GERONTOLOGY & GERIATRICS EDUCATION最新文献

Interdisciplinary education and research foster cross disciplinary collaboration. The study of age and aging is complex and needs to be carried out by scholars from myriad disciplines, making interdisciplinary collaboration paramount. Non-formal, extracurricular, and interdisciplinary networks are increasingly filling gaps in academia's largely siloed disciplinary training. This study examines the experiences of trainees (undergraduate, graduate, and post-graduate students) who belonged to one such network devoted to interdisciplinary approaches to education and research on aging. Fifty-three trainees completed the survey. Among respondents, some faculties (e.g., Health Sciences) were disproportionately represented over others (e.g., Business, Engineering, and Humanities). Most trainees valued their participation in the interdisciplinary network for research on aging. They also valued expanding their social and professional network, the nature of which was qualitatively described in open-text responses. We then relate our findings to three types of social capital: bonding; bridging; and linking. Finally, we conclude with recommendations for the intentional design and/or refinement of similar networks to maximize value to trainees, provide the skills necessary for interdisciplinary collaboration, and foster egalitarian and representative participation therein.

At a time when the older adult population is increasing exponentially and health care agencies are fraught with crisis-level short-handedness and burnout, addressing the Quadruple Aim of enhancing patient experience, improving population health, reducing costs, and improving the work life of health care providers is more crucial than ever. A multi-step education model was designed to advance competencies in geriatrics and Interprofessional Collaborative Practice (IPCP) for health profession students focused on each element of the Quadruple Aim. The goals of this education were to equip students with knowledge and experience to provide team-based care for older adults and achieve satisfaction with the education program. The education steps consisted of online didactics, team icebreaker, skills practice, professional huddles, and interprofessional simulation with debriefing. Over 2,300 students and 87 facilitators from 16 professions completed the training over three years. A positive statistically significant increase was found between pre- and post-measures of IPCP competency, knowledge, and attitudes. Additionally, high satisfaction with the education was reported by students and facilitators. By providing positive geriatric education and experiences for health students to work in interprofessional teams, it can translate into future improvements in older adult population health, health care provider job satisfaction, and reduced health care costs.

The development of a skilled research workforce in aging is fundamental to understanding conditions associated with growing older and extending healthy, active years of life. The National Institutes of Health (NIH) supports the training of health scientists, and its National Institute on Aging (NIA) prioritizes the professional development of investigators with an interest in aging. Since 1987, NIA's Summer Institute on Aging Research, renamed the Butler-Williams (B-W) Scholars Program in 2013, has offered an intensive one-week experience on issues, opportunities, and challenges of research on aging, with emphasis on disparities and health equity. The first 30 years of the Program are described in this report, including its history, selected curriculum highlights, Scholar outcomes, and qualitative data from faculty, and the program's impact on the training, growth, and development of scientists in aging research. Questions raised over a decade ago by the Committee on the Future Health Care Workforce for Older Americans Board on Health Care Services are revisited, and recommendations for the future are provided. This important Program remains an exemplar for the training and development of health scientists for careers that advance biomedical research and emphasize an equitable understanding of factors related to extending healthy years of life.

The development and evaluation of an interprofessional education (IPE) pre-professional geriatrics experience involving learners from 10 different health discipline programs is described. The experience provided learners with opportunities to use small-group collaborative approaches in two 3-hour interprofessional sessions. Learners gained exposure to geriatric principles and awareness of the needs of older adults and their families using case studies developed by experienced interprofessional faculty. Learners completed pre- and post-experience surveys and worksheets on their confidence to function in interprofessional teams, knowledge of other disciplines, perceptions of importance of each discipline in providing older adult care, and the qualities considered for a successful team. Data were collected over three offerings of the experience (2016, 2017, 2018) and analyzed using paired sample t-tests and ANOVA. A total of 562 learners participated with outcome measures indicating increased knowledge of older adult services different health professionals provide and increased confidence in knowing when to complete care referrals. Mean increase in learners' confidence to function in interprofessional teams was significant, suggesting the experience was effective in facilitating confidence in functioning and improving views of other disciplines' roles. This experience demonstrated that learners gained exposure to apply geriatric principle skills and critical thinking as interprofessional team members.

Trauma-informed approaches may promote the well-being of CNAs and disrupt organizational practices that perpetuate inequities. There is a dearth of literature addressing evidence-based, trauma-informed training for direct care staff, yet CMS now requires trauma-informed care in nursing homes. Five focus groups exploring trauma and resilience-related concepts were conducted using an expressive-collaborative model with 18 CNAs at four nursing homes. A thematic analysis was conducted and themes were identified related to identity, relationships with residents, organizational values, and personal wellness. CNAs voiced frustration at limited time and support to implement well-being or stress management practices. Relationships with residents were sources of strength and, conversely, sources of emotional injury due to disrespect, disregard, and hostile behavior directed at CNAs. Central to health and well-being, CNAs called for change within facility cultures experienced as disrespectful, inequitable, and contrary to work-life balance. Trauma-informed training can be used to give particular attention to direct care staff. Administrators would benefit from learning about trauma and resilience among CNAs and precipitating organizational factors such as reasonable care ratios, equitable benefits, and peer support that impact CNA well-being, job satisfaction, and quality of care. The development and implementation of a trauma-informed training curriculum for CNAs are warranted.

Given the growing prevalence of Alzheimer's disease (AD), we assessed the impact of virtually embodying someone with progressive AD. This pilot explored students' understanding of individuals' needs with dementia, as well as, the efficacy of virtual reality (VR) as a curricular tool. Second-year medical students (n = 150) completed a pre-survey, Embodied Labs, Inc. Beatriz Lab VR module, and a post-survey. Most students knew someone with dementia (72%), were a family member of someone with dementia (52%) or had worked with a patient (61%) with dementia. Using paired survey questions, students reported significant increases in understanding how their lives would be affected by dementia (71% vs. 94%) and the needs of a person with dementia (64% vs. 95%) after VR. They reported increased understanding of being a caregiver of someone with dementia (24% vs. 81%) and the impact it can have on the entire family (64% vs. 97%). Overall students agreed this simulation made them think about their approach to clinical skills (94%) and should be utilized more in the curriculum (76%). This pilot study indicated that this VR experience can be used to advance understanding of a person's experiences with dementia and that integrating VR into the medical curricula should be considered.

Physician faculty learn teaching skills informally while fighting competing professional obligations. One underutilized proven technique to improve teaching skills is peer observation with feedback. We aimed to understand benefits and challenges of a physician faculty development program based on peer observation of teaching and to develop best practice recommendations for future program development. The authors developed a peer observation-based physician faculty development program from 2015 to 2017. Two interviewers conducted and analyzed qualitative interviews with 13 faculty participants and four non-participants using content analysis to identify themes and subthemes in NVivo©. Participant-identified program benefits included conveyed institutional support for teaching, the opportunity for peer observation with direct and timely feedback, the opportunity for community building, and overall program feasibility. Program challenges included competing scheduling demands, variability in feedback quality, and difficulty maintaining engagement for the program duration. Potential areas for improvement included participation incentives, external faculty involvement, assistance with program logistics and administration, and improvement in the consistency of the feedback experience. While peer observation is a valued approach to physician faculty development of teaching skills, competing demands on physicians may still limit program effectiveness. Program sustainability depends on optimizing feedback quality, boosting motivation for participation, and providing administrative support.

There is a need for more Registered Dietitian Nutritionists (RDNs) trained to provide nutritional care to older adults with dementia who experience mealtime difficulties. The purpose of this single-arm, pre/post pilot study was to adapt a generalized dementia care curriculum to the learning needs of RDNs who work with individuals with dementia and to determine the feasibility and acceptability of the adapted program. Using an existing evidence-based dementia care curriculum, the research team identified learning objectives and content pertinent to the scope of RDNs. The adapted program was piloted with RDNs who work with older adults with dementia. Twenty-five RDNs registered for the training while 80% (20) attended the training and completed the post-training survey. All participants agreed that the module met the learning needs of RDNs who work with older adults with dementia, the two-hour workshop was a good use of their time, and the experience and skills gained would be useful in their work as an RDN. Implementation costs totaled $1,310. Based on the post-training feedback, the adapted program was deemed feasible and acceptable by RDN participants, who also expressed interest in using the module to train other caregivers on providing mealtime assistance to older adults with dementia.

Geriatric patients with complex health care needs can benefit from interprofessional (IP) care; however, a major gap in health professional education is determining how to prepare future providers for IP collaboration. Effective IP team behavior assessment tools are needed to teach, implement, and evaluate IP practice skills. After review of IP evaluation tools, the Standardized Patient Encounter Evaluation Rubric (SPEER) was created to evaluate team dynamics in IP practice sites.Independent sample t-tests between faculty and learner SPEER scores showed learners scored themselves 15 points higher than their faculty scores (p < .001). Cronbach's α showed high internal consistency (α = 0.91). Paired t-tests found that learners identified improvements in the team's ability to address the patient's education needs and to allow the patients to voice their expectations. Faculty identified improvements in the teams' ability to make recommendations. Faculty evaluations of learner teams showed improvements in raw ratings on all but two items. Qualitative data analysis for emergent themes showed learners desired team functioning feedback and how teamwork could improve to provide optimal IP care.In conclusion, the SPEER can help faculty and learners identify growth in their teams' ability to perform key IP skills in clinical sites.

Increased training is necessary to ensure that the next generation of health care professionals are prepared to effectively and compassionately serve patients with Alzheimer's Disease. Second Life® is a virtual world shown to provide a safe, convenient, and effective environment for teaching health-related content. To date, there has been no comprehensive review of studies using Second Life in education about Alzheimer's Disease. The authors conducted a scoping review of the literature on the use of Second Life in the education of medical, nursing, and health professions students about Alzheimer's Disease. Searches were conducted in PubMed, SCOPUS, and CINAHL. Thirty-two studies containing outcomes of the application of virtual reality and the virtual world Second Life were identified. Studies were classified using the Kirkpatrick Four-Level Training Evaluation Model. Changes in knowledge, attitudes, and confidence (Level 2), were most commonly reported, followed by positive reactions (Level 1). No studies identified system-level results and few examined changes in behavior. While results indicate positive student reactions and enhanced learning from Second Life interventions related to Alzheimer's Disease, they also highlight a need for future research examining outcomes at the higher Kirkpatrick levels.