Practicing Physician Education in Geriatrics: Lessons Learned from a Train‐the‐Trainer Model

Abstract

Evidence of poor performance in the evaluation and management of common geriatric conditions suggests the need for changing physician behavior in these areas. Traditional lecture-style continuing medical education (CME) has not been shown to be effective. Expert faculty initially trained 60 nonexpert peer educators to conduct small-group, learner-centered CME using tool kits on memory loss, incontinence, and depression. Peer educators presented 109 community-based sessions to 1,309 medical practitioners. Surveys were administered to community participants immediately and 6 months after a session. Evidence of effectiveness included statistically significant increases in self-reported knowledge, attitudes, and office-based practices on the target topics at the time of training and at the 6-month follow-up (P<.001) and two-thirds of respondents reporting continued use of three or more tools at 6 months. Participants reported that the interactive presentation aided their understanding of and ability to use the tool kits more than an off-the-shelf review (mean rating+/-standard deviation 4.1+/-0.71, with 1 = not at all and 5 = significantly). After the formal evaluation period, additional information about the project dynamics and tool kits was obtained through a small interview sample and an on-line survey, respectively. Receiving copies of the tool kits was an important factor in enabling educators to offer sessions. Barriers to offering sessions included finding time, an audience, and space. Findings suggest that modest positive changes in practice in relation to common geriatric problems can be achieved through peer-led, community-based sessions using principles of knowledge translation and evidence-based tool kits with materials for providers and patients.

Advancing geriatrics education: An efficient faculty development program for academic hospitalists increases geriatric teaching

“…First, using hospitalist peers and local geriatricians likely increased trust in the educational curricula and allowed for strong communication channels between instructors. 25,26 Second, coteaching allowed for hospitalist mentorship. Hospitalists acknowledged their coleaders as mentors and several hospitalists subsequently engaged in new geriatric projects.…”

Using Appreciative Inquiry to develop, implement and evaluate a multi-organisation ‘Cultivating Compassion’ programme for health professionals and support staff

“…Members of the project team facilitated 'training days' in each of the participating organisations and monthly follow-up meetings were provided for participants. Levine et al (2007Levine et al ( :1281 also identified that 'toolkits' were important in enabling peer-educators to facilitate learning. The 'train the trainers' model has been successfully used in public health initiatives where large numbers of people, spread across a range of settings, need to be reached.…”

“…The project aims included a 'train the trainers' approach in order to effectively cascade learning activity (Levine et al, 2007) and promote a sustainable culture of compassionate care at all levels of an organisation. Members of the project team facilitated 'training days' in each of the participating organisations and monthly follow-up meetings were provided for participants.…”

“…Indeed, Levine et al (2007) found that traditional lecture style training was not effective so introduced the 'train the trainer' model. Their aim was to change physician behaviour in the management of common conditions.…”

“…Follow up research on the impact of this method showed statistically significant increases in self-reported knowledge and attitudes six months after the peer sessions. Levine et al (2007Levine et al ( :1281 also found that the toolkits were important factors in 6 enabling their peer-educators to facilitate learning. This Levine et al finding are supported by Barac et al (2014), however, they found that many of the reports in their scoping review on the use of toolkits lacked robust evaluation of their impact.…”