ensure an adequately trained geriatrics workforce for the aging population, it is crucial to intensify efforts to encourage health profession students to pursue careers in geriatric care. Creating opportunities to increase interest and addressing factors that discourage interest may augment the pipeline of pharmacy students wishing to seek a career specializing in older adult care.

Training of Doctors at the Geriatric Centre, University College Hospital, Ibadan, Nigeria.

BACKGROUND: The population of older people is increasing exponentially and geriatric care is just evolving in Nigeria. There is a shortage of training opportunities for doctors in Nigeria to care for older people. METHODS: This was an account of the conceptualisation, structure, and outcomes of the annual two-week basic certificate course in geriatric medicine for doctors at the University College Hospital (UCH), Ibadan, Nigeria, between 2016 and 2022. RESULTS: In all, 204 doctors were trained. Their mean age was 40.1 ± 8.5 years, and 105 (51.5%) were females. Majority (80%) worked in public hospitals, especially in the tertiary health sector (62.2%). Annual participation increased from 26 participants in 2016 to 39 participants in 2022. Knowledge acquisition was the main reason for attending the course (56.7%). There were 42 didactic lectures and ten clinical/practical sessions. On average, participants' self-rating in caring for older persons improved significantly after (80.2 ± 12.7%) than before (49.9 ± 16.4%) the course [mean difference = 30.24%, 95%CI (25.91-34.57), p<0.0001]. Similarly, the overall post-course test score in the 20 MCQs (14.08 ± 2.89) was significantly higher than the pre-course test (12.51 ± 2.01) scores [Mean difference = 1.57, 95%CI (0.45-2.69), p = 0.007]. Some participants (37.8%) had commenced special clinics for older persons in 39 institutions across Nigeria. CONCLUSION: Our training programme has yielded a modest increase in the capacity building of doctors for the care of older Nigerians. However, more concerted efforts are needed to train more doctors throughout Nigeria.

CONTEXTE: La population des personnes âgées augmente de façon exponentielle et les soins gériatriques sont en pleine évolution au Nigeria. Les médecins nigérians manquent de possibilités de formation pour s'occuper des personnes âgées. MÉTHODES: Il s'agit d'un compte rendu de la conceptualisation, de la structure et des résultats du cours annuel de certificat de base de deux semaines en médecine gériatrique pour les médecins à l'University College Hospital (UCH), Ibadan, Nigéria, entre 2016 et 2022. RÉSULTATS: Au total, 204 médecins ont été formés. Leur âge moyen était de 40,1±8,5 ans et 105 (51,5%) étaient des femmes. La majorité (80%) travaillait dans des hôpitaux publics, en particulier dans le secteur tertiaire de la santé (62,2%). La participation annuelle a augmenté de 26 participants en 2016 à 39 participants en 2022. L'acquisition de connaissances était la principale raison de participer au cours (56,7 %). Il y a eu 42 conférences didactiques et dix sessions cliniques/pratiques. En moyenne, l'auto-évaluation des participants en matière de soins aux personnes âgées s'est améliorée de manière significative après (80,2±12,7%) qu'avant (49,9±16,4%) le cours [différence moyenne=30,24%, 95%CI (25,91-34,57), p<0,0001]. De même, le score global au test post-cours dans les 20 QCM (14,08±2,89) était significativement plus élevé que le score au test pré-cours (12,51±2,01) [différence moyenne=1,57, 95%CI (0,45- 2,69), p=0,007]. Certains participants (37,8%) ont commencé à travailler dans des cliniques spéciales pour les personnes âgées dans 39 institutions à travers le Nigeria. CONCLUSION: Notre programme de formation a permis une augmentation modeste de la capacité des médecins à soigner les Nigérians âgés. Cependant, des efforts plus concertés sont nécessaires pour former davantage de médecins dans tout le Nigeria. Mots-clés: Main-d'œuvre, Formation, Médecins, Gériatrie, Nigeria.

The Paradoxical Decline of Geriatric Medicine as a Profession.

In this Viewpoint, author Jerry Gurwitz discusses the attrition of geriatric medicine as a profession, attributing it in part to societal attitudes about aging and compounded by the negative effects of lower compensation and lack of career prestige.

Geriatrics Fellows Learning Online And Together (Geri-a-FLOAT): A sustainable model of learning and support.

BACKGROUND: Geriatrics Fellows Learning Online And Together (Geri-a-FLOAT) is a virtual curriculum designed to convene fellows nationwide for learning and peer support. This paper presents the expansion and evaluation of the program from the "Wave 1" pilot to the "Wave 2" year-long curriculum. METHODS: Kern's six-step approach to curriculum development was used to develop the Wave 2 curriculum. Participation was collected via Zoom. Post-session web-based surveys evaluated participant satisfaction regarding speaker, content, and overall session quality; intent-to-change; and a free-response section. A one-year follow-up survey sent to participants with valid e-mail addresses assessed sustained knowledge, skills, and behavior change. RESULTS: Nineteen sessions were held with mean (SD) of 23 (13) participants per session, totaling 182 unique participants. Fifteen of 19 sessions were evaluated with 96 evaluations completed (mean [SD] 6 [4] evaluations per session). Mean (SD) ratings per session that were excellent or above average was 100% (0) for content, 99% (4) for speaker, and 99% (4) overall. Mean (SD) evaluations per session noting intent to change was 90% (14). Respondents reported helpful aspects as sharing resources and examples, perspectives and experiences of others, professional connections, and collaborative discussion. Of 127 participants with valid e-mail addresses, 40 (response rate = 31%) completed the one-year follow-up survey. Mean (SD) respondents reporting some or significant sustained impact was 89% (7) across all learning outcomes. CONCLUSIONS: This virtual, national curriculum for geriatrics fellows was well-received and associated with high rates of self-reported, sustained impact one-year post curriculum. Geri-a-FLOAT may be a model to standardize education and build collaboration and peer support across a discipline.

[The situation of geriatric medicine in Hungary today]. / A geriátria helyzete ma Magyarországon.

There is no systematic geriatric supply service and active geriatric wards are very rarely found in Hungary. That is why these wards need to be established in every leading county hospital as a regional system. The reasons for this lack are that active geriatric wards do not exist in the financing agreements, and, on the other hand, there is no sufficient number of geriatric specialists to fulfil the minimum personal conditions of a geriatric ward. The hospitals do not operate geriatric wards in lack of specialists, hence management pathways cannot be built in the system, therefore, no colleagues choose this subspecialty. Undoubtedly, the educational system does not support the training of geriatricians and, as a consequence of European Union regulations, secondary geriatrician subspecialization is not supported any more. The situation is extremely disadvantageous, most of the hospitals do not realize the importance of geriatrics, hence they do not work on establishing a care pathway between active care (internal medicine, surgery, gynecology, neurology, etc.), active geriatrics and chronic care. There is no geriatric outpatient service, daytime hospital system, their existence and operation are contingent. Finally, no geriatric consultant system (mobile, county, territorial) has been established. Orv Hetil. 2023; 164(23): 891-893.

Educación en salud destinada a personas mayores: valoración de las estrategias de enseñanza-aprendizaje / Healthcare education for the elderly: assessment of teaching-learning strategies

Objetivo principal: Interpretar el significado que se le asigna a las estrategias de enseñanza-aprendizaje en el área de salud destinada a personas mayores. Método: Estudio cualitativo de carácter exploratorio. Participaron personas mayores de 60 años y profesionales del área gerontológica con experiencia en la planificación y ejecución de educación en salud. La información fue recolectada a través de entrevista semiestructurada, y los datos fueron analizados a través de análisis de contenido. Resultados principales: Las personas mayores reconocen el realizar talleres y la educación individual como las mejores estrategias para recibir educación. Al triangular la información, los profesionales gerontológicos coinciden con la apreciación positiva de los talleres, pero acompañados de un adecuado diagnóstico participativo y desde la experiencia del participante. Conclusión principal: Los talleres se reconocen como la mejor estrategia de enseñanza-aprendizaje para personas mayores. Esta debe aplicarse considerando un diagnóstico participativo, con la experiencia de la persona mayor y ser mantenido en el tiempo. (AU)

Objective: To interpret the meaning assigned to the teaching-learning strategies in the area of healthcare for the elderly. Methods: Qualitative exploratory study. People over 60 years of age and professionals from the gerontology area with experience in planning and executing health education participated. The information was collected through a semi-structured interview, and the data was analyzed through content analysis. Results: People over 60 years of age and professionals from the gerontology area with experience in healthcare education activities. Information was collected through a semi-structured interview, and the data was analyzed through content analysis. When triangulating the information, the gerontological professionals agree with the positive appreciation of the workshops but accompanied by an adequate participatory diagnosis and from the experience of the participant. Conclusions: The workshops are recognized as the best teaching-learning strategy for the elderly. This must be applied considering a participatory diagnosis, with the experience of the older person and be maintained over time. (AU)

Improving care for older adults with hematological malignancies in India: Conquering the challenge.

In India, the number of older adults is steadily increasing and expected to reach around 200 million by 2030. Along with demographic change, India is experiencing a shift in family structure from multi-generational to nuclear families, affecting the social and psychological support available to older adults. The majority of hematological malignancies are diagnosed after the age of 60 years. Multiple issues associated with ageing, denoted as geriatric impairments, adversely affect the care of patients with cancer. Geriatric assessment and management is conspicuously underutilized and missing from the medical education curriculum in developing countries including India. Geriatric assessments may provide valuable information for the care of older adults with hematological malignancies, but incorporating geriatrics into the care of older patients with cancer in India will require knowledge of different approaches and consideration of the local healthcare context. In this article we will discuss the distinctive considerations in caring for older adults with hematological malignancies in India and to examine the unmet needs, challenges, and opportunities in improving the care of this population in the Indian context.

Geriatrics Education: Phone Calls With Older Adults and Medical Students.

BACKGROUND AND OBJECTIVES: The rapid increase in the older adult population necessitates an increase in physicians who are adept at caring for the various medical comorbidities that accompany aging. To fill the gap in geriatric medical education and overcome barriers to medical student interest in geriatrics, we developed a friendly caller program that links medical students to older adults through multiple weekly phone calls. This study examines the impact of this program on geriatric care competency, a foundational skill for primary care physicians, in first-year medical students. METHODS: We used a mixed-methods design to measure how medical students' self-assessed geriatric knowledge was impacted by their longitudinal interactions with seniors. We compared pre- and postsurvey data using a Mann-Whitney test. We used deductive qualitative analysis to examine themes that emerged from narrative feedback. RESULTS: Our results demonstrated that students (n=29) showed a statistically significant increase in components of their self-assessed geriatric care competency. Qualitative analysis of student responses revealed five common themes: transformation of preconceived notions regarding older adults, relationship building, greater understanding of older adults, communication skills, and self-compassion. CONCLUSIONS: Given the shortage of physicians competent in geriatric care amid a rapidly growing older adult population, this study highlights a novel, older adult service-learning program that positively impacts geriatric knowledge in medical students.