Preparing the front line for the increase in the aging population: geriatric curriculum development for an emergency medicine residency program.

BACKGROUND: Emergency Departments (EDs) are common entry points to the health care system for elders. Emergency Medicine residents need specialized education about geriatric patients to maximize health outcomes.

OBJECTIVES: To determine whether geriatric education provided to residents in Emergency Medicine results in improved knowledge of and attitudes toward geriatric patients.

METHOD: A pre- and post-intervention survey was conducted in a 3-year university-based residency program in Emergency Medicine. Participants were Emergency Medicine residents (PGY 1-3). The curriculum "Care of the Aging Patient in Emergency Medicine" was introduced. Topic selection was based upon geriatric curriculum recommendations and resident surveys. Before starting the curriculum and at its conclusion, residents completed Geriatric Clinical Decision-making Assessments and the Geriatric Attitude Scale Survey. Pre- and post-assessments were compared. Residents also completed written assessments for each educational activity in the curriculum.

RESULTS: After participating in the program, residents demonstrated improved knowledge of the geriatric patient, and their attitudes toward caring for geriatric patients had shifted from negative to neutral or positive. One statistically relevant change centered on the item, "Taking a medical history from an elderly patient is an ordeal" (p = 0.033) Pre-intervention, 8.3% (n = 3) of residents strongly agreed with the statement. After the intervention, strong disagreement with the statement increased from 2.8% (n = 1) to 11% (n = 4) on the educational surveys. In addition, an increase in the percentage of neutral responses was observed.

CONCLUSIONS: Using familiar educational formats with heavy emphasis on "hands-on" activities to present the geriatric care curriculum had a positive impact on resident knowledge and confidence in dealing with geriatric patients.