Equipping tomorrow's doctors for the patients of today

Abstract

As the proportion of older patients with frailty presenting to health services increases, so does the need for doctors to be adequately trained to meet their needs. The presentations seen in such patients, the evidence-based models of care and skillsets required to deliver them are different than for younger patient groups-so specific training is required. Several research programmes have used detailed and explicit methods to establish evidence-based expert-validated curricula outlining learning outcomes for undergraduates in geriatric medicine-there is now broad-consensus on what newly qualified doctors need to know. There are, despite this, shortcomings in the teaching of undergraduates about geriatric medicine. National and international surveys from the UK, EU, USA, Canada, Austria and the Netherlands have all shown shortcomings in the content and amount of undergraduate teaching. Mechanisms to improve this situation, aside from specifying curricula, include developing academic departments and professorships in geriatric medicine, providing grants to develop teaching in geriatric medicine and developing novel teaching interventions to make the best of existing resources. Under the last of these headings, innovations have been shown to improve outcomes by: using technology to ensure the most effective allocation of teaching time and resources; using inter-professional education as a means of improving attitudes towards care of older patients; focusing teaching specifically on attitudes towards older patients and those who work with them; and trying to engage patients in teaching. Research areas going forward include how to incentivise medical schools to deliver specified curricula, how to choose from an ever-expanding array of teaching technologies, how to implement interprofessional education in a sustainable way and how to design teaching interventions using a qualitative understanding of attitudes towards older patients and the teams that care for them.

Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: A multicenter study

“…Although this is a limitation, the other geriatric attitude scales also generally focus on older individuals. Furthermore, as stated by Oakley et al (2014), current assessment instruments are ordinal in nature and do not give detailed information. Oakley et al suggest that qualitative studies to seek factors underlying negative attitudes in detail should be performed.…”

The development and evaluation of mini-GEMs – short, focused, online e-learning videos in geriatric medicine

“…Harnessing innovative teaching methods, such as technology-enhanced learning (TEL), may help to address this training deficit [3].…”

The development of a geriatric postgraduate education assessment instrument using a modified Delphi procedure

“…They illustrate the broad remit of geriatric medicine including prevention, diagnosis, treatment and social aspects of illness in older people [13]. The third domain focuses on additional skills and attitudes that reflect the complex roles geriatricians have to fulfill [14,15].…”