Objectives The authors conducted a randomised controlled trial of four pedagogical methods commonly used to deliver teamwork training and measured the effects of each method on the acquisition of student teamwork knowledge, skills, and attitudes. Methods The authors recruited 203 senior nursing students and 235 fourth-year medical students (total N¼438) from two major universities for a 1-day interdisciplinary teamwork training course. All participants received a didactic lecture and then were randomly assigned to one of four educational methods: didactic (control), audience response didactic, role play and human patient simulation. Student performance was assessed for teamwork attitudes, knowledge and skills using: (a) a 36-item teamwork attitudes instrument (CHIRP), (b) a 12-item teamwork knowledge test, (c) a 10-item standardised patient (SP) evaluation of student teamwork skills performance and (d) a 20-item modification of items from the Mayo High Performance Teamwork Scale (MHPTS The TeamSTEPPS programme is designed to improve care and patient safety through improved teamwork training to enhance provider communication skills. While the 7 h multidisciplinary Team-STEPPS programme has proven very effective, questions remain regarding the most effective and cost-efficient approach to providing this content to learners at all stages of the health-education continuum.Various educational approaches have been used to address training in team coordination skills in healthcare. Methods such as crisis resource management training using high fidelity human patient simulation provide realism and interactivity.1e3 However, this training modality is both costly and time-consuming, with one instructor per five trainees costing as much as $5000 per day. 12Because of this, medical and nursing schools are implementing more traditional didactic approaches to teaching team coordination skills as well as computer-based instruction, small-group sessions, analysis of videotaped team coordination scenarios and workplace practice experiences.10 11 13 Questions remain about the effectiveness of any of these methods to achieve the necessary changes in student attitudes, knowledge and skills, and there is little evidence for selecting particular methods. Therefore, this study was designed and implemented to adapt the TeamSTEPPS content to pre-licensure nursing and medical students, and measure the effectiveness of four educational interventions at teaching this material. METHODS ProtocolWe conducted a full-day teamwork training and assessment exercise for 438 students composed of fourth-year medical students (N¼235) and finalsemester nursing students (N¼203) from four health-professional schools at two major universities: all students convened on the one campus where they were randomised to one of four educational intervention groups. Students were offered the option of not participating in the research project but could not decline the educational experience. Institutional review boards of both universities approved the proj...

Objectives: Despite an increasing number of elderly emergency department (ED) patients, emergency medicine (EM) residency training lacks geriatric-specific curricula. The objective was to determine if a 1-year geriatric curriculum, designed for residents, would affect residents' attitudes, knowledge, and decision-making for older patients seen in the ED. Methods: The authors created a geriatric curriculum for EM residents composed of six lectures on the following topics: trauma, abdominal pain, transitions of care, medication management, iatrogenic injuries, and confusional states. A second component of the curriculum included seven high-fidelity simulation skills training sessions on aortic aneurysm, salicylate toxicity, drugs of abuse, infection from a posterior pressure ulcer, medication-induced elevated prothrombin time resulting in gastrointestinal bleeding, mesenteric ischemia, and myocardial infarction. Before and after completion of the curriculum, residents were assessed on attitudes toward caring for geriatric patients using a validated survey and knowledge of geriatric principals of care using a 35-question multiple choice test. To determine differences before and after the new curriculum was implemented, the paired t-test was performed on knowledge and attitude scores. ED records were also reviewed for frequency of chemical sedation and urinary catheter placement in patients aged 65 and over, both before and after the educational intervention , as a measure of appropriate decision-making. Appropriateness of urinary catheter placement was determined by two physician reviewers using criteria adapted from the Centers for Disease Control and Prevention indications for appropriate urinary catheter use. Reviewers met to adjudicate any disagreements about appropriateness. Fisher's exact test was used to examine differences in frequency of chemical sedation and urinary catheter placement. Results: Twenty-nine EM residents underwent the training. There was no measured change in attitudes. Knowledge improved from the pre-to posttest with average scores of 58.5 and 68.0%, respectively (p < 0.0001), among the 25 residents who completed both tests. There was no change in the percentage of elderly patients receiving chemical sedation and urinary catheters before and after the curriculum (5.4% vs. 4.5%, p = 0.47; and 7.4% vs. 5.9%, p = 0.3, respectively). The number of inappropriate urinary cathe-ters placed significantly decreased after the curriculum, from 8 of 49 to 1 of 47 (16.3% vs. 2.1%, p = 0.03). Conclusions: Geriatric educational curricula for EM residents may positively affect knowledge base and appropriate decision-making when working with older adults in the ED. These educational enhancements may place elderly patients at less risk of adverse outcomes. ACADEMIC EMERGENCY MEDICINE 2011; 18:S92-S96 ª

This study tested the reliability and validity of the Carolina Opinions on Care of Older Adults (COCOA) survey compared with the Geriatric Assessment Survey (GAS). Participants were first year medical students (n ¼ 160). A Linear Structural Relations (LISREL) measurement model for COCOA had a moderately strong fit that was significantly better than the null model (GFI ¼ 0.81, TLI ¼ 0.90) and the GAS (GFI ¼ 0.76). A reduced, 24-item COCOA performed well (GFI ¼ 0.90, TLI ¼ 1.00) with R 2 ¼ .595 on five factors. The COCOA and GAS represent complementary instruments for assessing attitudes towards older adults.

GRIEV_ING provides an effective model medical educators can use to train medical students to provide competent death notifications. Senior medical students are primed to learn death notification and do not require a preexposure.