Project

Geriatrics/Medical Education Initiatives

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Project log

G. Darryl Wieland
added a research item
Context: The aging of the U.S. population mandates improvements in geriatric education. The Donald W. Reynolds Foundation [DWRF] invested $60m in 30 medical schools from 2001-2010 with the goal of improving geriatric medical education. Objective: To determine the impact of DWRF funding on graduate outcomes pertaining to geriatrics competencies. Objective: To determine the impact of DWRF funding on graduate outcomes pertaining to geriatrics competencies. Design: Secondary analysis of the Association of American Medical Colleges [AAMC] Graduation Questionnaire [GQ], contrasting mean agreement scores with geriatrics competency statements for groups defined by year (2008, 2009), school award status (DWRF v. control, and across three DWRF cohorts), and year-by-group interactions. Participants: 2008 (n=11,504) and 2009 (n=11,306) GQ respondents from medical schools receiving and not receiving DWRF support. Interventions: Thirty allopathic medical schools received funding ($2m each over 4 years, matched by $1m from the school), in three rounds: Cohorts I (funded from 2001-4), II (2003-6), and III (2006-9). Awardees implemented a variety of geriatrics training initiatives with strong emphasis on school-specific medical school curriculum innovations, and committed to sustaining program after the end of funding. Main Outcome Measures: Agreement with seven positively worded statements of geriatrics competencies selected from 26 consensus minimum competency standards for graduating students. Results: Across outcomes, DWRF respondents had significantly higher scores than controls (p<.0001), and there was a significant decline in all scores between 2008 and 2009 (p<.0001). DWRF respondent scores declined more than controls (p=.0412), and among DWRF graduates, scores declined more for those from earlier v. later funding cohorts (p<.0001). Conclusions: External funding by private foundations can have a significant impact on medical education, but sustaining change after funding remains challenging. We still may lack the knowledge and means to make fundamental curriculum reforms to meet important social and healthcare priorities. Thus, the larger question concerning the reformability of undergraduate medical education remains open.
G. Darryl Wieland
added a research item
Staff development and training is one of a number of tools available to nursing-home managers for addressing a variety of workforce and resident-care problems. The organization and objectives of staff development, and characteristics of the staff developer are described for a sample of nursing homes surveyed in 1988. Factors related to perceived program efficacy and obstacles to improvement of staff development were also explored. While the survey was exploratory, the results suggest that nursing-home staff development programs can be effective in addressing a variety of management and quality-of-care objectives, but that specific resource issues must be addressed to affect improvement and to attain common program objectives.
G. Darryl Wieland
added 23 research items
Most medical schools do not have a separate course in geriatrics, but rather incorporate geriatrics into existing courses. Tracking and assessing curriculum content is more difficult in this setting. This paper describes and compares two approaches to assess curriculum content in geriatrics: a survey of course directors and a course objectives review. The results suggest that course directors report more geriatric content when asked as part of a regular survey than they identify as specific course objectives. Course objectives may be more reflective of the actual emphasis placed on aging-related material in courses. These two approaches appear to be complementary. Medical educators may find both self-report and course objective analysis to be useful and complementary in tracking geriatric material in the undergraduate medical curriculum.