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1.
J Forensic Nurs ; 16(1): 36-46, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31299671

RESUMO

INTRODUCTION: Corrections agencies are exploring ways to securely and cost-effectively increase access to high-quality, evidence-based educational programs for personnel. Technology-based instructional tools hold strong potential for continuing education. The Institute for Healthcare Improvement's Framework for Going to Full Scale was employed to guide a systematic approach. PURPOSE: The purpose of this article is to outline and describe the design and development of a media-rich interactive computer-based learning product, Enhancing Care for Aged and Dying in Prison, which addresses geriatric and end-of-life care issues in corrections. METHOD: Through an iterative process, the research team developed the computer-based educational program that included program and module-specific objectives in alignment with goals and priorities of the end users, detailed evidence-based content that was engaging and visually appealing, and assessments aimed at testing the user's knowledge. RESULTS: The Enhancing Care for Aged and Dying in Prison contains six modules, created under the careful guidance of the research team and the two advisory boards. Contents, including images and testimonials, were selected purposefully and strategically. Module objectives were developed in alignment with the goals and priorities of each module, and assessments tested user knowledge level pre/post module exposure. Completion of the training product advances the research and development necessary to further the goal of full-scale dissemination of the computer-based education. DISCUSSION/CONCLUSIONS: The goal of this program is to enhance care and improve quality of life for aged and dying inmates. Evidence-based training products are critical in preparing not only forensic nurses who work in corrections but also the broader group of correctional personnel in how to better meet the care needs of incarcerated persons.


Assuntos
Instrução por Computador , Geriatria/educação , Prisioneiros , Desenho de Programas de Computador , Assistência Terminal , Idoso , Humanos , Desenvolvimento de Programas , Interface Usuário-Computador
4.
BMC Med Educ ; 19(1): 322, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31455354

RESUMO

BACKGROUND: Given the increasing evidence and expansion of integrated care (IC) in healthcare, new IC curricula introduced early in undergraduate medical education (UME) are needed. Building on a pilot IC simulation called "Getting to Know Patients' System of Care" (GPS-Care), we aimed to explore students' understanding of patients' complex physical and mental health needs, and to increase our understanding of how students learned in this simulation. METHODS: 177 of 259 first-year medical students participated in GPS-Care at the University of Toronto. Students role-played an elderly patient or caregiver within 5 simulated healthcare professional appointments. Students completed written reflections and 7 students participated in one-on-one interviews. A thematic analysis of the reflections and transcripts was conducted and descriptive data was generated for questionnaires. RESULTS: Data saturation was reached at 43 reflections and 7 transcripts and the following themes emerged: a) students reflected on patients' complex care experiences, b) students reflected on of the healthcare system needs care, c) students increased understanding of IC, and d) students desire to improve the care of IC patients within the healthcare system. CONCLUSIONS: In addition to confirming previous pilot study themes, the results from this study identified the role of productive struggle to provide students with a deeper understanding of patients' IC care needs. Moreover, GPS-Care resulted in a transformative learning experience resulting in new insights into the importance of IC early in UME training.


Assuntos
Educação de Graduação em Medicina , Geriatria/educação , Simulação de Paciente , Estudantes de Medicina , Humanos , Projetos Piloto , Aprendizagem Baseada em Problemas
5.
Am J Health Syst Pharm ; 76(4): 236-241, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31415680

RESUMO

PURPOSE: In this article we describe a novel required longitudinal experience focused on deprescribing designed for postgraduate year 2 (PGY2) geriatric pharmacy residents. This experience was embedded within a clinical pharmacist-driven deprescribing service. Insights on challenges faced and benefits gained during the first offering are also highlighted. SUMMARY: Through collaboration with the University of Pittsburgh School of Pharmacy (UPMC) Palliative and Supportive Institute and the UPMC St. Margaret PGY2 geriatric pharmacy residency program, a year-long required deprescribing-focused experience was developed and executed. The experience was aligned with the American Society of Health-System Pharmacists' standard goals and objectives and was designed to focus and evaluate 3 skills necessary for all pharmacy practitioners: empathy, critical thinking, and communication. There is a need for proactive deprescribing initiatives to reduce the unnecessary burden and cost associated with potentially inappropriate medications for older patients. Focused deprescribing experiences can better equip pharmacist learners with the ability to lead these initiatives. CONCLUSION: A required longitudinal deprescribing-focused experience can provide PGY2 geriatric pharmacy residents with opportunities to practice empathy, critical thinking, and communication beyond those typically offered in a residency program.


Assuntos
Desprescrições , Educação de Pós-Graduação em Farmácia/organização & administração , Residências em Farmácia/organização & administração , Desenvolvimento de Programas , Idoso de 80 Anos ou mais , Avaliação Educacional , Feminino , Geriatria/educação , Humanos , Masculino , Cuidados Paliativos/métodos , Farmacêuticos , Serviço de Farmácia Hospitalar , Papel Profissional
8.
BMC Med Educ ; 19(1): 283, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31345198

RESUMO

BACKGROUND: Physical and psychological health problems are prevalent in older adults and rarely exist in isolation. Treating these problems in isolation is resourceful and can be potentially harmful to patients due to delays in diagnosis and treatment and incomplete holistic care plans. Historically, trainees in geriatric medicine and old age psychiatry within the United Kingdom have completed very different training programmes. METHODS: We undertook a pre-feasibility pilot study of collaborative postgraduate training between trainees in geriatric medicine and old age psychiatry within the West Midlands training region, United Kingdom. Trainees in each specialty were paired with each other and advised to arrange appropriate training opportunities for their counterpart; these included shadowing each other in their workplace and arranging opportunities to attend training opportunities with their consultants. Pre- and post-pilot surveys were completed by all trainees and reflections from trainees were collated. RESULTS: Five trainee pairs were formed and arranged shadowing and training opportunities between October 2017 and May 2018. This included a combination of inpatient, outpatient, and community work. For both specialties, trainees' confidence in topics relating to their counterparts' specialty increased between the pre- and post-pilot surveys. Recurrent themes included within reflections included the benefits of collaborative training. CONCLUSIONS: Our pilot has demonstrated that it is feasible to implement a programme of joint training into postgraduate medical training, and that this can have a positive impact upon the confidence of both specialties. An extended pilot is planned for the training year 2018-2019.


Assuntos
Comportamento Cooperativo , Educação de Pós-Graduação em Medicina , Geriatria/educação , Psiquiatria/educação , Idoso , Estudos de Viabilidade , Humanos , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Reino Unido
9.
Nurs Educ Perspect ; 40(4): 257-258, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31232901

RESUMO

The focus of this article is an innovative approach to teaching gerontology by utilizing a collaborative approach to structuring clinical experiences. The goal was to better prepare future nurses for the growing epidemic of baby boomers. Faculty were challenged to rethink clinical education and design a new method to better prepare nursing students to care for older adults.


Assuntos
Bacharelado em Enfermagem , Educação em Enfermagem , Geriatria , Estudantes de Enfermagem , Idoso , Currículo , Geriatria/educação , Humanos
10.
Geriatr Nurs ; 40(6): 579-583, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31147174

RESUMO

Interprofessional education of health care professionals caring for older adults is critical to address the unique needs of geriatric patients. An interprofessional education program - the Geriatric Care Boot Camp Series ("Series") - was designed for health care professionals to fill this education gap. The program consisted of three half-day, intensive boot camps conducted over a one-year period. A total of 112 learners participated; more than half were nurses. Data analysis revealed statistically significant increases following each boot camp in attendees' reported knowledge about caring for older adults; statistically significant increases in comfort caring for older adults were also seen among participants in two boot camps. Attendees found the interprofessional nature of the program beneficial and said they would attend a similar program again. The Series is easily replicable, appealing to the target audience, and fulfills the need to better educate health care professionals on caring for older adults.


Assuntos
Educação Continuada , Geriatria/educação , Pessoal de Saúde/educação , Relações Interprofissionais , Idoso , Avaliação Educacional , Feminino , Humanos , Masculino
11.
Am J Med ; 132(8): e634-e647, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31075225

RESUMO

PURPOSE: This study was intended to determine whether a simulation-based education addressed to physicians was able to increase the proportion of hospitalized elderly with atrial fibrillation prescribed with oral anticoagulants (OACs) compared with the usual practice. METHODS: We conducted a cluster randomized trial (from April 2015 to September 2018) on 32 Italian internal medicine and geriatric wards randomized 1:1 to intervention or control arms. The physicians of wards randomized to intervention received a computer-based e-learning tool with clinical scenarios (Dr Sim), and those of wards randomized to control received no formal educational intervention. The primary outcome was the OAC prescription rate at hospital discharge in the intervention and control arms. RESULTS: Of 452 patients scrutinized, 247 were included in the analysis. Of them, 186 (75.3%) were prescribed with OACs at hospital discharge. No difference was found between the intervention and control arms in the post-intervention phase (odds ratio, 1.46; 95% confidence interval [CI], 0.81-2.64). The differences from the pre- to post-intervention phases in the proportions of patients prescribed with OACs (15.1%; 95% CI, 0%-31.5%) and with direct oral anticoagulants (DOACs) (20%; 95% CI, 0%-39.8%) increased more in the intervention than in the control arm. CONCLUSIONS: This simulation-based course did not succeed in increasing the rate of elderly patients prescribed with OACs at hospital discharge compared with the usual practice. Notwithstanding, over time there was a greater increase in the intervention than in the control arm in the proportion of patients prescribed with OACs and DOACs. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03188211.


Assuntos
Anticoagulantes/administração & dosagem , Fibrilação Atrial/tratamento farmacológico , Simulação de Paciente , Treinamento por Simulação/métodos , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Competência Clínica/normas , Análise por Conglomerados , Educação Médica Continuada/métodos , Feminino , Geriatria/educação , Geriatria/métodos , Humanos , Masculino , Razão de Chances , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/prevenção & controle
12.
J Dent Educ ; 83(6): 638-644, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30910927

RESUMO

The aim of this study was to investigate the effect that an interprofessional clinical experience (IPCE) had on dental and adult-gerontology primary care nurse practitioner (NP) students' attitudes towards health care collaboration. A survey study was conducted with dental and NP students before and after completing IPCE rotations in a dental clinic and a tertiary care setting in the 2016-17 academic year. All dental students (N=159) and all NP students enrolled in the adult-gerontology primary care program (N=37) participated in the IPCE. Students were asked to complete the Readiness for Interprofessional Learning Scale (RIPLS) survey anonymously prior to and immediately after the experience. All 37 NP students completed both pretest and posttest, for a 100% response rate on both. Among the dental students, 120 completed the pretest, for a 75% response rate, and 106 completed the posttest, for a 67% response rate. The results showed a significant increase in total RIPLS score for both the dental and NP students following the experience (p<0.001). Attitudes about teamwork and collaboration and about roles and responsibilities improved for both the dental and NP students (p<0.001) following the IPCE. There was a difference between dental students' and NP students' teamwork and collaboration subscale scores before IPCE (p=0.006), but it diminished after the intervention (p=0.09). These results suggest the IPCE succeeded in building positive attitudes about interprofessional collaboration between dental and NP students. Clinical rotations should be considered to enhance the scope of students' experiences with interprofessional patient care.


Assuntos
Atitude do Pessoal de Saúde , Relações Interprofissionais , Profissionais de Enfermagem/educação , Estudantes de Odontologia/psicologia , Estudantes de Enfermagem/psicologia , Adulto , Educação em Odontologia/métodos , Educação em Enfermagem/métodos , Feminino , Geriatria/educação , Humanos , Masculino , Profissionais de Enfermagem/psicologia
13.
Public Health Nurs ; 36(3): 401-410, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30734363

RESUMO

The purpose of this article is to explain the strategies used in the "Set-up" phase of developing computer-based education on the care and management of incarcerated people who are older and/or dying. Public health nurses have an opportunity to support efforts in educating corrections staff to enhance health care for older and dying inmates. Such endeavors can promote social justice through inmates receiving evidence-based care that parallels that received by the community at large. "Set-up" is the first of four phases in the Institute for Healthcare Improvement's Framework for Going to Full Scale. Our design approach was threefold and included an environmental scan, a modified Delphi survey, and a usability study. An expert advisory board was consulted throughout the Set-up Phase. Participants for the Delphi Survey had expertise in geriatrics and corrections health care. Usability testing was conducted at two State Correctional Institutions. The Delphi Survey consisted of three Qualtrics surveys. Usability testing examined navigability; detected problems; observed time spent solving problems; identified problem severity; and developed recovery strategies. The Set-up established proof of concept, three prototype modules, and a specifications document to guide future programming. In addition, a Technology Niche Analyses® provided a preliminary commercialization plan (NIH, 2017). The Set-up phase has been instrumental in exposing the available infrastructure for dissemination of an educational product within corrections and may be a first step in addressing public health concerns on issues in aging. Commercial feasibility of the program and the need for continued research for Developing the Scalable Unit were established.


Assuntos
Instrução por Computador/métodos , Geriatria/educação , Educação em Saúde/métodos , Serviços de Saúde para Idosos , Prisioneiros , Assistência Terminal/métodos , Idoso , Idoso de 80 Anos ou mais , Prova Pericial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Australas J Ageing ; 38(2): e58-e66, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30761707

RESUMO

OBJECTIVE: To describe the experience of a Brazilian medical school in implementing different active methods to teach Geriatric Medicine, reporting the students' opinions and satisfaction with the classes and comparing pre- and postcourse measurements of knowledge, attitudes and skills. METHODS: A total of 166 third-year medical students received different active theoretical-practical activities for teaching Geriatric Medicine and their knowledge, attitudes, clinical skills and satisfaction were investigated. RESULTS: All activities had good acceptance among students ranging from 8.54 in the activity "Walking aids" to 9.81 in the activity "Nursing Home visit" (ranging 0-10). After the course, students had better attitudes towards older persons (r = 0.55-0.81, P < 0.001), better knowledge (r = 0.84, P < 0.001), greater empathy (r = 0.51, P < 0.001) and better clinical skills (r = 0.86, P < 0.001). Finally, the course was evaluated positively by the students. CONCLUSION: New active Geriatric Medicine learning activities resulted in improvement in medical students knowledge, attitudes and skills.


Assuntos
Competência Clínica , Geriatria/educação , Conhecimentos, Atitudes e Prática em Saúde , Estudantes de Medicina , Ensino , Adulto , Feminino , Humanos , Masculino
15.
Gerontol Geriatr Educ ; 40(2): 153-165, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30763180

RESUMO

Situated within a Canadian context, but with implications for a broad range of institutional settings, this paper describes the events that preceded the adoption of the Age-Friendly University (AFU) framework at the University of Manitoba (U of M), as well as the specific strategies being employed within the university to assess and encourage age-friendliness. These include: a) the university's Centre on Aging and its mandate to foster interdisciplinary age-related research and community dialogue, b) the creation of an interdisciplinary AFU committee and several working groups, c) innovative research projects that have assessed university age-friendliness from a variety of stakeholder perspectives, and d) an interactive undergraduate course activity being used to educate students about AFU features. Present and future AFU challenge areas and potential solutions are discussed.


Assuntos
Envelhecimento , Geriatria/educação , Pesquisa/organização & administração , Universidades/organização & administração , Idoso , Idoso de 80 Anos ou mais , Participação da Comunidade , Competência Cultural , Humanos , Índios Norte-Americanos , Comunicação Interdisciplinar , Relação entre Gerações , Conhecimento , Manitoba , Fotografação , Projetos Piloto , Dinâmica Populacional/tendências , Pesquisa Qualitativa , Características de Residência
16.
Gerontol Geriatr Educ ; 40(2): 194-202, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30753118

RESUMO

This article elucidates opportunities for health professions education programs to make a mark in the Age Friendly University (AFU) initiative. Specifically, key approaches are introduced for health professions education programs based on the Age Friendly University Global Network initiative and the Academy for Gerontology/Geriatrics in Higher Education (AGHE) Program of Merit for Health Professions Programs. Higher Education Institutions (HEIs) that offer health professions education, have various options to establish and enhance student gerontology/geriatrics competence and confidence. However, two options are germane to new initiatives that are making their mark in HEIs. First, Age Friendly University Guiding Principles applicable to health professions education allow health gerontology faculty to be catalysts to promote and integrate these principles within their program's curriculum contributing to their institution's readiness to apply for the Age Friendly University designation. Second, the Academy for Gerontology in Higher Education (AGHE) Program of Merit (POM) provides specific geriatrics/gerontology competencies for health professions programs to integrate into the program's curriculum along with an option to attain recognition as an AGHE Program of Merit. Attaining both designations contributes to preparing future health professions providers with improved older adult health care skills that also benefits older adults.


Assuntos
Envelhecimento , Geriatria/educação , Ocupações em Saúde/educação , Estudantes , Universidades/organização & administração , Idoso , Idoso de 80 Anos ou mais , Currículo , Humanos , Relação entre Gerações , Conhecimento , Aprendizagem , Dinâmica Populacional/tendências , Competência Profissional , Estados Unidos
18.
Artigo em Inglês | MEDLINE | ID: mdl-30649847

RESUMO

The Workforce Education and Training component of California's Mental Health Services Act, which passed in 2004, has infused funding into the public mental health system. However, funding has not kept pace with an existing behavioral health workforce shortage crisis, the rapid growth of an aging population, and the historical lack of geriatric training in higher education for the helping professions. This policy brief draws on recent study findings, state planning documents, and a review of the literature to describe gaps and deficiencies in the behavioral health workforce that serves older adults in California. The brief offers recommendations to the following specific audiences for improving workforce preparation and distribution: state policymakers and administrators; educational institutions, accrediting bodies, and licensing boards; and county mental health/behavioral health departments and their contracted providers.


Assuntos
Medicina do Comportamento , Serviços de Saúde para Idosos , Mão de Obra em Saúde/estatística & dados numéricos , Serviços de Saúde Mental , Idoso , Idoso de 80 Anos ou mais , Medicina do Comportamento/educação , Credenciamento , Geriatria/educação , Humanos , Serviços de Saúde Mental/provisão & distribução , Transtornos Relacionados ao Uso de Substâncias , Suicídio/prevenção & controle
19.
Gerontol Geriatr Educ ; 40(2): 203-220, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30693846

RESUMO

The University of Massachusetts Boston endorsed the Age Friendly University (AFU) principles in 2017, becoming the second campus in the Commonwealth to join the AFU movement. In order to demonstrate what it means to become an AFU, a research team worked to audit the University's level of age-friendliness. A workgroup of 12 volunteers from across campus departments and constituencies was convened in 2018 to operationalize the 10 principles with the goal of designing an audit tool and then piloting the tool. Nineteen key informants were interviewed representing a wide range of campus life including administration, career counseling, advising, communications, student life, campus services, distance education, and health and wellness services. Major themes emerged related to educational programming, accessibility and inclusivity. The importance of conducting an audit was demonstrated in the opportunities it presented to increase awareness among diverse stakeholders who comprise a campus community about making the vision of age-friendliness a reality.


Assuntos
Envelhecimento , Geriatria/educação , Pesquisa/organização & administração , Estudantes , Universidades/organização & administração , Idoso , Idoso de 80 Anos ou mais , Boston , Participação da Comunidade , Humanos , Relação entre Gerações , Conhecimento , Projetos Piloto , Dinâmica Populacional/tendências
20.
Health Aff (Millwood) ; 38(1): 164-168, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30615526

RESUMO

Motivated by the increasing number of older people-many with chronic illnesses-and the lack of support for them, the John A. Hartford Foundation (JAHF) made improving the care of older adults one of its two priorities in 1983 and its sole priority in 1994. To accomplish this, the foundation adopted a two-part strategy: first, create a field of professionals capable of caring for an aging population, and second, test models of care for older adults. The JAHF steadfastly pursued that strategy until 2013, when it adopted an approach focused on advancing age-friendly health systems. Geriatrics is now a recognized medical, nursing, and social work specialty, although low reimbursement, the stigma associated with caring for older people, and low prestige discourage students from entering it. Foundation-funded models of care have proven viable, and one of them-palliative care-has been widely adopted. The JAHF focused on an important social need for more than three decades, and this targeted and consistent effort has magnified its impact.


Assuntos
Fundações/organização & administração , Geriatria , Serviço Social/educação , Idoso , Idoso de 80 Anos ou mais , Geriatria/educação , Geriatria/organização & administração , Humanos
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