Emergency Department, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
IQ Health Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
J Am Geriatr Soc. 2019 Nov;67(11):2402-2409. doi: 10.1111/jgs.16067. Epub 2019 Jul 23.
To evaluate geriatric education programs for emergency department (ED) professionals based on: content and teaching methods and learning outcome effects and factors promoting or hindering program implementation.
Systematic review.
ED.
Physicians, nurses, and medical residents working in the ED.
Five major biomedical databases were searched for (quasi) experimental studies, published between 1990 and April 2018, evaluating geriatric education programs for ED professionals. Data were synthesized around study quality, learning participants, teaching content and methods, and Kirkpatrick learning outcomes.
Nine before-after studies were included. Learners were mostly ED residents and, to a smaller extent, ED nurses and physicians. Study quality was moderate, with the lowest scores on sampling and instrument validity. Programs varied from a 1-day workshop to a 2-year curriculum, mostly combining didactic lectures with active and experiential learning formats. Topics commonly addressed included managing: geriatric syndromes, trauma and falls, medication, atypical presentations, and care transitions. Statistically significant improvements were mostly found in learners' knowledge acquisition (six studies). Significant improvements were also found in single studies on: self-reported geriatric screening, documentation of geriatric care, and appropriate urinary catheter placement. Factors promoting program implementation included: solving competing educational demands and busy work schedules, embedding the program in preexisting curricula, and close collaboration between emergency and geriatric medicine faculties.
Various geriatric education programs improve the geriatric knowledge of ED professionals and seem to positively impact their clinical practice. However, more program evaluations with larger study samples, and use of valid and reliable outcome measures, are needed to provide robust evidence on the effectiveness of such programs. J Am Geriatr Soc, 1-8, 2019. J Am Geriatr Soc 67:2402-2409, 2019.
评估急诊科（ED）专业人员的老年医学教育计划，依据为：内容和教学方法以及学习结果的影响，以及促进或阻碍计划实施的因素。
系统回顾。
ED。
在 ED 工作的医师、护士和住院医师。
在五个主要的生物医学数据库中搜索（准）实验研究，发表时间为 1990 年至 2018 年 4 月，评估 ED 专业人员的老年医学教育计划。数据综合了研究质量、学习参与者、教学内容和方法以及 Kirkpatrick 学习结果。
纳入了 9 项前后对照研究。学习者主要是 ED 住院医师，其次是 ED 护士和医师。研究质量为中等，在抽样和仪器有效性方面得分最低。计划从为期 1 天的研讨会到为期 2 年的课程不等，大多将理论讲座与主动和体验式学习模式相结合。常见的主题包括管理：老年综合征、创伤和跌倒、药物治疗、不典型表现和护理交接。在学习者的知识获取方面（6 项研究），大多数发现了统计学显著的改善。在单一研究中还发现了显著的改善：老年筛查的自我报告、老年护理记录和适当的导尿放置。促进计划实施的因素包括：解决相互竞争的教育需求和繁忙的工作时间表，将计划嵌入现有的课程中，以及急诊和老年医学系之间的密切合作。
各种老年医学教育计划可提高 ED 专业人员的老年医学知识，并且似乎对其临床实践产生积极影响。但是，需要更多具有较大研究样本和使用有效可靠的结果测量的计划评估，以提供此类计划有效性的可靠证据。美国老年医学会杂志，1-8，2019。美国老年医学会杂志 67:2402-2409，2019。
