scholarly journals Medical Students' Longitudinal Learning With Older Adults: Geriatrics Education Mentor Program

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 14-14
Author(s):  
Marilyn Gugliucci ◽  
Victoria Thieme
Keyword(s):  
Older Adults ◽  
Medical Students ◽  
New England ◽  
Older Adult ◽  
Clinical Skills ◽  
Snowball Sampling ◽  
Program Goal ◽  
Joint Project ◽  
Geriatrics Education ◽  
College Of Osteopathic Medicine

Abstract The University of New England College of Osteopathic Medicine (UNECOM) Geriatrics Education Mentor (GEM) Program is in its sixth year. It's a joint project between older community living adults and 2nd year medical students within the Osteopathic Clinical Skills course. The GEM program goal is to foster understanding and importance of the person/patient-provider relationship. Pairs of osteopathic medical students (N=87 +/- 5) were assigned to an older adult GEM (mentor) volunteer (N=87 +/-5) living within a 50 mile radius of UNECOM. Snowball sampling was used to recruit the GEMs; student participation is required. Four (4) home visits were conducted over 9 months with an assigned GEM; each visit included a new assignment. Students observed, summarized, and recorded experiences communicated by the GEM for each cumulative assignment. Data from assignments were “graded” and content analyses of open ended evaluation/summary questions were conducted. This program is UNE IRB approved. Student pairs completed all assignments. Assignments analysis on Blackboard revealed that students developed respect and awareness of life and medical experiences of the GEM; expressed understanding of the GEM’s life experiences and goals for what “matters most”. Relationships with older adults were established while students maintained professionalism and succeeded in competent and confident interactions. Documentation review from the 4 assignments aided in building students’ geriatrics knowledge, attitudes and skills. Pre-clinical medical education tends to be episodic; providing an opportunity to establish longitudinal assignments over the course of the academic year with the same older adult augments relationship skills and learning in geriatrics.

scholarly journals KNOWLEDGE OF AGEISM AND ATTITUDES ABOUT AGING AS A CORE COMPETENCY FOR HEALTH PROFESSIONALS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S832-S833
Author(s):  
Sarah Marrs ◽  
Tracey Gendron ◽  
Leland Waters ◽  
Jenny Inker ◽  
Maddie McIntyre
Keyword(s):  
Older Adults ◽  
Medical Students ◽  
Older Adult ◽  
Medical Training ◽  
Qualitative Content Analysis ◽  
Health Professions ◽  
Community Dwelling ◽  
Mentoring Program ◽  
Term Care ◽  
The Impact

Abstract Senior mentoring programs have been established that provide medical students exposure to a community-dwelling older adult mentor with whom they meet multiple times throughout the program. The goal of these programs is to expose students to healthy older adults, increase knowledge of geriatrics, and prepare them to care for an aging population. However, even while participating in a senior mentoring program, health professions students still demonstrate some discriminatory language towards older adults (e.g., Gendron, Inker, & Welleford, 2018). In fact, research suggests ageist practices occur, intentionally or not, among health professions in disciplines such as medicine, nursing, and social work and even within assisted and long-term care facilities (e.g., Bowling, 1999; Dobbs et al., 2008; Kane & Kane, 2005). We evaluated a senior mentoring program to gauge the impact of a new pedagogical approach and to gain a deeper understanding of the learning gained in relation to ageism and elderhood. This qualitative content analysis explored first-year medical students’ opinions of their own aging and attitudes towards caring for older adults. Students (n = 216) participating in a brief curriculum model of a senior mentoring program responded to the following open-ended prompts before and after the program: 1) How do you feel about your own aging?; 2) How do you feel about working with older adult patients after you complete your medical training? Responses suggest that students’ views of their own aging and views towards towards working with older patients are positively impacted by their experiences in the senior mentoring program.

scholarly journals A Longitudinal Aging and End-of-Life Care Curriculum for Medical Students Using the Geriatric 5Ms Framework

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 9-9
Author(s):  
Andrea Schwartz ◽  
Kristen Schaefer
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Medical Student ◽  
Medical Students ◽  
End Of Life ◽  
Curriculum Design ◽  
End Of Life Care ◽  
Flipped Classroom ◽  
Clinical Skills ◽  
Life Care

Abstract Medical student training in geriatrics and palliative care is critical to prepare them to care for older adults and those facing serious illness. We created a longitudinal Aging and End of Life Care Curriculum at Harvard Medical School, using Kern’s Curriculum Design Model. We conducted a focused needs assessment survey with course and clerkship directors, then implemented curricula based on the AAMC and Hartford Foundation’s 26 learning objectives in Geriatrics (Leipzig et al, Acad Med 2009), and “Raising the Bar for the care of seriously ill patients” which established competencies for medical students in palliative care (Schaefer at al, Acad Med 2014). We structured the curricular content to enable spaced learning, using the Geriatric 5Ms framework of Mobility, Mind, Medications, Multi-complexity and Matters Most (Tinetti at al, JAGS 2017), which aligns with the Age Friendly Health Systems Initiative priorities. Students participate in trainings on Delivering Serious News and Goals of Care Conversations, structured home visits with older adults, and clinical reasoning sessions focused on falls, delirium and polypharmacy risk reduction. The curriculum includes interactive, case based and jigsaw learning, as well as flipped classroom learning. Students are evaluated using a three part longitudinal Objective Structured Clinical Examination with an aging patient, which demonstrates an increase in medical student clinical skills in geriatrics. Individual sessions of the curriculum demonstrate increases in student knowledge of and attitude to geriatrics; longitudinal assessment is ongoing to ensure that students graduate ready to care for an aging society with competence, knowledge and compassion.

scholarly journals Medical/Pharmacy Students Interprofessional Older Adult Medication Interactions/Contraindications Project

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 828-828
Author(s):  
Marilyn Gugliucci ◽  
Victoria Thieme
Keyword(s):  
New England ◽  
Student Experiences ◽  
First Year ◽  
Medication List ◽  
Student Collaboration ◽  
Geriatrics Education ◽  
Medication Reviews ◽  
College Of Osteopathic Medicine ◽  
The University ◽  
First Year Medical Students

Abstract The University of New England College of Osteopathic Medicine (UNECOM) Geriatrics Education Mentors [GEM] program, established in 2014, pairs UNECOM students with older community living adults. GEM assignments focus on health review, medical humanities, and geriatrics training. Each year approximately 90 older adults participate in GEMs. In 2019, the GEM program was expanded with Geriatrics Workforce Enhancement Program (GWEP) grant funding to: include first year medical students, include 2 additional assignments (4 assignments over 10 months to 6 assignments over 18 months), and to create interprofessional student collaboration. In the new GEM Assignment 4: Medication Interactions/Contraindications, UNECOM students with their GEM compiled details on the GEM’s medication list (prescriptions, herbal, OTC); one of 4 Ms of Age Friendly Health Care. UNECOM students (84 pairs) were then assigned to UNE School of Pharmacy (SOP) students (42 SOP students had 2 UNECOM pairs) to conduct a “Lexicomp” (App) medication interactions and Beers Criteria review. UNECOM students documented findings with the SOP student partner; discussed the processes of review with their GEM and the resultant findings; documented the GEM’s questions and how the UNECOM student answered those questions; and discussed next steps for the GEM regarding options for different medications - especially follow up with their prescribing physician(s) for any noted interactions/contraindications. For GEMs with few medications, a mock medication list was assigned to ensure student experiences with medication reviews and GEM discussion. Although time intensive preparation is required, UNECOM & SOP students attained significant learning as did the GEM mentors.

scholarly journals Teaching Medical Students How to Ask Older Adults What Matters Using Simulated Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 582-582
Author(s):  
Laurin Mack ◽  
Jamie Cvengros ◽  
Erin Emery-Tiburcio
Keyword(s):  
Older Adults ◽  
Medical Students ◽  
Communication Skills ◽  
Clinical Skills ◽  
Clinical Care ◽  
Simulated Patients ◽  
Clinical Skills Assessment ◽  
Medical Needs ◽  
Skills Lab ◽  
What Matters

Abstract It is vital the workforce is prepared to meet the medical needs of our aging population. Asking older adults What Matters is an important aspect of excellence in clinical care. During a small group session in a two-year communication skills course, second year medical students (N=149) at Rush were taught how to ask What Matters as part of the 4Ms. Students then completed a video recorded Communication Skills Lab with a simulated older adult patient as they practiced how to discuss What Matters. Students then met with their instructors in individual feedback sessions to review the video and discuss strengths and areas for improvement in communicating with older adults. Students then completed a Clinical Skills Assessment for formal testing of their communication skills with older adults. Outcomes of the summative assessment will be presented and recommendations for integrating 4Ms into existing medical school and allied health curriculum will be discussed.

scholarly journals KEY LEARNING FOR TWELVE UNECOM MEDICAL STUDENTS IMMERSED FOR 48 HOURS IN AN ACUTE CARE HOSPICE HOME DURING 2017-18

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S849-S849
Author(s):  
Emily Tamimie ◽  
Marilyn R Gugliucci
Keyword(s):  
Medical Students ◽  
New England ◽  
End Of Life ◽  
Acute Care ◽  
Critical Education ◽  
Research Fellowship ◽  
Care Family ◽  
Practical Experiences ◽  
College Of Osteopathic Medicine ◽  
The Many

Abstract Introduction: Most US medical schools are not able to provide practical experiences in end-of-life or palliative care. The University of New England College of Osteopathic Medicine Learning by Living 48 Hour Hospice Home Immersion (HHI) Project provides intense learning for second through fourth year medical students. Students are immersed into an acute care 18-bed in-patient hospice home for 48 hours to provide patient care, family support, and post-mortem. Students work with an Interprofessional staff team and independently. Methods: The HHI utilizes qualitative ethnographic/autobiographic research designs. Two key research questions include: (1) What is it like for ME to live in the Hospice Home for 48 hours? and (2) What will I take from this experience to my future as a practitioner?” Each student writes a journal during the three research stages; pre-fieldwork; fieldwork; post-fieldwork. Twelve 2nd year medical student journals randomly selected from 2017-18 immersions (N=24) were analyzed 5/2019-7/2019. Detailed qualitative manual and content analysis utilizing established interrater-reliability procedures were conducted on 300+ pages of data (UNECOM Morgane Student Research Fellowship). Results: Of the many themes identified, three key themes were notable for all 12 students for question one: Religion/Spirituality; Acceptance; and Reactions to Death. Key takeaways for question two included being: (a) able to have conversations about death; (b) at peace with death; (c) present with death, and knowing death is a part of life. Conclusion: Each student experienced his/her immersion differently, but all expressed this was a life-altering project providing critical education on hospice and end-of life care.

Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Gait Speed ◽  
Well Being ◽  
Self Report ◽  
Subjective Report ◽  
Healthy Older Adults ◽  
Relative Value ◽  
Cognitive Speed ◽  
Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

Prescription of Exercise in Older Adults, Physiotherapeutic Approach

2017 ◽  
Vol 2 (5) ◽  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Exercise Prescription

• Identify the changes related to aging that must be taken into account for the prescription of the exercise • Define the appropriate functional assessmentsforthe prescription of the exercise in the older adult • Recognize the factors that influence the adherence to exercise by older adults • Describe according to the objectives the correct exercise prescription for older adults.

scholarly journals Physical Inactivity in Older Adult Couples: A Dyadic Analysis Using Continuous In-Home Monitoring

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 412-412
Author(s):  
Chao-Yi Wu ◽  
Lyndsey Miller ◽  
Rachel Wall ◽  
Zachary Beattie ◽  
Jeffrey Kaye ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older Adult ◽  
Physical Inactivity ◽  
Home Monitoring ◽  
Health Determinants ◽  
Dyadic Analysis ◽  
Physical And Mental Health ◽  
Positive Health ◽  
Aging Research

Abstract Many older adults remain inactive despite the known positive health implications of physical activity (e.g. improved mood, reduced mortality risk). Physical inactivity is a known interdependent phenomenon in couples, but the majority of research identifies determinants of physical inactivity at the individual level. We estimated the average amount of physical inactivity for older adult couples and, using dyadic analysis, identified physical and mental health determinants thereof. Forty-eight heterosexual older adult couples (mean age=70.6, SD=6.63) from the Veterans Integrated Service Network 20 cohort of the Collaborative Aging Research using Technology (CART) initiative were included in this study. Both dyad members wore actigraph devices for a month. The average number per day of inactive periods (defined as no movement or sleep activity for ≥ 30 minutes) was estimated. Multilevel modeling revealed that, within couples, there was no difference between partners in the average number of inactive periods, but on average across couples, males had more inactive periods per day (13.4, SD=4.43) than females (12.3, SD=4.87). For males, older age was the only variable associated with more inactive periods (β=0.13, p=.013). For females, more depressive symptoms in men were associated with fewer inactive periods (β=-0.37, p=.002), and more dependence in completing their own IADLs predicted more inactive periods (β=2.80, p<.001). All models were adjusted for covariates. Viewing couples’ activity as a unit, rather than as separate individuals, provides a novel approach to identifying pathways to reduce inactivity in older adults, especially when focusing on mental health issues and decreased independence within the couple.

scholarly journals Sex Difference in Self-Reported Sexual Functioning Among Frail Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 313-313
Author(s):  
Brianne Olivieri-Mui ◽  
Sandra Shi ◽  
Ellen McCarthy ◽  
Dae Kim
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Sex Differences ◽  
Sexual Function ◽  
Older Adult ◽  
Sexual Functioning ◽  
Social Life ◽  
Well Being ◽  
Adult Males ◽  
Males And Females

Abstract Frailty may differentially impact how older adult males and females perceive sexual functioning, an important part of well-being. We assessed the level of frailty (robust, pre-frail, frail) for anyone with data on 11 sexual functioning questions asked in wave 2 of the National Social Life, Health, and Aging Project, 2010-2011 (n=2060). Questions covered five domains: overall sexual function (OSF), sexual function anxiety (SFA), changes in sexual function (CSF), erectile/vaginal dysfunction (EVD), and masturbation. Logistic regression identified sex differences in frailty and reporting worse sexual functioning. Linear regression predicted the number of domains reported as worse. Among males (n=1057), pre-frailty meant higher odds of reporting SFA (OR 1.8 95%CI 1.2-6.6), CSF (OR 1.7 95%CI 1.1-2.7), and EVD (OR 1.5 95%CI 1.0-2.2). Among females (n=1003), there was no difference in reporting by frailty. Females were more likely to report worse OSF (Robust: OR 7.4, 95%CI 4.8-11.4; Pre-frail: OR 6.2, 95%CI 3.9-9.9; Frail: OR 3.4 95%CI 1.7-6.6), but less likely to report SFA (Robust OR .3, 95%CI .2-.5; Pre-frail OR .2, 95%CI .1-.3; Frail OR .2 95%CI .1-.3). Pre-frail and frail females reported fewer domains as worse (Pre-frail coefficient -0.21 SE 0.09, Frail -0.43 SE 0.14). As frailty worsened, males reported more domains as worse (Pre-frail 0.24 SE 0.07, Frail 0.29 SE 0.08). Self-reported sexual functioning differs by sex at all levels of frailty, and reporting by males, but not females, changes with frailty. Providers should be aware that sexual functioning is of importance to both sexes despite varying degrees of frailty.

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