Ringer Thom, Dougherty Megan, McQuown Colleen, Melady Don, Ouchi Kei, Southerland Lauren T, Hogan Teresita M
Mount Sinai Academic Family Health Team Toronto Ontario Canada.
Ascension Macomb-Oakland Hospital Warren MI.
AEM Educ Train. 2018 Nov 12;2(Suppl Suppl 1):S5-S16. doi: 10.1002/aet2.10205. eCollection 2018 Dec.
Older adults account for 25% of all emergency department (ED) patient encounters. One in five Americans will be 65 or older by 2030. In response to this need, geriatric emergency medicine (GEM) has developed into a robust area of academic and clinical interest, with extensive evidence-based research and guidelines, including clear undergraduate and postgraduate GEM competencies. Despite these developments, GEM content remains underrepresented in curricula and licensing examinations. The complex reasons for these deficits include a perception that care of older adults is not a core emergency medicine (EM) competency, a disjunction between traditional definitions of expertise and the GEM perspective, and lack of curricular capacity. This White Paper, prepared on behalf of the Academy of Geriatric Emergency Medicine, describes the state of GEM education, identifies the challenges it faces, and reviews innovations, including research presented at the 2018 Society for Academic Emergency Medicine (SAEM) Annual Scientific Meeting. The authors propose a number of recommendations. These include recognizing GEM as a core educational priority in EM, enhancing academic support for GEM clinician-educators, using social learning and practical problem solving to teach GEM concepts, emphasizing a whole-person multisystem approach to care of older adults, and identifying ageist attitudes as a hurdle to safe and effective GEM care.
老年人占急诊科所有患者就诊人数的25%。到2030年,每五个美国人中就会有一个年龄在65岁及以上。为满足这一需求,老年急诊医学(GEM)已发展成为一个在学术和临床方面备受关注的领域,有广泛的循证研究和指南,包括明确的本科及研究生阶段的老年急诊医学能力要求。尽管有这些发展,但老年急诊医学的内容在课程设置和执照考试中所占比例仍然较低。造成这些不足的复杂原因包括:认为照顾老年人不是急诊医学(EM)的核心能力;传统的专业定义与老年急诊医学观点之间存在脱节;以及课程容量不足。这份代表老年急诊医学学会编写的白皮书描述了老年急诊医学教育的现状,确定了其面临的挑战,并回顾了相关创新,包括在2018年学术急诊医学学会(SAEM)年度科学会议上发表的研究。作者提出了一些建议。这些建议包括:将老年急诊医学视为急诊医学核心教育重点;加强对老年急诊医学临床教育工作者的学术支持;利用社会学习和实际问题解决方法来教授老年急诊医学概念;强调采用全人多系统方法照顾老年人;并将年龄歧视态度视为安全有效的老年急诊医学护理的障碍。