G iven the increase in the aging population, the prevention of cognitive decline in healthy older adults deserves close attention. Mild cognitive impairment affects 10%-25% of people over the age of 70 years.1 Mild cognitive impairment involves cognitive decline beyond that normally expected in a person of the same age with preservation of function. Dementia is defined as cognitive decline in one of several cognitive domains, along with difficulty in functional abilities. The annual rate of conversion from mild cognitive impairment to dementia is about 10%. 2Given this rate, in combination with the aging population, it is estimated that the prevalence of dementia will double to more than 1 million Canadians over the next 25 years.
Background: Formal goal-setting has been shown to enhance performance and improve educational experiences. We initiated a standardized goal-setting intervention for all residents rotating through a Geriatric Medicine rotation. Objectives: This study aims to describe the feasibility of a goal-setting intervention on a geriatric medicine rotation, the resources required, and the barriers to implementation. As well, this study aims to describe the learning goals residents created regarding content and quality. Methods: A pilot goal-setting intervention was initiated. A goal-setting form was provided at the beginning of their rotation and reviewed at the end of the rotation. Residents were invited to complete an anonymous online survey to gather feedback on the initiative. Goals were analysed for content and quality. Feedback from the survey results was incorporated into the goal-setting process. Results: Between March and December 2018, 26 of 44 residents completed the goal-setting initiative. Explanations for the poor adherence included limited protected time for faculty and residents to engage in coaching, its voluntary nature, and trainee absence during orientation. Reasons for difficulty in achieving goals included lack of faculty and trainee time and difficulty assisting residents in achieving goals when no clinical opportunities arose. Although only 59% of residents completed the intervention, if goal-setting took place, most of the goals were specific (71 of 77; 92%) and 35 of 77 (45.5%) goals were not related to medical knowledge. Conclusions: This pilot study outlines the successes and barriers of a brief goal-setting intervention during a Geriatric Medicine rotation. Adherence was limited; however, of those who did complete the intervention, the creation of specific goals with a short, structured goal-setting form was possible. To enhance the intervention, goal-setting form completion should be enforced and efforts should be made to engage in mid-rotation check-ins and coaching.
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