Resident Training in Nursing Home Care: Survey of Successful Educational Strategies

Counsell, Steve; Katz, Paul R.; Karuza, Jurgis; Sullivan, Gail M.

doi:10.1111/j.1532-5415.1994.tb06988.x

Cited by 21 publications

(13 citation statements)

References 33 publications

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“…26 Published transitional care curricula in internal medicine and family medicine rarely describe use of experiential learning (eg, direct patient contact, real-life experience with different care systems and disciplines) in diverse care systems, 10,[28][29][30][31][32] whereas residency curricula in home or nursing home settings or interdisciplinary teams do not focus on transitional care. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] For example, nursing home curricula do not focus on how the complex care structure of postacute care affects transitions, or how transitional care to and from the nursing home can be optimized at an individual patient and system level. 20,21,24 Our curriculum addresses this gap by providing exposure to the continuum of care that patients experience.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] For example, nursing home curricula do not focus on how the complex care structure of postacute care affects transitions, or how transitional care to and from the nursing home can be optimized at an individual patient and system level. 20,21,24 Our curriculum addresses this gap by providing exposure to the continuum of care that patients experience.…”

Section: Discussionmentioning

confidence: 99%

“…10 Other curricula involve different care settings or interdisciplinary teams but do not focus on transitional care. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] We describe a curriculum to teach internal medicine residents to provide better transitional care at hospital discharge through experiential learning in different care settings outside of the acute hospital with a focus on other health care disciplines involved in care transitions.…”

Section: Introductionmentioning

confidence: 99%

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Getting Out of Silos: An Innovative Transitional Care Curriculum for Internal Medicine Residents Through Experiential Interdisciplinary Learning

Schoenborn¹,

Christmas²

2013

Journal of Graduate Medical Education

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Background Care transitions are common and highly vulnerable times during illness. Physicians need better training to improve care transitions. Existing transitional care curricula infrequently involve settings outside of the hospital or other health care disciplines. Intervention We created a curriculum to teach internal medicine residents how to provide better transitional care at hospital discharge through experiential, interdisciplinary learning in different care settings outside of the acute hospital, and we engaged other health care disciplines frequently involved in care transitions. Setting/Participants Nineteen postgraduate year-1 internal medicine trainees at an academic medical center in an urban location completed experiences in a postacute care facility, home health care, and outpatient clinics. Program Description The 2-week required curriculum involved teachers from geriatric medicine; physical, occupational, and speech therapy; and home health care, with both didactic and experiential components and self-reflective exercises. Program Evaluation The curriculum was highly rated (6.86 on a 9-point scale) and was associated with a significant increase in the rating of the overall quality of transitional care education (from 4.09 on a 5-point scale in 2011 to 4.53 in 2012) on the annual residency program survey. Learners reported improved knowledge in key curricular areas and that they would change practice as a result of the curriculum. Conclusions Our transitional care curriculum for internal medicine residents provides exposure to care settings and health care disciplines that patients frequently encounter. The curriculum has shown positive, short-term effects on learners' perceived knowledge and behavior.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Getting Out of Silos: An Innovative Transitional Care Curriculum for Internal Medicine Residents Through Experiential Interdisciplinary Learning

Schoenborn¹,

Christmas²

2013

Journal of Graduate Medical Education

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“…[51][52][53] Finally, the system for health care reimbursement should recognize the complexity of dementia care and appropriately reimburse these efforts. The training of physicians and other health professionals about these issues will be critical.…”

Section: The Futurementioning

confidence: 99%

Barriers to Treatment: The Unique Challenges for Physicians Providing Dementia Care

Foster¹

2001

J Geriatr Psychiatry Neurol

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Evaluating and treating dementia is intellectually demanding and enormously satisfying. However, physicians providing dementia care also confront unique challenges that cause discomfort and overwhelming frustration unless they are recognized and overcome. Physicians must care for individuals who do not adopt the "sick role." They must establish and maintain rapport with patients while also approaching collateral sources to obtain a complete history. They must develop a complex alliance with the patient, caregivers, community agencies, and other health professionals to provide effective treatment. Physicians must relate "bad news" to several people at once who are unequally prepared for it, while dealing with their own diagnostic uncertainty. Furthermore, physicians must honor patient autonomy and balance it with the needs of caregivers. Since the demands of providing dementia care are not typical of most medical practice, the special attributes needed are often not taught to students or adequately reimbursed by health insurance. The quality of dementia care will improve when strategies that address these aspects of care for patients with dementia are widely adopted.

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“…Today's general internal medicine (GIM) residents will need focused training that imparts the attitudes, knowledge, and skills required to provide superior geriatric care. Reports that have documented the status of geriatrics training in GIM are either outdated or they have concentrated on only 1 aspect of geriatric education 6,7 . This study addresses this gap by reporting the results of a comprehensive survey of current efforts and trends in geriatric education for GIM residencies.…”

mentioning

confidence: 99%

A national survey on the current status of general internal medicine residency education in geriatric medicine

et al. 2003

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OBJECTIVES:The dramatic increase in the U.S. elderly population expected over the coming decades will place a heavy strain on the current health care system. General internal medicine (GIM) residents need to be prepared to take care of this population. In this study, we document the current and future trends in geriatric education in GIM residency programs.DESIGN, SETTING, PARTICIPANTS: An original survey was mailed to all the GIM residency directors in the United States (N = 390).RESULTS: A 53% response rate was achieved (n = 206). Ninetythree percent of GIM residencies had a required geriatrics curriculum. Seventy one percent of the programs required 13 to 36 half days of geriatric medicine clinical training during the 3-year residency, and 29% required 12 half days or less of clinical training. Nursing homes, outpatient geriatric assessment centers, and nongeriatric ambulatory settings were the predominant training sites for geriatrics in GIM. Training was most often offered in a block format. The average number of physician faculty available to teach geriatrics was 6.4 per program (2.8 full-time equivalents). Conflicting time demands with other curricula was ranked as the most significant barrier to geriatric education. CONCLUSIONS:A required geriatric medicine curriculum is now included in most GIM residency programs. Variability in the amount of time devoted to geriatrics exists across GIM residencies. Residents in some programs spend very little time in specific, required geriatric medicine clinical experiences. The results of this survey can guide the development of future curricular content and structure. Emphasizing geriatrics in GIM residencies helps ensure that these residents are equipped to care for the expanding aging population.

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Resident Training in Nursing Home Care: Survey of Successful Educational Strategies

Cited by 21 publications

References 33 publications

Getting Out of Silos: An Innovative Transitional Care Curriculum for Internal Medicine Residents Through Experiential Interdisciplinary Learning

Getting Out of Silos: An Innovative Transitional Care Curriculum for Internal Medicine Residents Through Experiential Interdisciplinary Learning

Barriers to Treatment: The Unique Challenges for Physicians Providing Dementia Care

A national survey on the current status of general internal medicine residency education in geriatric medicine

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