The Future of Geriatric and Interdisciplinary Education

Abstract

Support for geriatric and interdisciplinary education has increased recently for philosophical, clinical, and economic reasons. In medical education programs, trainees, and funding (mostly federal and university) has increased. However, programs are largely elective, reach few medical trainees, are carried by few and junior faculty, and are peripheral because of their novelty and unstable funding. The range of geriatric education is illustrated. Nonmedical health professions also have increased geriatric education, and are more likely to make it required and pervasive, led by more senior faculty. But they, too, face the lack of trained educators, negative faculty and student attitudes, and lack of funding and institutional support. The future of geriatric education is mixed, with an increase in social recognition and support, but with uncertain public funding and reluctant acceptance by conservative clinical schools and professions.Interdisciplinary education in geriatrics is supported by the complexity of the health needs of the aged and the multiplicity of health disciplines and treatments involved. Several studies and support programs encourage interdisciplinary education. However, it runs counter to traditions, vested interests, and educational structure. It also raises social and environmental issues in pofessional practice that highlight limitations in competence and that conflict with conservative political philosophies. For the future, the recognition of the importance of comprehensive and integrated health care will support education for more collaboration among disciplines. However, it is unlikely that strong vested interests in disciplinary autonomy will allow truly interdisciplinary education to expand beyond a few model programs. Several examples are described.

Describing the Structure and Content of Interdisciplinary Collaboration in an Educational Center on Aging and Health

“…This trend has been fueled by both the emerging field of collaborative learning (e.g., Bruffee, 1987;Whipple, 1987), of which the goal is to foster the development of shared or group learning experiences, and the increasing application of principles of total quality management to higher education (e.g., Cornesky, McCool, Byrnes, & Weber, 1991), supporting the development of educational teams with the shared objective of improving program quality. In the health sciences in particular, the need for training students to work in interdisciplinary teams has attracted growing interest from fields such as gerontology and geriatrics, in which the multifaceted needs of the frail elderly demand the integrated application of several disciplines in assessment and care plan development (Feather, Karuza, MacKellar, & Calkins, 1988;Gardner & Johnson, 1988;Satin, 1986;Tsukuda, 1990;Zeiss & Steffen, 1996). Fostering the development of such interdisciplinary courses, curricula, programs, and projects in higher education is very difficult, however, because of the barriers that hinder these initiatives (Clark, Spence, & Sheehan, 1987) and a value system that supports competition and disciplinary defensiveness rather than cooperation and crossdisciplinary efforts (Clark, 1994).…”

“…The term "discipline" is used in this context to identify either a profession or occupation that, based on its own set of knowledge, skills, values, and experiences, brings a unique perspective to group functioning (Satin, 1986). Ultimately, such collaboration, defined in the dictionary as simply "working together jointly," can be measured by gathering basic information about the disciplines participating together on a specific project (e.g., medicine, nursing, social work) and the purpose for their joint work.…”

Training and Development of Future Educational Gerontologists

“…A majority of programs in gerontology are interdisciplinary in which course work is selected from various departments and colleges such as education, social work, nursing, sociology, psychology, leisure and recreation, and health service management. Johnson (1986) and Satin (1986) recommended an interdisciplinary approach to gerontological education if it is to expand. Training and development of educational gerontologists are thus provided in formal educational settings; however, other nonformal and informal ways of acquiring needed skills by those who help older adults learn are scarcely documented in the literature.…”

St Joseph's Community Health Centre model of community-based interdisciplinary health care team education

“…Although there is no hard evidence that interdisciplinary education or practice is superior, expert opinion repeatedly emphasizes that interdisciplinarity is necessary as a teaching method, learning experience, and practice orientation (Kindig 1975, Nagi 1975, Crooks et al 1982, Bailey 1984, Satin 1986, Areskog 1988, Madsen et a / . 1988, Schmitt et al 1988, Clark 1993.…”

“…Over the last three decades most health discipline programmes have recognized the need for interdisciplinary or interprofessional education. Some programmes do offer interdisciplinary learning but many single discipline programmes continue to be challenged by students and health care professionals to provide interdisciplinary instruction or learning experiences (Satin 1986, Clark 1992. It is important for students to learn about future roles in teamwork during their education or training.…”