Description of Geriatrics Training Grants Approved in October 2008

Medical University of South Carolina, Charleston, SC – $2,000,000

 

The Medical University of South Carolina developed a quality-focused program called Aging Q³.  Aging Q³ is an educational and practice-based program to improve geriatrics competency for resident physicians.   The three Qs represent: quality education, quality care and quality of life.  The quality education component used the University of South Carolina’s faculty-development program to create a cadre of influential faculty with geriatrics knowledge and teaching experience who in turn teach residents and students.  The quality care component focused on translating knowledge into practice changes to improve the process of care delivery and educate residents and faculty.  And the quality of life component seeks to demonstrate improved care outcomes such as maximized cognitive and functional status and reduction in age-associated syndromes as well as compassionate end of life care.  Indicators of quality of care are taken from the Assessing Care of Vulnerable Elders (ACOVE) project because vulnerable elders are at exceptionally high risk for functional decline or death within two years. 

 

University of Alabama, Birmingham, AL – $2,000,000

 

The University of Alabama at Birmingham (UAB) is known for its research strength in geriatrics.  To build on that strength, UAB built a program to strengthen the geriatrics educational training of over 875 medical students, 350 residents, and numerous faculty and community physicians, using the Care of the Complex Older Adult (COCOA) curriculum.  The COCOA program developed and implemented educational curriculum to address five key domains necessary for delivering high quality care to complex older adults: advanced illness and multi-morbidity, transitions in care, family systems and self/caregiver management, cultural aspects of aging, and health literacy and disparities.  UAB used a variety of educational techniques including standardized virtual patients (actors with scripted conditions presenting as patients), web-based curricula and distance learning.

 

University of California, Irvine, Irvine, CA – $1,999,994

 

Over the past decade, the Program in Geriatrics at the University of California at Irvine (UCI) has built relationships and worked cooperatively with a multitude of UCI departments to build a foundation for the inclusion of geriatrics content to new areas.  Therefore they chose to focus their project on the Return to the Patient-Doctor Relationship (PDR), with the enthusiastic inclusion of the departments of anesthesiology, emergency medicine, psychiatry, family medicine, internal medicine and oncology.  The departments committed to intensive review, development and implementation of geriatrics into their undergraduate and graduate education.  The theme of PDR is integrated throughout medical student and resident education using the geriatrics competencies developed nationally by the American Association of Medical Colleges (AAMC).  Compassionate, patient-centered care is taught through a triad of sub-themes: health literacy, communication skills and medical decision making.  Experts from the University of Arizona collaborated on the development and implementation of PDR. Also, a major collaboration with Vanderbilt University utilized their innovative informatics technology as the basis for a database to track the impact of the new curriculum on learners.  

 

University of Massachusetts, Worcester, MA – $ 1,983,066

 

In recent years, the University of Massachusetts has focused mounting attention on geriatric medicine, including the creation of a new and increasingly robust Division of Geriatric Medicine.  Now, with the fall 2008 launching of a comprehensive curriculum redesign and the support of institutional leadership, the University of Massachusetts created an enhanced integrated educational program in geriatrics that spans undergraduate, resident and faculty training.  For instance, they are training all students, in every course, during every year, for a total of 80 mandatory geriatrics contact hours in the undergraduate curriculum.  The overall plan included establishing a course resource center called the Geriatrics Education Resource Center, the enhancement of faculty and chief resident clinical educator geriatrics training, and the recruitment of new, fellowship-trained geriatrician educators.  

 

University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine, Stratford, NJ – $1,998,421

 

The University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine has a long-standing reputation as a leader in undergraduate and graduate geriatric education in the osteopathic profession. UMDNJ-SOM built on existing strengths with the implementation of three major aims: to expand and enrich medical students’ geriatrics education over all four years of the curriculum; to enhance resident training in geriatrics in primary care, emergency medicine, and psychiatry; and to improve faculty skills in e-technology and competency-based assessment to enrich instruction and assessment in the geriatric curriculum. The program employs several curricular innovations new to the medical school including e-learning and Objective Structure Clinical Exams (OSCEs). 

 

 

University of North Texas Health Science Center, Fort Worth, TX – $1,998,504

 

There is a national shortage of primary care physicians, a shortage that is heightened in rural areas.  At the University of North Texas Health Science Center, however, and its medical school, the Texas College of Osteopathic Medicine, the curriculum is grounded in the philosophy and approach to “whole-person” patient care with a focus on primary care.  Nearly 70% of the graduates of the Texas College of Osteopathic Medicine enter primary care and 30% practice in rural communities in Texas. Therefore, the medical school developed a program focused heavily on establishing a geriatrics faculty development program for rural osteopathic faculty and developing geriatrics continuing medical education programs for practicing physicians.  In addition, they integrated geriatrics curriculum throughout all four years of the school’s undergraduate medical education and during residency training through the Texas Osteopathic Postdoctoral Training Institution, a statewide consortium that consists of 26 residency programs including family practice, internal medicine and medical subspecialties such as cardiology, general surgery, radiology, OB/GYN, and psychiatry, among others.

 

University of Pennsylvania, Philadelphia, PA – $1,939,517

 

The Penn CARES (Community and Academic Resources for Education about Seniors) Program of the University of Pennsylvania strengthens the capacity of physicians trained throughout the University of Pennsylvania Health System to provide high quality care of older adults.  Penn CARES targets three learner groups: medical students; residents in family medicine, internal medicine, orthopedic surgery, physical medicine and rehabilitation, psychiatry and urology; and faculty preceptors of medical students and residents.  An innovative community-based service learning model for medical students and residents in family medicine and internal medicine was anchored by a new transitions of care program.  The transitions program teaches primary care residents to improve the quality of care of older adults and to prevent unnecessary re-admissions of older patients who are discharged from the hospital, by collaborating with nurse practitioners in direct patient care and advocacy.  Additional community based learning links the learning of aging topics by the trainees with delivery of geriatrics health promotion and prevention services to community organizations. Penn CARES established a comprehensive longitudinal curriculum for medical students, augments teaching on an Acute Care for Elders (ACE) unit, and substantially increases the expertise in geriatrics among key faculty teachers and chief residents. 

 

University of Texas, Houston, Houston, TX – $2,000,000

 

The University of Texas Medical School at Houston (UTH) is located in the Texas Medical Center, the largest medical center in the world.  In 2007, the institution initiated a new division of Geriatric and Palliative Medicine. With strong support from university leadership, UTH created the Training Excellence in Aging Studies (TEXAS) program to educate approximately 12,000 medical students, residents, non-geriatrics faculty, practicing physicians and geriatricians over four years. TEXAS curriculum is based on geriatric competencies that are required for student, resident, faculty and practicing physician learners to achieve improvements in knowledge and care delivery at both the individual and organizational levels. The program faculty implemented several novel methods of training, such as the integration of geriatrics education through a 3-D virtual world of simulated interactive learning experiences, spaced interactive educational sound-bytes, and case-studies of complex geriatric patients. They train non-geriatrician faculty through the University of Chicago Curriculum for Hospitalized Aging Medical Patient program and evaluate and monitor content and learner impact using the Vanderbilt KnowledgeMap. 

 

University of Texas Southwestern Medical Center, Dallas, TX – $1,994,480

 

The University of Texas Southwestern Medical School and its affiliated hospitals implemented the Southwestern Aging and Geriatrics Education (SAGE) program to increase geriatrics in undergraduate and graduate medical education through an innovative curriculum focused on patient safety and patient-centered care for the vulnerable elder.  The program impacts every medical student, every internal medicine, family medicine and psychiatry resident and many surgical specialty and subspecialty trainees throughout the medical school.  Some of the means they have chosen to increase geriatrics education include: the integration of geriatrics content into all four years of the medical student curriculum; the implementation of an online patient safety curriculum highlighting care of the vulnerable elderly patient for use by surgical subspecialty and internal medicine specialty residents; a new, month-long rotation in geriatrics for all psychiatry interns; and mentoring and collaboration with two prior Reynolds grantees from the Universities of Arizona and Chicago.

 

Wake Forest University, Winston-Salem, NC – $1,994,741

 

Wake Forest University has a 20-year history of excellence in geriatric medicine.  The School of Medicine built on this experience to strengthen and further integrate principles of geriatric care into key specialties that provide clinical education to all Wake Forest medical students, internal medicine and family medicine residents, specialty residents and fellows, and to community physicians providing primary care for residents of Continuing Care Retirement Communities in their region.  Through the implementation of three major aims the following innovative programs have been developed:  a curriculum for specialty physicians to integrate geriatrics principles into their teaching programs; a program for certification of geriatrics competencies for all medical students; and new training opportunities for medical students, residents, and fellows including a Senior Mentor Independent Living Education program which combines student education with the local Meals-on-Wheels program and a geriatrics telemedicine consultation educational program.