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Geriatrics and clerkship

Brian J Nagle, Andrea Berry, Laurel Gorman, Mariana Dangiolo
INTRODUCTION: The aging population is growing quickly and has a higher prevalence of comorbid and chronic diseases. A majority of this group resides in the home setting. The purpose of this study was to examine the attitudes of third-year medical students following a pilot component of an internal medicine clerkship, consisting of four in-home visits with geriatric patients. METHODS: A qualitative study design, utilizing focus groups, was used to assess general themes in students' responses regarding their attitudes to geriatrics, the field of geriatrics and the in-home care pilot program...
April 3, 2018: Curēus
Sube Banerjee, Nicolas Farina, Stephanie Daley, Wendy Grosvenor, Leila Hughes, Molly Hebditch, Sophie Mackrell, Ramin Nilforooshan, Chris Wyatt, Kay de Vries, Inam Haq, Juliet Wright
OBJECTIVES: Traditional healthcare education, delivered through a series of time-limited clinical placements, often fails to deliver an understanding of the experiences of those with long-term conditions, a growing issue for healthcare systems. Responses include longitudinal integrated clerkships and senior mentor programmes allowing students' longer placements, continuity of contact and opportunities to learn about chronic illness and patient experience. We review their development and delivery in dementia and present the Time for Dementia (TFD) Programme, a novel 2-year interdisciplinary educational programme...
January 2017: International Journal of Geriatric Psychiatry
Sophia Eilat-Tsanani, M Weingarten, M Ben-Ami, Mordechai Dayan, H Tabenkin
BACKGROUND: Teaching Internal Medicine is mainly hospital-based. Chronic diseases are treated mostly in community-based ambulatory care. This study describes our experience during the first year of teaching Internal Medicine in the community, with a focus on chronic disease management. METHODS: This was an observational study describing the content of clinical exposure and the feedback from students after a two-week clerkship in community health centers. RESULTS: Over a period of three months, 54 students spent two weeks in health centers singly or in pairs...
September 2015: Education for Health: Change in Training & Practice
John Agens, Jonathan S Appelbaum, Suzanne Baker, Kenneth Brummel-Smith, Eli Friedman, Suzanne L Harrison, Mitchell Kutner, Jonathan McKenzie
BACKGROUND AND OBJECTIVES: Functional and cognitive impairment correlates with medical outcomes in older persons, yet documentation in the medical record is often inadequate. The purpose of this pilot study was to evaluate fourth year (M4) medical students' charting performance of cognition and functional status in older persons during non-geriatric clerkships using an audit tool. METHODS: The research assistants used a chart abstracting tool to retrospectively review patients' charts...
January 2016: Family Medicine
Peng You, Marie Leung, Victoria Y Y Xu, Alexander Astell, Sudeep S Gill, Michelle Gibson, Christopher Frank
BACKGROUND AND PURPOSE: To foster interest in geriatric care, the Queen's Geriatrics Interest Group (QGIG) collaborated with the Division of Geriatric Medicine to arrange a Geriatrics Pre-Clerkship Observership Program. METHODS: Forty-two pre-clerkship medical students participated in the program between October 2013 and May 2014. Participants were paired with a resident and/or attending physician for a four-hour weekend observership on an inpatient geriatric rehabilitation unit...
December 2015: Canadian Geriatrics Journal: CGJ
Justin C De Biasio, Valerie Parkas, Rainier P Soriano
Delivering adequate care to older people requires an increasing number of physicians competent in the treatment of this expanding subpopulation. Attitudes toward older adults are important as predictors of the quality of care of older people and of medical trainee likelihood to enter the geriatrics field. This study assessed the attitudes of 404 US medical students (MS) from the start of medical school to graduation using the University of California, Los Angeles (UCLA) Geriatrics Attitude Scale. It is the first study to utilize a longitudinal design to assess attitudes among students in a medical school with a longitudinal geriatrics clinical experience in the first two years and a required geriatrics clerkship in the third year...
August 2016: Medical Teacher
Benedict F DiGiovanni, Leigh T Sundem, Richard D Southgate, David R Lambert
BACKGROUND: Musculoskeletal (MSK) conditions are common, and their burden on the healthcare system is increasing as the general population ages. It is essential that medical students be well prepared to evaluate and treat MSK disorders in a confident manner as they enter the workforce. Recent studies and the American Association of Medical Colleges have raised concern that medical schools may not give sufficient instruction on this topic. Other authors have shown that preclinical instruction has increased over the past decade; however, it is unclear if required clinical instruction also has followed that trend...
April 2016: Clinical Orthopaedics and related Research
Susan W Lehmann, Mary C Blazek, Dennis M Popeo
OBJECTIVE: The aging of the US population and shortage of geriatric psychiatrists mean that all medical students must be prepared to evaluate psychiatric symptoms in older patients. The authors sought to describe current geriatric psychiatry teaching practices during the psychiatry clerkship. METHODS: Psychiatry clerkship directors at 110 American medical schools were surveyed about didactic and clinical experiences of geriatric psychiatry. RESULTS: Sixty-two (56 %) of programs responded...
June 2015: Academic Psychiatry
Marije Huls, Sophia E de Rooij, Annemie Diepstraten, Raymond Koopmans, Esther Helmich
CONTEXT: A significant challenge facing health care is the ageing of the population, which calls for a major response in medical education. Most clinical learning takes place within hospitals, but nursing homes may also represent suitable learning environments in which students can gain competencies in geriatric medicine. OBJECTIVES: This study explores what students perceive as the main learning outcomes of a geriatric medicine clerkship in a hospital or a nursing home, and explicitly addresses factors that may stimulate or hamper the learning process...
March 2015: Medical Education
Laura Diachun, Andrea Charise, Mark Goldszmidt, Yin Hui, Lorelei Lingard
BACKGROUND: While major clerkship blocks may have objectives related to specialized areas such as geriatrics, gay and lesbian bisexual transgender health, and palliative care, there is concern that teaching activities may not attend sufficiently to these objectives. Rather, these objectives are assumed to be met "by random opportunity".((1)) This study explored the case of geriatric learning opportunities on internal medicine clinical teaching units, to better understand the affordances and limitations of curriculum by random opportunity...
December 2014: Canadian Geriatrics Journal: CGJ
Sara M Bradley, Dennis Chang, Robert Fallar, Reena Karani
The elderly are the most vulnerable to adverse events during and after hospitalization. This study sought to evaluate the effectiveness of a curriculum on patient safety and transitions of care for medical students during an Internal Medicine-Geriatrics Clerkship on students' knowledge, skills, and attitudes. The curriculum included didactics on patient safety, health literacy, discharge planning and transitions of care, and postdischarge visits to patients. Analysis of pre- and postassessments showed afterwards students were significantly more comfortable assessing a patient's health literacy and confident performing a medication reconciliation, providing education regarding medications, and identifying barriers during transitions...
2015: Gerontology & Geriatrics Education
Nisha Rughwani, Peter Gliatto, Reena Karani
The varied, atypical manifestations of geriatric syndromes make knowledge transfer the ability to extend knowledge from one context to another a particularly relevant concept. The authors hypothesized that multiple, contrasting short cases, by facilitating knowledge transfer, would improve knowledge more than a single long case in geriatric medicine. The authors' objective was to assess the impact of two instructional methods (a single long case vs. contrasting short cases) on knowledge and knowledge retention among 3rd-year medical students on their Internal Medicine-Geriatrics Clerkship...
2015: Gerontology & Geriatrics Education
Jamehl L Demons, Swapna Chenna, Kathryn E Callahan, Brooke L Davis, Linda Kearsley, Kaycee M Sink, Franklin S Watkins, Jeff D Williamson, Hal H Atkinson
Falls are a critical public health issue for older adults, and falls risk assessment is an expected competency for medical students. The aim of this study was to design an innovative method to teach falls risk assessment using community-based resources and limited geriatrics faculty. The authors developed a Fall Prevention Program through a partnership with Meals-on-Wheels (MOW). A 3rd-year medical student accompanies a MOW client services associate to a client's home and performs a falls risk assessment including history of falls, fear of falling, medication review, visual acuity, a Get Up and Go test, a Mini-Cog, and a home safety evaluation, reviewed in a small group session with a faculty member...
2014: Gerontology & Geriatrics Education
Debra K Weiner, Natalia E Morone, Heiko Spallek, Jordan F Karp, Michael Schneider, Carol Washburn, Michael P Dziabiak, John G Hennon, D Michael Elnicki
The Institute of Medicine has highlighted the urgent need to close undergraduate and graduate educational gaps in treating pain. Chronic low back pain (CLBP) is one of the most common pain conditions, and older adults are particularly vulnerable to potential morbidities associated with misinformed treatment. An e-learning case-based interactive module was developed at the University of Pittsburgh Center of Excellence in Pain Education, one of 12 National Institutes of Health-designated centers, to teach students important principles for evaluating and managing CLBP in older adults...
June 2014: Journal of the American Geriatrics Society
Andalib F Haque, Daniel G Soong, Camilla L Wong
BACKGROUND: The aging population requires an improvement in physicians' attitudes, knowledge, and skills, regardless of their specialty. This study aimed to identify attitude changes of University of Toronto pre-clerkship medical students towards geriatrics after participation in a Geriatric Clinical Skills Day (GCSD). METHODS: This was a before and after study. The GCSD consisted of one large and four small interactive, inter-professional geriatric medicine workshops facilitated by various health professionals...
March 2014: Canadian Geriatrics Journal: CGJ
A A Meiboom, H de Vries, B A M Hesselink, C M P M Hertogh, F Scheele
In order to develop strategies for raising the interest of medical students in a career in elderly care medicine (a specialty in The Netherlands) we should start by gaining more insight into the process influencing career choices among medical students and graduates. In this qualitative study we conducted three focus group discussions with trainees in elderly care medicine and two focus group discussions with obstetrics and gynaecology trainees. We found that all trainees made their career choice after clinical exposure in the field...
January 2014: Tijdschrift Voor Gerontologie en Geriatrie
Joye St Onge, George Ioannidis, Alexandra Papaioannou, Heather McLeod, Sharon Marr
BACKGROUND: The impact of geriatric medicine educational programs on patient level outcomes, as opposed to educational measures, is not well studied. We aimed to determine whether completion of a mandatory geriatrics rotation changed the clinical behaviors of clerks caring for older patients admitted to a medical clinical teaching unit. METHODS: We reviewed the charts of 132 older (>70y) patients, admitted to one medical clinical teaching unit (CTU) during 2005, and cared for by a clinical clerk, for documented functional assessment, cognitive assessment, recognition of medications that cause confusion, and early removal of indwelling urinary catheters...
2013: BMC Medical Education
Benjamin A Bensadon, Thomas A Teasdale, Germaine L Odenheimer
For more than half a century, scientific research has documented widespread avoidance and even denial of aging. Though nothing new, aversive reactions to the elderly are not only unfortunate but dangerous today, as increasing life expectancy and consequent demand for specialized geriatric medical care vastly outpace the supply of qualified clinicians equipped to provide it. This discrepancy has led to a crisis that is not easily resolved. At the same time, geriatrics reports the highest level of physician satisfaction among medical specialties...
November 2013: Academic Medicine: Journal of the Association of American Medical Colleges
Elisabeth Igenbergs, Tobias Deutsch, Thomas Frese, Hagen Sandholzer
BACKGROUND: With regard to the growing proportion of elderly multimorbid patients, a sound undergraduate geriatric education becomes more important. Therefore we included the execution and interpretation of a comprehensive geriatric assessment (CGA) into a mandatory two-week clerkship at a general practitioner's office. The present study examined the effect of a guide structuring the students' considerations when interpreting a CGA on the quantity and accuracy of the documented findings and conclusions...
2013: BMC Medical Education
Annie L Nguyen, Elizabeth A Duthie, Kathryn M Denson, Jose Franco, Edmund H Duthie
Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine knowledge and medical student attitudes toward older adults. Mean National Board of Medical Examiners (NBME) internal medicine subject exam scores from geriatrics and internal medicine students who matriculated from 2005 to 2011 were compared using student's t-tests...
2013: Gerontology & Geriatrics Education
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