An age‐friendly residency: Geriatrician and internist perspectives on geriatric education in an internal medicine residency

Author:

Loewenthal Julia12ORCID,Beltran Christine P.3,Schwartz Andrea Wershof124ORCID,Ramani Subha25

Affiliation:

1. Division of Aging Brigham and Women's Hospital Boston Massachusetts USA

2. Harvard Medical School Boston Massachusetts USA

3. Division of General Internal Medicine and Clinical Innovation, Department of Medicine New York University Grossman School of Medicine New York New York USA

4. New England Geriatrics Research Education and Clinical Center Veterans Boston Healthcare System Boston Massachusetts USA

5. Division of General Internal Medicine Brigham and Women's Hospital Boston Massachusetts USA

Abstract

AbstractBackgroundGeneral internists and subspecialists need skills to deliver age‐friendly care to older adults, yet a minority of Internal Medicine (IM) residency programs provide robust geriatric‐specific clinical instruction. We sought to explore internist and geriatrician perspectives regarding current strengths and weakness of geriatric education, and perceived supports, barriers, and strategies to enhance geriatric education in an IM residency program.MethodsUsing social learning theory as a conceptual framework, we conducted a needs assessment using focus groups and semi‐structured interviews with IM residency leadership and geriatricians at an academic medical center. Interviews were recorded and transcribed; thematic analysis was performed on deidentified transcripts.ResultsWe recruited faculty by e‐mail in 2021; eight geriatricians and seven internists participated (60% female, 13% Hispanic/Latino, and 73% White). Six participated in two virtual focus groups and nine participated in virtual one‐on‐one interviews. All had at least monthly teaching contact with residents and six were associate program directors. We identified five key themes: (1) professional role models, (2) personal attitudes toward aging, (3) the powerful influence of patients, (4) clinical complexity of geriatrics, and (5) branding and prestige of the field. Participants offered multiple suggestions for improvement, especially faculty development for non‐geriatrician faculty.ConclusionsGeriatric education for IM residents is impacted by multiple factors, but uniformly viewed as important. Moving forward, programs could capitalize on opportunities for closer collaboration between residency leadership, internists, and geriatricians to train the next generation of IM residency graduates to deliver age‐friendly care.

Funder

Harvard Medical School

Publisher

Wiley

Subject

Geriatrics and Gerontology

Reference40 articles.

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2. U.S. Department of Health and Human Services.Health Resources and Services Administration Bureau of Health Processions National Center for Health Workforce Analysis. Exhibit 2. 11. Estimated percentage of physician's time spent providing care to patients by age of patient. Changing Demographics: Implications for Physicians Nurses and Other Health Workers. Vol Section 2: Aging of the Population. Accessed May 12 2020.http://bhpr.hrsa.gov/healthworkforce/reports/changedemo/images/2.11.htm

3. Comparison of the Complexity of Patients Seen by Different Medical Subspecialists in a Universal Health Care System

4. Are Internal Medicine Residency Programs Adequately Preparing Physicians to Care for the Baby Boomers? A National Survey from the Association of Directors of Geriatric Academic Programs Status of Geriatrics Workforce Study

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