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Evaluating Medical Student Geriatric Competency Using A 5ms-Based Assessment Tool, Lauren R. Hersh Md, Amy Cunningham Phd, Mph, Xiya Wu Md

Cooper Rowan Medical Journal

INTRODUCTION

Driven by an aging Baby Boomer generation, the United States is navigating a demographic transformation with far-reaching implications that include increased demand for chronic disease management and long-term care as well as increased stress on both healthcare costs and infrastructure. Generating a workforce competent in the delivery of care to older patients with complex, multimorbid conditions is fundamental to addressing this shift. Recognizing that the development of primary and specialty care physicians skilled in geriatric care begins in medical school, the American Geriatric Society developed minimum competencies grounded in the Geriatric 5Ms (Mind, Mobility, Medication, Multicomplexity, and …

Disposition At Equipoise: A Qualitative Study Of Emergency Physicians' Decision-Making About Hospitalizing People With Dementia, Anita N Chary, Annika R Bhananker, Rebecca Franks, Jason Bowman, Adrian D Haimovich, Victoria Martell, Elizabeth M Schoenfeld, Cameron J Gettel, Shan W Liu, Kei Ouchi, Maura Kennedy, Aanand Naik, Manish N Shah

Faculty, Staff and Student Publications

Background: People with dementia are often hospitalized from the emergency department (ED) for conditions that could potentially be treated in the outpatient setting. In scenarios of clinical equipoise-where either admission or discharge may be appropriate-little is known about how emergency physicians make disposition decisions.

Methods: We conducted a qualitative study with attending emergency physicians at a single academic medical center. Interviews included open-ended questions about disposition decision-making in general as well as structured case scenarios using a think-aloud protocol. We used an inductive approach to code interview data and elucidate themes about the factors emergency physicians consider in disposition decisions …

A Qualitative Study Of Health Priorities Of People With Dementia And Care Partners In Emergency Department And Hospital Care In A Public Safety-Net Setting, Anita Chary, Sumin Yoon, Victor Lara, Annika Bhananker, Michelle Suh, Kei Ouchi, Maura Kennedy, Aanand D Naik

Faculty, Staff and Student Publications

Background: Over half of the people with dementia visit the emergency department (ED) each year. Little is known about how people with dementia and their care partners conceptualize or communicate about health outcome goals or care preferences during acute care episodes.

Participants and setting: We conducted interviews with 14 Hispanic people with dementia and 19 care partners recruited from a public safety net hospital system in the southeastern United States. Participants were community-dwelling and had recently visited the ED.

Methods: We used a qualitative study design informed by phenomenology and guided by the patient priorities care (PPC) framework. Interviews elicited …

A Model For Developing Subspecialty Clinical Practice Guidelines: The Geriatric Emergency Department Guidelines 20, Satheesh Gunaga, Christopher R Carpenter, Maura Kennedy, Lauren T Southerland, Alexander X Lo, Sangil Lee, Kirby Swan, Fabrice Mowbray, Rachel M Skains, Teresita M Hogan, Martin F Casey, Kei Ouchi, Naomi R George, Kerstin De Wit, Cameron J Gettel, Katherine Selman, Luna C Ragsdale, Anita N Chary, James D Van Oppen, Glenn Arendts, Charles L Maddow, Katherine M Hunold, Katren R Tyler, Danya Khoujah, Ula Hwang, Shan Liu

Faculty, Staff and Students Publications

The original consensus-based Geriatric Emergency Department (GED) Guidelines, published in 2014, established a framework of core principles for delivering high-quality, age-appropriate emergency care for older adults. In response to significant advances in geriatric emergency medicine research and evolving clinical priorities, we developed the GED Guidelines 2.0 to ensure continued relevance, clinical utility, and evidence-based rigor. This concept paper describes the systematic and iterative process undertaken to update the guidelines, including the formation of multidisciplinary working groups and the application of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Unlike the original GED Guidelines, our approach prioritized methodological transparency, …

Inside Wamh, January 2008, Advocate Health - Midwest

Historical Documents - Combined

West Allis Memorial Hospital, West Allis, WI: Inside WAMH is a monthly newsletter for employees, volunteers, and guests of the hospital. This issue has a feature on Acute Care for the Elderly (ACE).

Drivers Of Frequent Emergency Department Use In Socioeconomically Disadvantaged Older Adults: A Qualitative Study, Anita Chary, Annika Bhananker, Michelle Suh, David Leavitt, Elise Brickhouse, Shreya Tamma, Jose Ramirez, Mariana Rios, Aanand D Naik, Margaret Samuels-Kalow, Naomi George

Faculty, Staff and Student Publications

Background: The emergency department (ED) is the safety net for and a common point of healthcare access for socioeconomically disadvantaged older adults. Little is known about socioeconomically disadvantaged older ED patients' perspectives on their health, healthcare access, and ED use. Such insights could guide tailored interventions to address unmet clinical and health-related social needs (HRSN).

Methods: We performed a qualitative study with older adults in a single public safety net hospital ED. We interviewed patients age 60+ who had ≥ 4 ED 4 visits in the past year. Semi-structured interviews explored perceived health needs and motivations underlying ED visits. We …

Building An Interdisciplinary Workforce In Geroscience: Aligning Perspectives And Educational Goals, Iman M Al-Naggar, Miranda E Orr, Et Al.

2020-Current year OA Pubs

The National Institute on Aging-funded Geroscience Education and Training Network held the "Building an Interdisciplinary Workforce in Geroscience: Aligning Perspectives and Educational Goals" preconference workshop at the 2023 Gerontological Society of America's Annual Meeting. Parties involved in geroscience education and interested stakeholders addressed the development of didactic educational materials, training, and career development opportunities to equip learners with the skills to meet the demands of the emerging field of geroscience, from research to clinic and industry. Recent successes were presented, existing opportunities, gaps, and challenges identified and discussed, and solutions and future directions described.

Aging Is Not All Doom And Gloom: How Do Beliefs About Aging Moderate The Effects Of Mortality Salience On Ageism Attitudes?, Kristen Schwindt Edmondson

Masters Theses & Specialist Projects

The purpose of the study is to examine how young adults’ beliefs about aging moderate the effects of mortality salience on their ageism attitudes. Past research suggests that ageism is, in part, due to the presence of elderly people reminding people of their own aging process and mortality (Martens et al., 2004). Little is known, however, about how individuals’ beliefs about aging may moderate the impact of mortality salience on their attitudes toward aging. Some people tend to perceive aging-related changes as relatively fixed (i.e., essentialist belief), whereas others perceive them as relatively malleable (nonessentialist belief). Would a more malleable …

Interprofessional Education: A Geriatric Immersion Experiential, Emily J. Balog, Jennifer Degennaro, Lisa Bodenheimer, Stephanie Berdugo-Hernandez, Isabella Berdugo-Hernandez, Matthew Mclaughlin, Kevin Overbeck, Elyse Perweiler

Rowan-Virtua SOM Faculty Teaching & Learning Seminar

The Geriatric Interprofessional Education Immersion (GIPEI) course was developed using a mixed methods design guided by the Knowledge-to-Action (KTA) Framework and embedded data-driven decision-making (DDDM). The eight-week, tri-weekly immersion integrates Experiential and Adult Learning Theories, the 4Ms Framework, IPEC competencies, and TeamSTEPPS to foster age-friendly clinical decision-making. Quantitative and qualitative data, including pre/post-tests, rubrics, observations, and student interviews, inform iterative improvement. The somato-psycho-socio-semiotic model of health further anchors student reflection and care planning. Findings aim to demonstrate improved learner ability to recognize and apply age-friendly care, while supporting evidence-informed curriculum refinement. The course is funded by the geriatric workforce enhancement …

Managing Hypercholesterolemia In Adults Older Than 75 Years Without A History Of Atherosclerotic Cardiovascular Disease: An Expert Clinical Consensus From The National Lipid Association And The American Geriatrics Society, Vera Bittner, Sunny A Linnebur, Dave L Dixon, Daniel E Forman, Ariel R Green, Terry A Jacobson, Ariela R Orkaby, Joseph J Saseen, Salim S Virani

Faculty, Staff and Students Publications

The risk of atherosclerotic cardiovascular disease increases with advancing age. Elevated LDL-cholesterol and non-HDL-cholesterol levels remain predictive of incident atherosclerotic cardiovascular events among individuals older than 75 years. Risk prediction among older individuals is less certain because most current risk calculators lack specificity in those older than 75 years and do not adjust for co-morbidities, functional status, frailty, and cognition which significantly impact prognosis in this age group. Data on the benefits and risks of lowering LDL-cholesterol with statins in older patients without atherosclerotic cardiovascular disease are also limited since most primary prevention trials have included mostly younger patients. Available …

Enhancing Physical Therapy Practice Through Interprofessional Collaboration: Addressing Elderly Self-Neglect Via Pt And Behavioral Health Integration, Alexia Stamas, Feroze Sio, Jodi Thomasian, Kate Jansen, Margaret R. Klausing

Journal of Interprofessional Practice and Collaboration

Purpose: This article examines the role of interprofessional collaboration between Physical Therapy (PT) and Behavioral Health (BH) services in identifying and supporting elderly individuals at risk of self-neglect. Through a case study, we explore the benefits of integrating interprofessional collaboration and APS reporting processes into PT practice.

Problem: Self-neglect among older adults is a critical public health issue often overlooked in healthcare settings. PTs, as mandated reporters, frequently encounter patients exhibiting signs of self-neglect but may lack training in psychosocial and cognitive assessment skills necessary for effective intervention.

Significance: Interprofessional collaboration enables PTs to address both physical …

A Mixed-Methods Usability Pilot Of A Value-Goal Elicitation Tool In The Inpatient Setting For Older Adults Anticipating Post-Acute Care, Kirstin M Piazza, Caroline Pascal, Syama R Patel, Caroline Sefcik, Marilyn M Schapira, Caroline Madrigal, Katherine C Ritchey, Longyi Yip, Aanand D Naik, Robert E Burke

Faculty, Staff and Student Publications

Age-Friendly Health Systems (AFHS) emphasize aligning care with "What Matters" most to older adults. Hospitalization represents a critical period where value-based goals could shape key decisions about post-acute care transitions. However, few tools designed for eliciting such goals have been adapted for use in the inpatient setting, where the acute nature of care poses unique challenges. This mixed-methods study evaluates the usability of the Health Priorities Primer Tool (HPPT) in older hospitalized adults who anticipate needing post-acute care, aiming to identify necessary adaptations for the inpatient setting. We conducted interviews, observations, and surveys with older hospitalized patients to understand their …

Implementing A Gerontological Nursing Competencies Programme In Aged Care: Participant Experiences, Victoria Traynor, Nicole Britten, Diane Gibson, Stephanie Munk, Lynn Chenoweth, Jolan Stokes, Tracey Moroney, Karen Strickland, Toni Donaghy, Kasia Bail

Research outputs 2022 to 2026

Aims: To explore the experience of registered nurses and their mentors in the implementation of the Gerontological Nursing Competencies in long-term aged care and the perceived effectiveness and suitability of the programme to support nurse development. Background: The global population is ageing and needs a reliable aged-care nursing workforce. Introduction: Opportunities for education and mentorship for newly qualified and experienced aged-care nurses warrant investigation. Methods: Qualitative evaluation using semi-structured focus groups was conducted following the implementation of the programme into five not-for-profit long-term aged-care organisations and analysed by a reflexive qualitative thematic approach and reported according to COREQ criteria. Results: …

Focus On Frailty: Co-Designing Digital Frailty Education With Healthcare Students, Kristiana Ludlow, Sarah Martin, Benignus Logan, Ruth E. Hubbard, Nicola Warren, Olivia Gallagher, Bonnie K. Kwok, Rosemary Saunders

Research outputs 2022 to 2026

Introduction: Frailty is prevalent in hospitals and is associated with adverse events and poor health outcomes. In Australia, there is a need for co-designed, multidisciplinary, and contextually relevant frailty education to improve healthcare students’ understanding and knowledge of frailty within the hospital setting. Objective: This study aimed to i) explore healthcare students’ understanding of frailty and their experiences with patients who are frail, and ii) seek healthcare students’ design ideas for the content of a new digital frailty education course.

Methods: Participants were university students enrolled in a health-related degree. Online focus groups and interviews were conducted between August and …

Food Allergies And Quality Of Life In Older Adults: Development Of A Food Allergy Questionnaire, Avalon F. Mustafa

UNF Graduate Theses and Dissertations

The United States is experiencing a rapid increase in the number of older adults, yet there is a lack of research on food allergies in this demographic. While there are survey instruments available to study food allergies and quality of life, none of these are tailored to the unique needs of elderly individuals. This study aims to create and validate an on-line survey instrument specifically designed for older adults, focusing on their quality of life in the context of food allergies. The survey will be used to establish a food allergy severity score and a quality-of-life score, enabling comparison between …

Proactive Use Of Perturbation Training On Balance And Posture Control In Geriatric Rehabilitation- An Experimental Study, Reema Joshi, Kinjal Shah

Chulalongkorn Medical Journal

Background:

Ageing is a complex process involving a range of variables that interact to cause deterioration of various physiological functions.

Objectives:

Study attempts to find effect of Perturbation training on postural control upon Centre of Gravity (COG) sway velocity in older individuals using modified-Clinical Test of Sensory Integration on Balance (mCTSIB) component on NeuroCom Balance master® and Timed up and go(TUG) test.

Methods:

An experimental study, employing a pre-post intervention model, involved 30 individuals aged 65-85 years with mild to moderate fall risk was conducted at Tertiary Hospital, Pune from August 2022 to January 2023. Perturbation Training was given …

After-Hours, Severity, And Distance Are Associated With Non-Vha Emergency Department Use For Older Veterans: Insights From A Regional Health Information Exchange, Elina Kurkurina, Kimberly M. Judon, Ula Hwang, Kenneth S. Boockvar, Juan Wisnivesky, Matthew R. Augustine

Journal of Geriatric Emergency Medicine

Background: Older adults treated in emergency departments (EDs) are at higher risk for adverse outcomes. Using multiple facilities can worsen this issue through service duplication and poor care transitions. Veterans with dual insurance coverage can access both Veterans Health Administration (VHA) and non-VHA EDs. This study aimed to identify factors associated with non-VHA ED use among veterans.

Methods: We conducted a retrospective observational study of patients aged ≥ 65 who had primary care at the James J Peters VA Medical Center and at least one VHA or non-VHA ED visit between October 2017 and February 2020. Data were collected from …

Integrating Geriatric House Call Practice Into Paramedic Education: A Novel Educational Approach On Attitudes And Acceptance, Phillip D. Magidson, Mariah L. Robertson, Robby May, Mattan Schuchman, Eric Garfinkel, Matthew J. Levy

Journal of Geriatric Emergency Medicine

Objective: This study aimed to assess the feasibility and acceptance of integrating geriatric house call practice clinical exposure into paramedic education and to explore the impact on attitudes towards older adults among paramedic students.

Methods: Paramedic students from a fire department training program participated in a geriatric house call practice in collaboration with an academic health system. Pre- and post-program surveys were conducted to evaluate changes in attitudes towards older adults using the Ageing Semantic Differential (ASD) scale. Patient feedback on paramedic involvement was collected through post-visit surveys.

Results: Six paramedic students completed 25 house call visits over eight weeks. …

Thoracic Trauma In The Geriatric Population And Possible Preventive Measures: A Retrospective Analysis Of 261 Cases, Mehmet Çeti̇n, Necati̇ Solak, Büşra Özdemi̇r Çi̇fli̇k, İlteri̇ş Türk, Sebahatti̇n Sefa Ermancik, Koray Aydoğdu

Turkish Journal of Medical Sciences

Background/aim: The rise in the proportion of the elderly population within society is concurrently escalating their vulnerability to traumas, notably falls associated with age-related comorbidities.Materials and Methods: The retrospective analysis involved the examination of data pertaining to patients aged 65 and above who were admitted to our clinic for inpatient treatment following thoracic trauma. Various parameters were statistically compared between the groups with indoor and outdoor traumas.Results: 59.4% of the 261 patients included in the study were male, and the average age in the entire sample was calculated as 75.52±7.79. 136 patients (52%) had indoor trauma, while 125 (48%) had …

Prevalence And General Characteristics Of Dementia: A Nationwide Population-Based Study Of Electronic Health Records In Türkiye, Merve Güner, Meltem Koca, Serdar Ceylan, Arzu Okyar Baş, Ayşe Di̇kmeer, Mert Eşme, Osman Çeli̇k, Mustafa Okan Ayvali, Murat Çağlayan, Mustafa Mahi̇r Ülgü, Gülni̇hal Gökçe Ünal, Cafer Balci, Nai̇m Ata, Mustafa Cankurtaran, Burcu Balam Doğu, Şuayi̇p Bi̇ri̇nci̇

Turkish Journal of Medical Sciences

Background/aim: Türkiye is a country with an increasing life expectancy and an older adult population in parallel with the rest of the world. Several national small-scale studies were performed regarding the prevalence and characteristics of dementia in Türkiye, and the results of these studies differ from each other. We aimed to determine the prevalence of dementia in Türkiye to present the demographic characteristics, the frequency of use of health services, and the management of dementia.Materials and methods: Patients aged 65 years and over with a diagnosis of any type of dementia between January 1, 2019, and December 31, 2020, were …

The Frailty Trajectory's Additional Edge Over The Frailty Index: Retrospective Cohort Study Of Veterans With Heart Failure, Javad Razjouyan, Ariela R Orkaby, Molly J Horstman, Parag Goyal, Orna Intrator, Aanand D Naik

Faculty, Staff and Students Publications

No abstract provided.

Integrating Geriatric Content Into Traditional Undergraduate Baccalaureate Nursing Curriculum, Gina B. Diaz

Dissertations

Geriatric content in baccalaureate nursing curriculum is essential. Nursing students need the knowledge, skills, and attitude in providing quality care to older adults. The goal of this project was to integrate geriatric content into the traditional undergraduate (TUG) baccalaureate nursing curriculum. This was completed by providing a 16-week didactic learning experience in the classroom and clinical experiences in the community setting and long-term care facility. Fourteen TUG baccalaureate nursing students from a private college participated in the project. Results indicate that the integration of geriatric content into baccalaureate nursing curriculum increases students' knowledge and skills and enhanced attitude towards older …

Academic Detailing As A Health Information Technology Implementation Method: Supporting The Design And Implementation Of An Emergency Department-Based Clinical Decision Support Tool To Prevent Future Falls, Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson

Faculty, Staff and Student Publications

BACKGROUND: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation.

OBJECTIVE: This study aimed to assess academic detailing as a method for simultaneously ensuring the correct …

Medical-Dental Staff Topics, 1991 March, Advocate Health - Midwest

Historical Documents - Combined

St. Luke's Medical Center, Milwaukee, WI: An issue of "Medical-Dental Staff Topics". This was an internal publication for ASLMC staff members reporting on news, research, events, and staffing updates. Includes a staff calendar and information on continuing education opportunities.

Outcomes From An Interprofessional, Dementia-Focused, Telementoring Program: A Brief Report, Julianna Fernandez, Kathryn S Agarwal, Amber B Amspoker, Kyler M Godwin, Erial Green, Sabrina Pickens, Jasmin Lindo, Ali Abbas Asghar-Ali

Faculty, Staff and Students Publications

Despite a burgeoning older-adult population, the number of healthcare professionals with geriatric expertise continues to lag behind. In 2014, the American Geriatrics Society’s position statement encouraged interprofessional training for healthcare professionals. Telementoring remotely connects clinicians with specialists for education and group mentoring. This dementia-focused, 11-month, 1-hour each, telementoring program was modeled on the Alzheimer’s Association ECHO. Our interprofessional expert panel consisted of a geriatrician, a geriatric psychiatrist, an adult nurse practitioner (with geriatrics expertise), 2 geriatric pharmacists, a licensed social worker (coordinating a dementia day program), and a project coordinator. Learners were residents in family medicine and general psychiatry, physician …

Describing And Predicting Trajectories Of Healthcare Utilization Among Older Adults Presenting To An Emergency Department Using The Interrai Emergency Department Screener, Matthew B. Downer, Kristina Kokorelias, Andrew P. Costa, Don Melady, Samir K. Sinha

Journal of Geriatric Emergency Medicine

Introduction: Although older adults visit emergency departments (EDs) more than any other age group, the trajectories of healthcare utilization older adults experience post-ED are not well described. Further, whether rapid ED assessment tools can predict trajectories and discharge destinations remains unclear.

Methods: Older adults (≥65 years) who presented to an ED at a large Canadian urban academic hospital were recruited (January 2018-April 2019). The interRAI ED Screener (EDS) was completed on presentation. Patients were categorized by EDS risk score (1/2=low, 3/4=moderate, 5/6=high) and had their discharge destinations tracked. Patients admitted to hospital were tracked until their final discharge destination. …

The Park Ridge Center Bulletin, 1998, N6, October/November, Advocate Aurora Health

Historical Documents - Combined

The Park Ridge Center, Park Ridge, IL: Issue of "The Park Ridge Center Bulletin", a bi-monthly publication from The Park Ridge Center - An Institute for the Study of Health, Faith, and Ethics, associated with Lutheran General Hospital. This issue has feature articles on aging, elder care, and nursing homes.

Web-Based Presence For Social Connectedness In Long-Term Care: Protocol For A Qualitative Multimethods Study, Anna Garnett, Halyna Yurkiv, Richard Booth, Denise Connelly, Lorie Donelle Phd, Rn, Fcan

Publications

BACKGROUND: The COVID-19 pandemic and resultant restrictions on social gatherings significantly impacted many peoples' sense of social connectedness, defined as an individual's subjective sense of having close relationships with others. Older adults living in long-term care homes (LTCHs) experienced extreme restrictions on social gatherings, which negatively impacted their physical and mental health as well as the health and well-being of their family caregivers. Their experiences highlighted the need to reconceptualize social connectedness. In particular, the pandemic highlighted the need to explore novel ways to attain fulfilling relationships with others in the absence of physical gatherings such as through the use …

Providing Personalized Interest-Based Activities To Prevent Delirium: A Multicomponent Quality Improvement Initiative In An Acute Care Setting, Qianwen Liu, Elena V. Donoso Brown, Shauni Johnson, Autumn Moss-Corcoran

The Open Journal of Occupational Therapy

Background: Hospital-induced delirium is a prevalent condition across inpatient settings, frequently impacting older adults’ recovery. A 10-week multi-component quality improvement (QI) project was designed for an existing delirium prevention program in four acute care units, aiming to support patient and caregiver engagement in delirium prevention activities.

Method: The participants were hospitalized adults who were 70 years of age and older and met specific inclusion criteria. The project provided personalized interest-based activities, orientation stimulation, and caregiver education. An abbreviated version of the Modified Interest Checklist was used to identify the participants’ activity choices. Activity daily logs, satisfaction survey, and …

Rounding With A Purpose: Reducing Falls In Geriatrics Residing In A Community Living Center, Ashley Wesson

Student Scholarly Projects

Practice Problem: Falls among geriatrics continue to be a significant concern for healthcare organizations and one of the costliest healthcare problems attributed to increased morbidity and mortality rates. Falls rates in residential dwellings such as nursing homes and community living centers (CLCs) continue to rise despite fall prevention efforts.

PICOT: The PICOT question that guided this project was In geriatrics, age 65 or older, who reside in the Community Living Center (P), how does one-hour purposeful rounding (I), compared to rounding without structured set time intervals (C), affect fall reduction rates (O), within eight weeks (T)?

Evidence: In fifteen high-quality …