Journal of Gerontology & Geriatric Medicine Category: Medical Type: Short Communication
Interprofessional Education and Training to Expand the Geriatrics Workforce
- Janice A Knebl1*, Jennifer J Severance2, Jessica Hartos3
- 1 Center For Geriatrics, University Of North Texas Health Science Center, 855 Montgomery Street, Fort Worth, Texas 76107, United States
- 2 Center For Geriatrics, University Of North Texas Health Science Center, Fort Worth, Texas, United States
- 3 Physician Assistant Studies, University Of North Texas Health Science Center, Fort Worth, Texas, United States
*Corresponding Author:Janice A Knebl
Center For Geriatrics, University Of North Texas Health Science Center, 855 Montgomery Street, Fort Worth, Texas 76107, United States
Received Date: Jun 06, 2019 Accepted Date: Jun 24, 2019 Published Date: Jul 02, 2019
To describe the collaborative processes that led to unique service-learning opportunities and experiential gerontology and geriatrics education for health professions students and family medicine residents.
An academic medical center collaborated with a county hospital, private university and Area Agency on Aging to create the only federally-awarded Geriatric Workforce Enhancement Program (WE HAIL) in Texas and expand interprofessional training models. Training enhancements focused on topics identified through a community needs assessment, including health literacy, falls prevention, medication management, chronic disease self-management and dementia.
Trainee evaluations demonstrate improved knowledge, confidence and attitudes in providing geriatrics care and connecting older adults and caregivers to needed social supports.
Through a multipronged approach targeting different trainee groups, WE HAIL programs enhanced geriatric education for health professions students and family medicine residents. This article describes the collaborative processes that led to unique service-learning opportunities and experiential education for health professions students and family medicine residents, the training outcomes resulting from three years of implementation and lessons learned from cross-systems collaboration in geriatrics education.
The Seniors Assisting in Geriatric Education, or SAGE Program, was established in 2008 with a grant from the Donald W Reynolds Foundation and includes more than 175 older adult volunteers and over 600 health profession students in medicine, pharmacy, physical therapy and physician assistant studies. Through a partnership with a private university, Texas Christian University’s Harris College of Nursing and Health Sciences, students in nursing, social work, dietetics and speech and language pathology are also involved with SAGE. The six SAGE in-home visits across two years provide a level of familiarity and confidence with evaluating and communicating with older adults, and an insight into the complex medical and social issues older adults face while maintaining their quality of life, dignity and independence. Interprofessional teams apply their knowledge to complete basic clinical activities at each visit. In another program, the Senior Health Education and Literacy Program (Senior HELP), health professions student teams learn health literacy principles to develop educational presentations for older adults with an emphasis on preventive medicine and health promotion based on medical evidence.
As part of the GWEP, clinical faculty and leadership of community organizations enhanced existing health professions in SAGE and Senior HELP curricula using the results of a community assessment conducted by the Area Agency on Aging to identify challenges of a growing population of older adults in the community. Applying the findings of these community needs to curriculum development, GWEP partners enhanced geriatrics education and training programs with a focus on five topics in geriatrics care: falls prevention, medication management, chronic disease self-management, Alzheimer’s disease and related dementias, and health literacy.
In a parallel project, these topics as well as evidence-based geriatric practices and unique learning experiences utilizing local programs were integrated into family medicine residency programs through another GWEP partner, John Peter Smith Health Network (JPS). JPS has the largest family medicine residency program in the United States with a Level 1 Trauma Center and an acute care-oriented curriculum. In 2000, the JPS Family Medicine Residency program was the first County Hospital-based program to start a Geriatrics Fellowship, developed in collaboration with the UNTHSC Geriatrics Division, to include at least 100 hours of didactic and experiential learning dedicated to team-based care of older patients across the care continuum during three years of specialized geriatrics training. Through the GWEP funding, this program was expanded to include geriatrics training with all family medicine residents (whether or not they were included in the Geriatric Fellowship).
To expand the Family Physician’s understanding and collaboration with community partners in geriatrics care, JPS Health Network enhanced curricular content in years two and three of the GWEP grant for family medicine residents (n=40). Program Directors, GWEP faculty and representatives from community organizations identified community programs providing experiential opportunities for residents, including nationally-recognized evidence-based programs provided through the Area Agency on Aging, such as A Matter of Balance fall prevention program, Resources for Enhancing Alzheimer’s Caregiver Health (REACH II) and the Home meds medication management program. The enhanced curricula was developed to include a four-hour home visit with a Meals on Wheels client receiving home-delivered meals and case management; a 4-hour home visit with a Alzheimer’s Association patient and caregiver; a 1-hour group session for A Matter of Balance fall prevention program; and a 1-hour Virtual Dementia Tour simulation. Residents were also provided the option of completing additional training in quality improvement processes, with an introduction to resources from the Institute for Healthcare Improvement and concepts in the Lean Six Sigma collaborative method for process improvement.
Applying a Plan-Do-Study-Act (PDSA) cycle throughout program development and implementation, GWEP partners worked with organizational faculty to implement curricular enhancements fall 2016 through spring 2018. Trainee evaluation of knowledge, attitudes and confidence in applying principles and strategies included a Likert scale survey delivered electronically. Open-ended responses were examined using qualitative thematic analysis.
Feedback about the training identified opportunities for program improvement, including logistical support for coordinating and maximizing time during off-campus visits; supplemental materials and didactic sessions; and role clarification among health professionals.
Collaborative interprofessional training models have the potential to broaden understanding of best practices and collaborative approaches to geriatrics care. However, it is crucial to engage all partners in quality improvement processes to meet inevitable challenges of implementing training across systems of care and measuring the impact of such collaborative ventures. Evaluation of this four-year initiative demonstrates the challenges and rewards of the evolution and expansion of training programs through partnerships with health professional training programs, healthcare systems, and community organizations. It is important to continue support for transformational training opportunities in geriatrics care that are greatly needed to respond to the growing population of older adults.
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Citation:Knebl JA, Severance JJ, Hartos J (2019) Interprofessional Education and Training to Expand the Geriatrics Workforce. J Gerontol Geriatr Med 5: 030.
Copyright: © 2019 Janice A Knebl, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.