Atkinson Hal H, Tan Zaldy S, Brennan Maura, Granville Lisa
Wake Forest School of Medicine, Winston-Salem, North Carolina.
J Am Geriatr Soc. 2014 Jun;62(6):1155-60. doi: 10.1111/jgs.12732. Epub 2014 Mar 11.
To ensure that the healthcare workforce is adequately prepared to care for the growing population of older adults, minimum competencies in geriatrics have been published for medical students and primary care residents. Approaches to teaching and assessing these competencies are needed to guide medical schools, residencies, and continuing medical education programs. With sponsorship by the Education Committee and Teachers Section of the American Geriatrics Society (AGS), geriatrics educators from multiple institutions collaborated to develop a model to teach and assess a major domain of student and resident competency: Gait and Falls Risk Evaluation. The model was introduced as a workshop at annual meetings of the AGS and the American College of Physicians in 2011 and 2012. Participants included medical students, residents, geriatrics fellows, practicing physicians, and midlevel practitioners. At both national meetings, participants rated the experience highly and reported statistically significant gains in overall competence in gait and falls risk evaluation. The largest gains were observed for medical students, residents, and practicing physicians (P < .001 for all); geriatrics fellows reported a higher level of baseline competence and therefore had a lower magnitude of improvement, albeit still significant (P = .02). Finally, the majority of participants reported intent to disseminate the model in their institutions. This article describes the design, implementation, and evaluation of this collaborative national model. A number of institutions have used the model, and the goal of this article is to aid in further dissemination of this successful approach to teaching and assessing geriatrics competencies.
为确保医疗保健人员有充分准备为日益增多的老年人提供护理,已针对医学生和基层医疗住院医师发布了老年医学的最低能力要求。需要教学和评估这些能力的方法来指导医学院校、住院医师培训项目及继续医学教育项目。在美国老年医学会(AGS)教育委员会和教师分会的赞助下,来自多个机构的老年医学教育工作者合作开发了一个用于教学和评估学生及住院医师能力主要领域的模型:步态与跌倒风险评估。该模型在2011年和2012年的AGS年会及美国医师学院年会上作为一个研讨会被介绍。参与者包括医学生、住院医师、老年医学研究员、执业医师和中级从业者。在这两次全国性会议上,参与者对该体验评价很高,并报告在步态和跌倒风险评估的总体能力上有统计学显著提高。医学生、住院医师和执业医师的提高最为显著(所有P < .001);老年医学研究员报告的基线能力水平较高,因此提高幅度较小,尽管仍具有显著性(P = .02)。最后,大多数参与者表示打算在其所在机构推广该模型。本文描述了这个全国性合作模型的设计、实施和评估。一些机构已经使用了该模型,本文的目的是帮助进一步推广这种成功的老年医学能力教学和评估方法。