Exploring the Challenges of Frailty in Medical Education

Abstract

Frailty is common, and medical students and doctors across all specialties will look after patients with frailty. The General Medical Council requires UK medical schools to teach and assess on frailty, and national geriatric societies across the globe include frailty in their recommended undergraduate curricula. However, frailty in medical education is challenging; there is uncertainty around what frailty is in medical education, including how and when to teach it; controversies in mapping teaching and assessments to recommended curricula; patients with frailty can be challenging to include in teaching and assessments due to functional, sensory, and/or cognitive impairments; an individual with frailty is likely to present atypically, with less predictable recovery, introducing complexities into clinical reasoning that can be challenging for students; the term frailty is often negatively perceived, used colloquially and avoided in educational interactions. This commentary discusses these challenges around frailty in undergraduate medical education and serves to provoke discussion about why frailty is so challenging to teach and learn about, including recommendations for how frailty education could be improved.

Literacy for Frailty among Undergraduate Medical Education: An Under-Recognized Opportunity to Improve Geriatric Care

“…Similarly, although several countries have incorporated frailty into postgraduate and undergraduate curricula, frailty education remains poorly defined and challenging to implement. Educators are unfamiliar with the biological meaning, construct, and dimensionality, and how to assess frailty with insufficient clinical experiences; students tend to see this syndrome negatively or describe it casually [ 22 ]. Therefore, we need a more concise, structured, and rational program for eliciting medical students’ motivation for understanding frailty during their undergraduate period.…”

“…Although several major geriatric societies support the inclusion of frailty in medical education, arguments have been raised regarding how best to implement programs aiming to enhance frailty awareness in undergraduate medication [ 25 ]. Misidentification and terminology confusion, uncertainty surrounding the care of frail older adults, and clinical decisions altered by the recognition of frailty, have all been implicated as potential factors responsible for the observed difficulty in formulating a formal targeted curriculum [ 22 ]. Notwithstanding these concerns, we design a potentially applicable undergraduate program with practial modules and course descriptions to enhance frailty literacy.…”

Diversity in Medical Education: A Review Article

“…In the context of medical education, "development" refers to the process of growth and improvement in different aspects of medical education, including curriculum design, teaching methods, assessment strategies, educational technologies, faculty development, and accreditation [1,4,7,20,24,25].…”

“…CME activities can include conferences, workshops, online courses, research, and other educational opportunities [22,23]. Other important components of medical education include assessment and evaluation of learners' knowledge & skills, accreditation of educational programs, professional development, and adherence to ethical & professional standards [11,13,24,25]. Medical education is constantly evolving in response to advances in medical knowledge, technology, and changes in healthcare delivery It plays a critical role in producing competent and compassionate healthcare professionals who can provide safe, effective, and high-quality care to patients.…”

“…This may involve assigning mentors or coaches to learners, who can provide guidance, feedback, and mentorship throughout their medical education journey.Addressing mental health and well-being:Recognizing the importance of mental health and well-being in medical education, efforts can be made to address stress, burnout, and other mental health challenges among learners. This may include providing resources for mental health support, promoting self-care, and addressing systemic issues that contribute to learner stress and burnout[1,11,24]. Community engagement and social accountability: Incorporating community engagement and social accountability into medical education can help learners in understanding the social determinants of health and the importance of addressing health disparities.…”