Prendergast Heather M, Jurivich Donald, Edison Marcia, Bunney E Bradshaw, Williams John, Schlichting Adam
Department of Emergency Medicine, University of Illinois Medical Center, Chicago, Illinois 60612, USA.
J Emerg Med. 2010 Apr;38(3):386-92. doi: 10.1016/j.jemermed.2008.05.003. Epub 2008 Nov 22.
Emergency Departments (EDs) are common entry points to the health care system for elders. Emergency Medicine residents need specialized education about geriatric patients to maximize health outcomes.
To determine whether geriatric education provided to residents in Emergency Medicine results in improved knowledge of and attitudes toward geriatric patients.
A pre- and post-intervention survey was conducted in a 3-year university-based residency program in Emergency Medicine. Participants were Emergency Medicine residents (PGY 1-3). The curriculum "Care of the Aging Patient in Emergency Medicine" was introduced. Topic selection was based upon geriatric curriculum recommendations and resident surveys. Before starting the curriculum and at its conclusion, residents completed Geriatric Clinical Decision-making Assessments and the Geriatric Attitude Scale Survey. Pre- and post-assessments were compared. Residents also completed written assessments for each educational activity in the curriculum.
After participating in the program, residents demonstrated improved knowledge of the geriatric patient, and their attitudes toward caring for geriatric patients had shifted from negative to neutral or positive. One statistically relevant change centered on the item, "Taking a medical history from an elderly patient is an ordeal" (p = 0.033) Pre-intervention, 8.3% (n = 3) of residents strongly agreed with the statement. After the intervention, strong disagreement with the statement increased from 2.8% (n = 1) to 11% (n = 4) on the educational surveys. In addition, an increase in the percentage of neutral responses was observed.
Using familiar educational formats with heavy emphasis on "hands-on" activities to present the geriatric care curriculum had a positive impact on resident knowledge and confidence in dealing with geriatric patients.
急诊科是老年人进入医疗保健系统的常见入口。急诊医学住院医师需要接受有关老年患者的专业教育，以实现最佳健康结果。
确定为急诊医学住院医师提供的老年医学教育是否能提高他们对老年患者的认知和态度。
在一个为期3年的大学急诊医学住院医师培训项目中进行了干预前后的调查。参与者为急诊医学住院医师（PGY 1 - 3）。引入了“急诊医学中老年患者的护理”课程。主题选择基于老年医学课程建议和住院医师调查。在课程开始前和结束时，住院医师完成老年临床决策评估和老年态度量表调查。对前后评估进行比较。住院医师还完成了课程中每项教育活动的书面评估。
参与该项目后，住院医师对老年患者的认知有所提高，他们对老年患者护理的态度从消极转变为中立或积极。一个具有统计学意义的变化集中在“从老年患者那里获取病史是一场折磨”这一项目上（p = 0.033）。干预前，8.3%（n = 3）的住院医师强烈同意该陈述。干预后，在教育调查中，强烈不同意该陈述的比例从2.8%（n = 1）增加到11%（n = 4）。此外，中立回答的百分比有所增加。
采用熟悉的教育形式，高度重视“实践”活动来呈现老年护理课程，对住院医师处理老年患者的知识和信心产生了积极影响。
