Schwartz Andrea Wershof, Sehgal Mandi, Dawson Catherine M P, Granville Lisa J, Powers Becky B, Shah Amit A, Sullivan Amy M, Leipzig Rosanne M
Acad Med. 2025 May 1;100(5):592-599. doi: 10.1097/ACM.0000000000005958. Epub 2024 Dec 23.
Medical student education in geriatrics is a critical need for every doctor-in-training as the population ages, with fewer than 7,000 geriatricians, and older patients, who now approach 20% of the U.S. population, having unique health care needs. This study presents the updated competencies in geriatrics for graduating medical students, framed by the Geriatrics 5Ms (Mind, Mobility, Medications, Multicomplexity, and What Matters Most).
From 2019-2022, a working group of the American Geriatrics Society (AGS) drafted the updated medical student geriatrics education competencies, using a modified Delphi approach.The working group reviewed the literature, conducted an initial survey of working group members, and drafted and refined proposed updates to the competencies. The 27 resulting competencies were disseminated as a national survey to geriatrics experts and medical school education deans. Following the national survey, the competencies were updated and presented at the 2021 AGS Annual Scientific Meeting and open to public comment before they were finalized.
The 27 updated geriatrics competencies for medical students included several new competencies, such as a focus on health equity, frailty, deprescribing, and patient priorities. A total of 211 respondents completed the national survey, including geriatrics experts (187/398, response rate: 47.0%) and education deans (24/191, response rate: 12.6%). All 27 proposed competencies met the predetermined threshold of 70% cumulative agreement, with a range of 93.0% (174/187) to 100% (187/187) among geriatrics experts and 87.5% (21/24) to 100% (24/24) among education deans.
The updated Geriatrics Competencies for Graduating Medical Students met with broad agreement among the geriatrics experts and medical school education deans who responded to the national survey. By focusing on the Geriatrics 5Ms, the competencies highlight key knowledge and skills graduating medical students need for the first day of internship to be prepared to deliver age-friendly care to older adults under their care.
随着人口老龄化，老年医学领域的医学生教育对每位正在接受培训的医生来说都至关重要，目前老年医学专家不足7000人，而老年患者已接近美国人口的20%，他们有着独特的医疗保健需求。本研究提出了针对即将毕业的医学生的最新老年医学能力要求，以老年医学5M（思维、活动能力、药物治疗、多重复杂性以及最重要的事项）为框架。
2019年至2022年期间，美国老年医学会（AGS）的一个工作组采用改良的德尔菲法起草了最新的医学生老年医学教育能力要求。该工作组查阅了文献，对工作组成员进行了初步调查，并起草和完善了能力要求的拟议更新内容。由此产生的27项能力要求作为全国性调查分发给老年医学专家和医学院教育院长。在全国性调查之后，这些能力要求得到更新，并在2021年AGS年会上公布，在最终确定之前接受公众评论。
针对医学生的27项更新后的老年医学能力要求包括几项新的能力要求，例如关注健康公平、衰弱、减药以及患者优先事项。共有211名受访者完成了全国性调查，包括老年医学专家（187/398，回复率：47.0%）和教育院长（24/191，回复率：12.6%）。所有27项拟议的能力要求均达到了70%累积共识的预定阈值，老年医学专家的共识率在93.0%（174/187）至100%（187/187）之间，教育院长的共识率在87.5%（21/24）至100%（24/24）之间。
针对即将毕业的医学生的最新老年医学能力要求在参与全国性调查的老年医学专家和医学院教育院长中获得了广泛认可。通过关注老年医学5M，这些能力要求突出了即将毕业的医学生在实习第一天为其照护的老年人提供关爱老年人护理所需的关键知识和技能。
