The effect of a 12-month longitudinal long-term care rotation on knowledge and attitudes of internal medicine residents about geriatrics.
*Attitude of Health Personnel; Aged; Attitudes; Clinical Competence/*standards; Cost-Benefit Analysis; Curriculum; Education; Educational Measurement; Efficiency; Geriatric Assessment; Geriatrics/*education; Graduate/organization & administration; Guidelines as Topic; Health Knowledge; Health Services Needs and Demand; Humans; Internal Medicine/*education; Internship and Residency/*organization & administration; Long-Term Care/*organization & administration; Longitudinal Studies; Medical; Nursing Homes; Ohio; Organizational; Practice; Program Evaluation; Self Efficacy; Surveys and Questionnaires
OBJECTIVE: To determine if participation in a 12-month longitudinal long-term care (LTC) rotation resulted in improved knowledge and attitudes about geriatrics. DESIGN: Longitudinal study with paired measurements. SETTING: A community LTC facility and a university-affiliated, community-based internal medicine residency program. PARTICIPANTS: Sixty-seven internal medicine residents who participated in the rotation from 1997 through 2004. INTERVENTION: The internal medicine residents attended nursing home (NH) rounds one half day per month for 1 year, during which time they participated in a case-based interactive lecture on a core geriatric topic and rounded on their assigned patients. MEASUREMENTS: Knowledge was assessed using a 70-item test. Attitudes were evaluated with a 28-item, 5-point Likert scale (1 = least positive, 5 = most positive). RESULTS: The percent correct responses on geriatric knowledge pretest was 47% (95% CI = 45.2% to 48.8%) and on the posttest it was 57.5% (95% CI = 55.3% to 59.6%) (t = 8.180, df = 67, P \textless .001). The pretest total attitude score was 3.6 (95% CI = 3.6 to 3.7), with a posttest score of 3.7 (95% CI = 3.7 to 3.8) (P \textless .001). The difference in this total was accounted for mainly by the significant changes in the attitude subscales in educational preparation (pretest 3.6 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P \textless .001]), general attitudes (pretest 4.0 [95% CI = 3.9 to 4.1]; posttest 4.2 [95% CI = 4.0 to 4.3] [P = .006]), and therapeutic potential (pretest 3.7 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P = .048]). CONCLUSION: A longitudinal LTC rotation is an efficient and effective way to systematically provide internal medicine residents their core knowledge and experience in geriatrics.
Baum Elizabeth E; Nelson Karl M
Journal of the American Medical Directors Association
2007
2007-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jamda.2006.05.009" target="_blank" rel="noreferrer noopener">10.1016/j.jamda.2006.05.009</a>
Directing an emergency medicine residency: the problems and their potential solutions.
Adult; Emergency Medicine/*education; Female; Humans; Internship and Residency/*organization & administration; Job Satisfaction; Male; Middle Aged; Physician Executives/*statistics & numerical data; United States
OBJECTIVE: To characterize the problems facing emergency medicine residency directors (EMRDs), to describe potential solutions, and to associate perceptions with anticipated duration in the position of EMRD. METHODS: A confidential questionnaire was mailed to the EMRDs at all Accreditation Council for Graduate Medical Education-approved programs. The survey included a problem and solution list constructed by a panel of EMRDs. The respondents were asked to rate problems using a Likert-like scale and were asked to indicate which of the listed solutions they had used and had found useful, or thought would be useful. Associations of these features and demographic variables with the intention to leave the position of EMRD within 5 years were sought. RESULTS: Eighty-seven of 93 EMRDs (93.5%) completed the survey. Their mean age was 40 years; 50% had been EMRDs for \textless 3 years. Most of the EMRDs (62%) had an associate EMRD, and 77% had at least one secretary. The EMRDs worked a median of 220 hours per month. Major problems included: insufficient time for the job (57%), career interfering with family needs (44%), and lack of adequate faculty help (38%). The most frequently cited and useful solutions included: attending education courses, self-reading on education and management techniques, and discussing problems with and seeking advice from others. Most (68%) of the EMRDs anticipated continuing as program director for \textless or = 5 years. Neither age, gender, previous amount of time in the position, number of hours worked, nor nature of the problems faced on the job was a significant predictor of which of the EMRDs anticipated leaving. CONCLUSIONS: Half the responding EMRDs were \textless 40 years of age, half had been EMRDs for \textless or = 3 years, and 68% anticipated continuing in their position for \textless or = 5 years. Major frustrations included lack of knowledge and time. Family and career conflicts were frequent. These problems are similar to those of program directors in other specialties. Some recommendations are made to assist EMRDs.
Weigand J; Kuhn G; Gerson L W
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
1995
1995-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/j.1553-2712.1995.tb03109.x" target="_blank" rel="noreferrer noopener">10.1111/j.1553-2712.1995.tb03109.x</a>