Demons Jamehl L, Chenna Swapna, Callahan Kathryn E, Davis Brooke L, Kearsley Linda, Sink Kaycee M, Watkins Franklin S, Williamson Jeff D, Atkinson Hal H
a Section on Gerontology and Geriatric Medicine , Sticht Center on Aging, Wake Forest School of Medicine , Winston-Salem , North Carolina , USA.
Gerontol Geriatr Educ. 2014;35(4):409-20. doi: 10.1080/02701960.2014.930033. Epub 2014 Aug 21.
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. During the 2010 academic year, 110 students completed the in-home falls risk assessment, rating it highly. One year later, 63 students voluntarily completed a retrospective pre/postsurvey, and the proportion of students reporting moderate to very high confidence in performing falls risk assessments increased from 30.6% to 87.3% (p < .001). Students also reported using most of the skills learned in subsequent clerkships. A single educational intervention in the MOW program effectively addressed geriatrics competencies with minimal faculty effort and could be adopted by many medical schools.
跌倒对于老年人来说是一个关键的公共卫生问题,而跌倒风险评估是医学生应具备的一项能力。本研究的目的是设计一种创新方法,利用社区资源和有限的老年医学教师来教授跌倒风险评估。作者通过与“送餐上门”(MOW)合作开发了一个预防跌倒项目。一名三年级医学生陪同MOW的客户服务助理前往客户家中,进行跌倒风险评估,包括跌倒史、跌倒恐惧、药物审查、视力、起立行走测试、简易认知评估和家庭安全评估,并在与一名教师的小组会议中进行回顾。在2010学年,110名学生完成了居家跌倒风险评估,并给予高度评价。一年后,63名学生自愿完成了一项回顾性前后调查,报告对进行跌倒风险评估有中度至高度信心的学生比例从30.6%增加到了87.3%(p < .001)。学生们还报告说在随后的临床实习中使用了所学的大部分技能。MOW项目中的单次教育干预以最小的教师工作量有效地解决了老年医学能力问题,并且许多医学院校都可以采用。