Medical DevicesInnovative Educational Program Designed To Improve Care For Growing Number Of Older Adults Expands To Three More Schools
A highly successful and innovative training program that prepares chief residents at medical schools to diagnose and treat health problems common to older adults -- and to prepare the medical students and residents who they help train to do the same -- will include three additional medical schools, the Association of Directors of Geriatric Academic Programs (ADGAP) has announced.
ADGAP has tapped Baystate Medical Center, which is the western campus of Tufts University School of Medicine in Massachusetts; Cooper University Hospital, the southern clinical campus for New Jersey"s Robert Wood Johnson Medical School; and North Carolina"s Wake Forest University School of Medicine to join the program -- the Chief Resident Immersion Training in the Care of Older Adults (CRIT) national demonstration project.
Chief residents play an important role in caring for the millions of patients treated in the nation"s teaching hospitals, and in training medical students and residents. Teaching the next generation of healthcare professionals how to meet the unique healthcare needs of older patients is critical as the US population ages. As the Institute of Medicine reported in its groundbreaking 2008 report, Retooling for An Aging America: Building the Health Care Workforce, the nation"s elder healthcare workforce is too small and ill-prepared to care for the growing number of older adults. The number of Americans 65 and older is expected to double in the next two decades.
Boston University Medical Center (BUMC) launched the CRIT program in 2005 with funding from the Donald W. Reynolds Foundation. In 2007, the John A. Hartford Foundation awarded a $2.095 million grant to BUMC and ADGAP to expand the program nationwide. The expansion added five schools -- at the universities of Colorado, Kansas, Nebraska, Rochester, and South Carolina. Four more, at Yale University, Marshall University, the Medical College of Wisconsin, and the University of Cincinnati, were selected to join CRIT last year.
"By further expanding this program to another three schools, we can help prepare the next generation of primary care doctors, surgeons, and medical specialists to care for the rapidly growing ranks of older adults," says Sharon A. Levine, MD, a geriatrician, the Project Director for the CRIT demonstration project, an Associate Professor of Medicine and Director of the Geriatrics and Geriatric-Oncology Fellowship Programs, and Associate Dean for Academic Affairs at BUMC. "With the expansion of CRIT, we expect continued and significant gains in geriatrics knowledge and skills among our trainees."
CRIT has shown impressive results. The 16 BUMC chief residents who participated in 2006, for example, saw their scores on a test of geriatrics knowledge jump 41% after they completed the two-and-a-half day intensive educational retreat that"s at the heart of the program. They also showed significantly greater understanding of multifaceted geriatric health problems, expertise in assessing older patients, and related skills.
CRIT familiarizes chief residents with health problems common among older adults, the assessment of older patients, preoperative and postoperative evaluation, and management and discharge planning. It is also designed to encourage positive attitudes toward caring for the aging and foster leadership and teaching skills, including skills required for small group teaching, dealing with "reluctant learners," giving feedback and managing conflict. In addition, the program aims to improve collaboration among the medical specialties and subspecialties involved in elder care.
"Through the CRIT program, we are training chief residents both to better meet the unique needs of older patients and to pass this training and knowledge on to the many students and residents they, in turn, train -- there"s an important multiplier effect," said Gavin W. Hougham, PhD, Senior Program Officer at the John A. Hartford Foundation. "The CRIT program has been shown to improve the quality of care that hospitalized older patients receive, and with the numbers of older Americans growing, we are very pleased to support its expansion."
Each institution participating in CRIT receives a 30-month grant of $114,000 to conduct two intensive CRIT training retreats and follow-up training for their chief residents. Teams including both a chief resident and a faculty member responsible for residency training in surgical and medical specialties attend the interactive 2 1/2 -day retreats. Each retreat includes roughly 15 chief residents and their mentors. Participating chief residents also complete an educational, clinical or administrative project designed to improve the care of older patients or enhance the training of residents so they can better care for older adults.
"They might, for example, develop and deliver a lecture on preventing post operative delirium in older patients undergoing otolaryngological surgery," says Dr. Levine. "The project is an important part of the program."
All told, the CRIT demonstration project will train a total of roughly 390 chief residents. These chief residents will, in turn, teach the geriatrics evaluation and management skills they learn to approximately 18,000 residents and medical students.
About ADGAP
Established in 1990, the Association of Directors of Geriatric Academic Programs (ADGAP) is committed to advancing academic geriatrics programs and supporting academic geriatrics program directors to enhance patient care, research, and teaching programs in geriatric medicine at accredited medical schools in the United States. ADGAP has built and fostered new methods of facilitating the development of leadership skills among academic geriatricians and has provided an ongoing forum for Program Directors and leaders in academic geriatrics to discuss the wide variety of issues that they encounter.
About The John A. Hartford Foundation
Founded in 1929, The John A. Hartford Foundation is a committed champion of health care, training, research and service system innovations that will ensure the well-being and vitality of older adults. Its overall goal is to increase the nation"s capacity to provide effective, affordable care to its rapidly increasing older population. Today, the Foundation is America"s leading philanthropy with a sustained interest in aging and health. Through its grantmaking, the John A. Hartford Foundation seeks specifically to:
- Enhance and expand the training of doctors, nurses, social workers and other health professionals who care for older adults, and
- Promote innovations in the integration and delivery of services for all older Americans.
Recognizing that its commitment alone is not sufficient to ensure the improvements it seeks, the John A. Hartford Foundation invites and encourages innovative partnerships with other foundations and funders, as well as public, non-profit and private groups dedicated to improving the health of older adults.
American Geriatrics Society