A scoping review of the changing landscape of geriatric medicine in undergraduate medical education: curricula, topics and teaching methods

Abstract

Purpose The world’s population is ageing. Therefore, every doctor should receive geriatric medicine training during their undergraduate education. This review aims to summarise recent developments in geriatric medicine that will potentially inform developments and updating of undergraduate medical curricula for geriatric content. Methods We systematically searched the electronic databases Ovid Medline, Ovid Embase and Pubmed, from 1st January 2009 to 18th May 2021. We included studies related to (1) undergraduate medical students and (2) geriatric medicine or ageing or older adults and (3) curriculum or curriculum topics or learning objectives or competencies or teaching methods or students’ attitudes and (4) published in a scientific journal. No language restrictions were applied. Results We identified 2503 records and assessed the full texts of 393 records for eligibility with 367 records included in the thematic analysis. Six major themes emerged: curriculum, topics, teaching methods, teaching settings, medical students’ skills and medical students’ attitudes. New curricula focussed on minimum Geriatrics Competencies, Geriatric Psychiatry and Comprehensive Geriatric Assessment; vertical integration of Geriatric Medicine into the curriculum has been advocated. Emerging or evolving topics included delirium, pharmacotherapeutics, healthy ageing and health promotion, and Telemedicine. Teaching methods emphasised interprofessional education, senior mentor programmes and intergenerational contact, student journaling and reflective writing, simulation, clinical placements and e-learning. Nursing homes featured among new teaching settings. Communication skills, empathy and professionalism were highlighted as essential skills for interacting with older adults. Conclusion We recommend that future undergraduate medical curricula in Geriatric Medicine should take into account recent developments described in this paper. In addition to including newly emerged topics and advances in existing topics, different teaching settings and methods should also be considered. Employing vertical integration throughout the undergraduate course can usefully supplement learning achieved in a dedicated Geriatric Medicine undergraduate course. Interprofessional education can improve understanding of the roles of other professionals and improve team-working skills. A focus on improving communication skills and empathy should particularly enable better interaction with older patients. Embedding expected levels of Geriatric competencies should ensure that medical students have acquired the skills necessary to effectively treat older patients.

Evidence, expertise, and patient/family preferences to maximize health for older adults with implications for evidence‐based practice

“…Communicating with older adults about self-management requires a healthcare workforce with a strong understanding tion, mentation, and mobility) for an age-friendly health system, may also be a viable alternative for preparing healthcare professionals (Hawley et al, 2021). Health care preparation also requires communication skills, empathy, and professionalism (Gellis et al, 2019;Masud et al, 2022). Engaging caregivers of older adults is also a best practice for IPE curricula (Farrell et al, 2018).…”

Geriatric Medicine in the Medical Curriculum: A MUST in the Globally Aging World

“…Although geriatric medicine has long been incorporated into the medical curriculum in some western countries, it is still in its early integration stage in most medical schools, specifically in the Asian region. The challenges in incorporating geriatric medicine into the medical curriculum are multidimensional -expanding a fully packed curriculum, resentment from maximally loaded faculty staff, shortage of trained teaching geriatricians, [10][11][12][13][14] and the administration's dilemma for salary adjustment. Furthermore, on the attitude of students towards the aged [11,[15][16][17][18], Bagri and Tiberius reported that students had not felt appropriately engaged in geriatrics, despaired at the futility of care, and were depressed and frustrated by the decline and death of their patients.…”

“…The challenges in incorporating geriatric medicine into the medical curriculum are multidimensional -expanding a fully packed curriculum, resentment from maximally loaded faculty staff, shortage of trained teaching geriatricians, [10][11][12][13][14] and the administration's dilemma for salary adjustment. Furthermore, on the attitude of students towards the aged [11,[15][16][17][18], Bagri and Tiberius reported that students had not felt appropriately engaged in geriatrics, despaired at the futility of care, and were depressed and frustrated by the decline and death of their patients. [19] The problem of non-geriatricians teaching Geriatrics has been addressed through various approaches.…”

“…Medical students' negative attitude towards the aged is another essential concern that must be recognized and curtailed. [11,[16][17][18] Personal contact, prior knowledge of aging, and exposure to aged patients have influenced students' interest in geriatric medicine. In a systematic review by Meiboom and his group, medical students prefer young patients with acute illnesses that can be cured.…”

Transforming undergraduate education in geriatric medicine: an innovative curriculum at Bristol Medical School

“…This marked curriculum transformation has afforded an opportunity to both innovate and evaluate undergraduate education in geriatric medicine, which will provide one model for teaching on aging, complementing the work of the European Geriatric Medicine Society [ 5 ]. We anticipate that by providing this high-quality education in geriatric medicine, we will equip and inspire physicians of the future with the expertise, knowledge and skills needed to care for the unique and complex needs of older people.…”