The Columbia Cooperative Aging Program: An Interdisciplinary and Interdepartmental Approach to Geriatric Education for Medical Interns

Abstract

Although there is a critical need to prepare physicians to care for the growing population of older adults, many academic medical centers lack the geriatric-trained faculty and dedicated resources needed to support comprehensive residency training programs in geriatrics. Because of this challenge at Columbia University, the Columbia Cooperative Aging Program was developed to foster geriatric training for medical interns. For approximately 60 interns each year completing their month-long geriatric rotations, an integral part of this training now involves conducting comprehensive assessments with "well" older people, supervised by an interdisciplinary team of preceptors from various disciplines, including cardiology, internal medicine, occupational therapy, geriatric nursing, psychiatry, education, public health, social work, and medical anthropology. Interns explore individual behaviors and social supports that promote health in older people; older people's strengths, vulnerabilities, and risk for functional decline; and strategies for maintaining quality of life and independence. In addition, a structured "narrative medicine" writing assignment is used to promote the interns' reflections on the assessment process, the data gathered, and their clinical reasoning throughout. Preliminary measures of the program's effect have shown significant improvements in attitudes toward, and knowledge of, older adults as patients, as well as in interns' self-assessed clinical skills. For academic medical centers, where certified geriatric providers are scarce, this approach may be an effective model for fostering residency geriatric education among interns.

Physician Assistant Studentsʼ Knowledge and Attitudes Towards Aging and Geriatric Medicine

“…30 Recent utilizations of the FAQ1 have included the assessment of aging knowledge and attitudes in various health care students and professionals. 14,15,17,19,20,27 This version of the FAQ1, with multiple-choice questions, has been shown to be more accurate and able to identify more specific misconceptions about aging than its previous true/false format. 29 Internal consistency reliability of the FAQ1 is 0.15, p < 0.05.…”

“…PAs and PA students need representation in a growing body of research that is examining health care providers' knowledge, attitudes, and interest concerning geriatrics. Knowledge of aging has been assessed recently in medical students and interns, [14][15][16][17] as well as nurses, 18 nursing students, 19 and physical therapy students. 20 Attitudes toward working with elderly patients have been evaluated in physicians, 21,22 medical students and interns, [14][15][16]23,24 nurses, 18,25 nursing students, 19,26 physical therapy students, 20 and college freshmen in allied health programs.…”

Emerging themes in using narrative in geriatric care: Implications for patient-centered practice and interprofessional teamwork

“…In addition, utilizing an interprofessional model of education broadens the understanding of the psychosocial context of aging for medical students and improves their ability to see the patient more holistically (Maurer et al, 2006;Yuen et al, 2006). Clearly, highlighting the need for multiple professions and many voices in geriatric care can have a positive effect on raising the awareness of physicians of the need for recognizing the whole older adult as the center of care and of the critical importance of interprofessional teamwork in providing that care.…”

O Ensino de Geriatria e Gerontologia na Graduação Médica

“…Na Columbia University, a interdisciplinaridade congrega diversos profissionais por meio do programa Columbia Cooperative Aging Program, que intercala conceitos, instrumentos e técnicas de assistência, caracterizando-se como uma conexão fundamental para a atenção do indivíduo idoso 19 .…”