Geriatric education: extending your reach!

These years, with the aging of the population and the silver tsunami reaching the health care system, geriatrics does not belong only the geriatrician. It is everybody’s business.

This is an obvious statement and most people will agree with it. But the problem is, how do we extend our reach to the community, primary care, medicine, specialty and inter-professional area?

Yesterday, at the Canadian Geriatric Association conference, Dr Don Melady, Dr Tammy Bach (care of the elderly), Dr Sid Feldman (care of the elderly), Dr Grace Leung (geriatrician) and myself led a workshop on education in geriatrics that addressed exactly this question. Here are the few key points we wanted to make.

Dr Sid Feldman asked the audience on what kind of personal positive experience they had in geriatric. Let’s hear their answers:

Mentorship and role modeling. (No pressure, but everyone around you should learn about geriatric and by providing good geriatric care yourself is the first step)
1-to-1 teaching
Flash cards (the example was, a doctor created the top 10 of things to know about geriatric when learners are doing a consult. Apparently, they loved it)
POGOe (an e-learning tool about geriatric care)
In summary, think about how you were inspired yourself and try to reproduce the same things on your learners.

Dr Grace Leung created a wordpress portal where she included all learning materials and tools for her learners. This way it is all in the same place and easily accessible.

Dr Tammy Bach emphasized the constructivism approach. You build on what learners know about a pathology and you teach the geriatric component of it. She likes paper and white board.

Dr Melady likes technology. He created http://www.geri-em.com, an e-learning tool for point of care geriatric emergency medicine addressed to physicians, residents, medical students and nurses. We also built another website on how to construct a Senior-Friendly-ED with a community sharing sense http://www.geriatric-ed.com

For myself, I added the principle of “What’s in it for me”. If you want to convince a subspecialty that is not usually interested in geriatric (for example emergency medicine, orthopedics, surgery, etc.) you have to speak their language and find some common ground. You can not say, “but it is good for patient”. Although we are all caregivers and put our patient’s first, we have so many other concerns to deal with and different version of patient care that this simple argument is not enough.

First step. Describe the typical personality or behavior of the group you are trying to convince. For example, emergency physicians are impatient, hard workers, want fast response and bloody things moving. Not very compatible with geriatrics so far.
Second step. Find some common ground. Emergency physicians usually like working in team, they like evidence based medicine and they like a good clinical mystery, but for 10 minutes max. They care about the ED management and patient outflow.
Third step. Prove that what you are trying to sell will make their life easier. Better geriatric care will improve their clinical efficiency, will reduce admission, will increase the bed turn over and reduce the frequent flyers. Plus, most of the care are done in an inter-professional way, so alleviate tasks for health care providers.
There you go, you convinced them! Implement your educational material according to their preferences:

Podcast (e.g.: GEMcast)
Blogs (e.g.: mine, life in the fast line)
e-learning modules (e.g.: POGOe, geri-em.com)
Mentorship
Formal presentation
White board teaching
Seminar
Videos
A patient’s testimony about his experience during his delirium for example
Arts!
An interesting project was presented about introducing geriatric to early learners. First, expose people to geriatric early in elementary and high school by spending time in nursing homes, projects with grandma, talking about elder abuse. Then, introduce more geriatric content in medical school and finally integration of competencies in clerkship and in every residency programs (except peds!). Interesting ideas !

In summary, there are a large numbers of learning opportunities and strategies to extend your reach! Your turn! Everybody loves a good challenge!!

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