Geriatrics and Aging through Transitional Environments (GATE) MS1 Curriculum: Obtaining a Functional History in the Home

Limaye, Seema; Williams, Shellie; Smith, Stephen L.; Baron, Aliza; Blood, Angela

doi:10.15766/mep_2374-8265.9227

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“…For several years, we have incorporated TPs into a longitudinal, geriatrics skill-based medical school curriculum. 19 The Geriatric Aging through Transitional Environments (GATE) program uses TPs who are trained to participate in medical student interviews conducted in their homes and to obtain functional histories and home safety evaluations. The success of the GATE program inspired the development of a novel curriculum in which TPs are utilized to improve communication skills on ACP.…”

Section: Introductionmentioning

confidence: 99%

Incorporating Older Adults as “Trained Patients” to Teach Advance Care Planning to Third-Year Medical Students

Nussbaum

Oyola

Egan³

et al. 2019

Am J Hosp Palliat Care

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Background: Advance care planning (ACP) is a critical component of end-of-life (EoL) care, yet infrequently taught in medical training. Objective: We designed a novel curriculum that affords third-year medical students (MS3s) the opportunity to practice EoL care discussions with a trained older adult in the patient's home. Design: Volunteers were instructed as trained patients (TPs) to evaluate MS3s interviewing and communication skills. The MS3s received a didactic lecture and supplemental material about ACP. Pairs of MS3s conducted ACP interviews with TPs who gave verbal and written feedback to students. Student evaluations included reflective essays and pre/postsurveys in ACP skills. Settings and Participants: A total of 223 US MS3s participated in the curriculum. Results: Qualitative analysis of reflective essays revealed 4 themes: (1) students' personal feelings, attitudes, and observations about conducting ACP interviews; (2) observations about the process of relationship building; (3) learning about and respecting patients' values and choices; and (4) the importance of practicing the ACP skills in medical school. Students' confidence in skills significantly improved in all 7 domains (P < .001): (1) introduce subject of EoL; (2) define advance directives; (3) assess values, goals, and priorities; (4) discuss prior experience with death; (5) assess expectations about treatment and hospitalization; (6) explain cardiopulmonary resuscitation and outcomes; and (7) deal with own feelings about EoL and providers' limitations. Conclusions: The use of older adults as TPs in an ACP curriculum provides students an opportunity to practice skills and receive feedback in the nonmedical setting, thereby improving comfort and confidence in approaching these conversations for future patients.

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Section: Introductionmentioning

confidence: 99%