Fifth‐year medical students' perceptions of the importance of frailty and competence in assessing, diagnosing and managing frailty before and after a geriatric medicine course

Abstract

Objective: To assess the changes in fifth-year medical students' perceptions of the importance of frailty and competence in assessing, diagnosing and managing frailty after a 4.5-week geriatric medicine course. Methods: Students' perceived importance and competence was assessed before and after the course using a 26-item Likert scale questionnaire with scores ranging from 1 to 6. Results: Students' perceptions of the importance of defining frailty (P = .01), explaining what frailty is (P = .03), advising on nutritional needs (P = .001) and exercise (P = .001) and prescribing an exercise program (P < .001) significantly improved after the course. Medical students' perceived competence in assessing, diagnosing and managing frailty was low to moderate precourse and increased significantly postcourse (2.3 [1.2] 4.9 [2.9], mean [IQR], P < .001) across all items. Conclusion: An appropriate curriculum focusing on geriatric health conditions such as frailty can improve senior medical students' perceived importance and competence in assessing, diagnosing and managing frailty.

A systematic review of frailty education programs for health care professionals

“…Following title and abstract screening and full‐text review, 10 studies, all published between 2018 to 2021, were included (Figure 1). These studies reported on the effectiveness of nine frailty training programs (Table 2) conducted in five Western countries 19–27 . Quality assessment was moderate with a mean of 5.9/8 for cross‐sectional studies and 8/11 for qualitative studies (Table 3).…”

“…The largest program, described by Donoghue et al, was completed by 356 participants, although fewer than half (approximately 40%) were involved in the assessment of the program. Two studies reported on training programs for medical students 19,25 . Three trained Emergency Department staff 22,26,27 and one reported on primary health care professional education 24 .…”

“…Only the frailty unit training program described by Recio‐Saucedo et al 20 involved extended training, shadowing of expert clinicians and case discussions. A period of supervised practice was also included in the program described by McKelvie et al 21 and both programs which targeted medical students included concurrent clinical exposure to frailty cases 19,25 . Most of the programs were delivered as in‐person lectures or workshops.…”

“…Donoghue et al 23 noted that there was a 74% improvement in perceived frailty knowledge and 73% subjective improvement in multidisciplinary clinicians' ability to define frailty 23 . When delivering frailty education to medical students, Arakawa et al reported the greatest increase in self‐perceived knowledge in those with no or limited prior exposure to geriatrics (54% of cohort) 19 . Both Kotsani et al and Nimmons et al reported benefits in reducing frailty misconceptions, with a reduction in attitudes such as ‘frailty is an inevitable consequence of aging’ 24,25 …”

“…Kotsani et al noted an initial increase in the self‐perceived ability to manage frailty, but this was not sustained over 3 months, with a drop from 70% to 32% of participants stating that they applied this knowledge to daily practice 24 . Arakawa et al also reported increased medical student perception of competence in frailty management, but there was no assessment of this perceived competence 19 …”