Geriatric Core Competencies for Family Medicine Curriculum and Enhanced Skills: Care of Elderly

Charles, Lesley; Triscott, Jean; Dobbs, Bonnie; McKay, Rhianne

doi:10.5770/cgj.17.95

Cited by 21 publications

(20 citation statements)

References 9 publications

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“…The key clinical situations and observable behaviours that the experts prioritized for senior care in the present study are consistent with those identified by others (Charles, Triscott, Dobbs, & McKay, 2014;Mezey, Mitty, Burger, & McCallion, 2008;Williams et al, 2010). For example, a recent expert consensus also identified cognitive disorders, functional decline, incontinence, medication management, and communication skills as geriatric core competencies for family medicine, converging with our findings (Charles et al, 2014).…”

Section: Competencies Associated With Senior Caresupporting

confidence: 91%

What Do Clinical Supervisors Require to Teach Residents in Family Medicine How to Care for Seniors?

et al. 2018

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We assessed clinicians' continuing professional development (CPD) needs at family practice teaching clinics in the province of Quebec. Our mixed methodology design comprised an environmental scan of training programs at four family medicine departments, an expert panel to determine priority clinical situations for senior care, a supervisors survey to assess their perceived CPD needs, and interviews to help understand the rationale behind their needs. From the environmental scan, the expert panel selected 13 priority situations. Key needs expressed by the 352 survey respondents (36% response rate) included behavioral and psychological symptoms of dementia, polypharmacy, depression, and cognitive disorders. Supervisors explained that these situations were sometimes complex to diagnose and manage because of psychosocial aspects, challenges of communicating with patients and families, and coordination of interprofessional teams. Supervisors also reported more CPD needs in long-term and home care, given the presence of caregivers and complexity of senior care in these settings.

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Section: Competencies Associated With Senior Caresupporting

confidence: 91%

What Do Clinical Supervisors Require to Teach Residents in Family Medicine How to Care for Seniors?

et al. 2018

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“…that presents core geriatric competencies for both family practice programs and specialized care of the elderly programs. (4) Naslund et al . have examined Canadian Study of Health and Aging data to demonstrate changes in health service utilization costs in the year prior to institutionalization.…”

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confidence: 99%

Precipitating and Predisposing Events and Symptoms For Admission to Assisted Living or Nursing Home Care

Rockwood¹,

Richard²,

Garden³

et al. 2013

Can Geri J

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BackgroundIn Canada, the rise of private-pay assisted living facilities is changing the long-term care landscape. Even so, few clinical implications of having these facilities in the spectrum of care have been studied. Our objective was to compare events and symptoms that might predispose and precipitate a move of older adults to assisted living or to a nursing home.MethodsCross-sectional, descriptive Nova Scotia survey of residents and family members on admission. Health-care use and dementia diagnosis were recorded from the admission record. Dementia was staged using the Global Deterioration Scale and the Dependence Scale. The SymptomGuide, a standardized dementia symptom inventory, was used to assay which symptoms were most influential in the decision to seek long term care. Caregiver stress was elicited by a self-report questionnaire.ResultsOf 353 people admitted during the enrolment period, 174 (49%) took part in the survey. Most (97; 55.7%) were involved in a move from the community to a nursing home, 54 (31.0%) from the community to assisted living, and 23 (13.2%) from assisted living to a nursing home. In each setting, dementia was the commonest predisposing factor (seen in >90%) with a precipitating event seen in 120 (69%) people. The precipitating events included a medical illness (n = 97; 55%) or caregiver illness, death or move (33; 19%). Dependence was associated with place of care, with more severely impaired people more commonly represented in people who moved to nursing homes.ConclusionsPeople move from the community chiefly due to dementia, and often with a precipitant. Compared with a move to assisted living, moving to nursing homes generally indicates greater dependence, and typically worse dementia severity. Even so, assisted-living facilities are not just for the “worried well”, but are used by people with dementia, caregiver stress, and recent hospitalization.

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“…It is imperative that health care practitioners are knowledgeable in all areas of geriatric care [3]. In order to educate the next generation of health care providers, competencies have been developed by the different professions to ensure that this training process includes the essential elements needed for practice [4]. The Academy of Geriatric Physical Therapy developed a comprehensive list of competencies that physical therapists must possess upon completion of their training [5].…”

Section: Introductionmentioning

confidence: 99%

Teaching Students the Art of Working with Patients with Cognitive Impairments: A Comparison between the Use of Standardized Patients vs a One-time Clinical Experience

Varrecchia¹,

Maritz²

2020

Phys Ther Rehabil

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Background: Working with individuals with cognitive impairment can be an uncomfortable experience for students in the health professions. Using a one-time clinical experience to expose them to this population is a common strategy used to increase comfort and improve skills. Unfortunately, relying on outside facilities to provide this experience introduces variability that can negatively affect outcomes. Objective: The purpose of this study was to compare the outcomes associated with a standardized patient (SP) encounter with a one-time clinical education experience in order to determine the optimal learning opportunity for students. Methods: Eighty-two DPT students participated in a session where they practiced communication skills and assessment procedures on individuals simulating cognitive impairment. Each group of students performed a brief interview with the SP, administered the Mini-Cog test to screen for cognitive impairment, and completed two performance-based functional outcome measures common in physical therapy. At the completion of the session the SPs stepped out of character and gave the student groups verbal feedback about their performance. Feedback was focused on student communication skills and ability to provide clear instructions while adapting to changes in the SP's cognition. Results: In order to assess the overall effectiveness of the SP experience, we compared learning outcomes with the one-time clinical experience. The total number of students participating in one of these experiences between 2016 and 2018 was 219. A strong positive trend of improvement is seen between each of the years and between the clinical site and standardized patient experiences. The ability to perform cognitive tests was considerably higher with the SPs than the clinical experiences. Chi-square tests of independence were used to compare students who reported achieving each of the goals of the activity and those who did not across each of the years. Significant relationships were found between achievement of outcomes and the year of participation and type of experience for all five outcomes reported. Effect size surpassed Cohen's definition of "small" (Cramer's V ≥ 0.1) for all five outcomes. Effect size was largest for "performed cognitive tests," with 2 (2, N=219)=74.24, p<0.00001 and =0.58. Student comments regarding each of the experiences was analyzed and compared using qualitative methods. Unique to 2018, was the emergence of the word "feedback." The opportunity to receive feedback was cited in 31 comments in the 2018 SP encounter. Other words emerging in 2018 include "real," "realistic," "convincing," and "accurate". Conclusion: Overall, there was high level of agreement among the students that the SP experience helped them recognize cognitive impairment and communicate with individuals with cognitive impairment. Students strongly agreed that the SP portrayal was realistic and that the feedback they provided was valuable to their learning. When comparing the SP encounter to the one-time clinical experience, f...

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Geriatric Core Competencies for Family Medicine Curriculum and Enhanced Skills: Care of Elderly

Cited by 21 publications

References 9 publications

What Do Clinical Supervisors Require to Teach Residents in Family Medicine How to Care for Seniors?

What Do Clinical Supervisors Require to Teach Residents in Family Medicine How to Care for Seniors?

Precipitating and Predisposing Events and Symptoms For Admission to Assisted Living or Nursing Home Care

Teaching Students the Art of Working with Patients with Cognitive Impairments: A Comparison between the Use of Standardized Patients vs a One-time Clinical Experience

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