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INTRODUCTION: Many older adults live in a community-based residential geriatric model of care (MOC; e.g., senior apartments, long-term care nursing facilities). While existing curricula focus on patient transitions to such care, none focus explicitly on MOC features, which are essential for creating effective care plans. We developed the Geriatric Models of Care (Geri MOC) curriculum to guide preclerkship medical students in comparing features of five MOCs. METHODS: On day 1 of the 2-day session, all second-year medical students spent half a day at different sites, interviewing administrators and touring facilities. On day 2, students debriefed and peer taught in small groups with peers who had visited different care models. Students applied their new knowledge to complex patient cases. Students completed retrospective pre/post self-assessments and offered qualitative feedback on the experience. A summative exam essay question assessed student knowledge application. RESULTS: From 2017 to 2019, 267 students gave the site visit experience a mean rating of 4.6 on a 5-point Likert scale (1 = poor, 5 = excellent). Students perceived confidence increased significantly (p < .001) for all four evaluated objectives. On the summative exam question, 89% of students passed. Students commented that the curriculum was a unique and effective learning approach, and 13 sites indicated a strong interest in ongoing annual participation. DISCUSSION: Community MOC visits were instructive and engaging for students and sites. The curricular materials are novel, adaptable for all levels of medical and health professions trainees, and adaptable for a virtual experience.

INTRODUCTION: Faculty development focused on interprofessional education (IPE) is essential to any IPE initiative aiming to produce a collaborative practice-ready workforce. Many faculty have not received IPE in their own training and struggle with interprofessional teaching. METHODS: To train faculty to conduct a peer-teaching observation and provide feedback focused on interprofessional teaching, we created a 3-hour didactic and skills practice workshop. The didactic portion considered ways interprofessional teaching differed from uniprofessional teaching, discussed elements of effective feedback, and reviewed the critical steps of a peer-teaching observation. In the skills practice portion, participants watched videos of different teaching scenarios and role-played as a peer observer providing feedback to the instructor in the videos. Participants completed a pre/post self-assessment and workshop evaluation form. RESULTS: Eighteen faculty from four professions (dentistry, medicine, nursing, and pharmacy) participated in the workshop from 2020 to 2021. On a 5-point scale (1 = poor, 5 = excellent), participants rated the overall workshop quality 4.9 and the likelihood of making a change in their teaching/professional practice 4.8. Workshop participants self-reported ability to provide feedback to a peer on their interprofessional teaching improved after workshop participation (preworkshop M = 2.9, postworkshop M = 3.8, p < .01). DISCUSSION: This IPE-focused faculty development workshop allows participants to practice skills and share their own interprofessional teaching insights and challenges. The workshop is adaptable for different professions and settings and for in-person or online implementation. It also can be integrated into an existing program or utilized as a stand-alone workshop.

IntroductionIntegrative health care and complementary medicine are widely used by the U.S. population, yet health professions learners are typically inadequately educated to counsel patients on the use of these approaches. This interprofessional standardized patient exercise (ISPE) provides learners the opportunity to discuss various health care professionals' roles in caring for a patient interested in integrative health strategies, and to collaborate on a care plan. Utilizing this ISPE format aligns with the principles of integrative health as it requires interprofessional collaboration to address the multifaceted needs of patients.MethodsThe ISPE is approximately three hours in duration, and required of all UCSF, third-year dentistry, physical therapy, and medical students; second-year nurse practitioner students, and fourth-year pharmacy students. Social work, nutrition, and chaplain trainees also participated. Working in interprofessional teams of 4-5 learners, team members discuss case information, interview the standardized patient (SP) individually, jointly formulate a care plan, and, discuss the plan with the SP. The experience is debriefed with a facilitator.ResultsIn 2016-17, 520 learners participated in the ISPE. They agreed that they learned about the roles of other health care professionals (M = 5.24 on a six-point scale, SD = 1.27), and that they would recommend the ISPE to fellow students in their profession (M = 5.25, SD = 1.30).DiscussionStudents appreciated the ability to observe learners from other health professions interacting with the SP, and how different perspectives and expertise were integrated to create a comprehensive care plan. The exercise can be adapted to accommodate local health professions learners.

ObjectivesTo develop, implement, and evaluate a training program in aging-related health for police officers.DesignCross-sectional.SettingCrisis intervention training program for police officers in San Francisco.ParticipantsPolice officers attending one of five 2-hour trainings (N = 143).InterventionA lecture on aging-related health conditions pertinent to police work followed by three experiential trainings on how it feels to be "old."MeasurementsParticipants evaluated the quality of the training and the likelihood that they would apply new knowledge to their work and rated their knowledge using a retrospective pre-post evaluation. In open-ended responses, participants reported work-related changes they anticipated making in response to the training.ResultsAll 143 participants completed the evaluation. Eighty-four percent reported interacting with older adults at least monthly; 45% reported daily interactions. Participants rated the training quality at 4.6/5 and the likelihood they would apply new knowledge to their work at 4.4/5. Retrospective pre-post knowledge scores increased for all domains, including how to identify aging-related health conditions that can affect safety during police interactions (2.9/5 to 4.2/5; P < .001). In open-ended responses, participants anticipated having more empathy for and awareness of aging-related conditions and greater ability to provide older adults with appropriate community referrals.ConclusionA brief training in aging-related health significantly increased police officers' self-reported knowledge and skills. Clinicians have an important opportunity to help enhance safe and effective community policing for older adults.

Interprofessional education (IPE) interventions aiming to promote collaborative competence and improve the delivery of health and social care processes and outcomes continue to evolve. This paper reports on a protocol for an update review that we will conduct to identify and describe how the IPE evidence base has evolved in the last 7 years. We will identify literature through a systematic search of the following electronic databases: Medline, Embase, CINAHL, Education Source, ERIC, and BEI. We will consider all IPE interventions delivered to health professions students and accredited professionals. Peer-reviewed empirical research studies published in any language from June 2014 onwards will be eligible for inclusion. The outcomes of interest are changes in the reaction, attitudes/perceptions, knowledge/skills acquisition, behaviors, organizational practice, and/or benefits to patients. We will perform each task of screening, critical appraisal, data abstraction, and synthesis using at least two members of the review team. The review will enable an update and comprehensive understanding of the IPE evidence base to inform future IPE developments, delivery and evaluation across education and clinical settings. [ABSTRACT FROM AUTHOR]

Health professionals work in complex environments that increasingly demand shared understanding of patients' needs, coordination of efforts to meet those needs, and effective communication. Most health professions' educational programs include curricular activities to prepare professionals to practice in these complex environments, but the processes by which learning occurs during these activities are not well understood. Research examining the relationship between the design of interprofessional curricular activities and the interactions that occur among professionals while participating in these activities can help inform and improve future design of curricula to support interprofessional practice. This paper describes interaction analysis, a research method well suited to the type of research needed in interprofessional education and practice. After providing a brief account of the origins and applications of interaction analysis, the authors describe how they designed and employed analytic procedures aligned with interaction analysis to examine learning opportunities afforded by an interprofessional simulated patient exercise. [ABSTRACT FROM AUTHOR]

Chronic kidney disease is common and associated with significant morbidity. Given the high risk of cardiovascular morbidity and mortality in patients with chronic kidney disease, it is important to identify and treat related risk factors. However, there is growing uncertainty about the benefits of some recommended treatment targets. The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative guidelines recommend an A1C level of less than 7 percent in patients with diabetes mellitus, although there is no evidence that treatment to this goal reduces cardiovascular events or progression to end-stage renal disease. Optimal blood pressure goals are controversial, and further study is needed to determine these goals in relation to amount of proteinuria. Concurrent use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers leads to worsening kidney function and is not recommended. Lipid-lowering therapy has been shown to reduce the risk of cardiovascular events and mortality, but not progression of chronic kidney disease. The treatment of anemia in patients with chronic kidney disease, particularly the use of erythropoiesis-stimulating agents and optimal hemoglobin goals, is also controversial. Studies have shown increased morbidity and mortality with use of erythropoiesis-stimulating agents aimed at normalizing hemoglobin levels. Patients with chronic kidney disease are at high risk of morbidity and mortality from the use of intravenous contrast agents. Isotonic intravenous hydration with sodium bicarbonate or saline has been shown to prevent contrast-induced nephropathy. Gadolinium-based contrast agents should be avoided if the glomerular filtration rate is less than 30 mL per minute per 1.73 m² because of the risk of nephrogenic systemic fibrosis. [ABSTRACT FROM AUTHOR]

Resident research has potential benefits and scholarly activity is an internal medicine residency training requirement. This study sought to learn about the resources needed and the barriers to performing scholarly work during residency from residents who had been successful.A questionnaire was delivered to 138 internal medicine residents presenting their work at the 2002 American College of Physicians-American Society of Internal Medicine annual session. Residents were asked to comment on why they had participated in a scholarly project, the skills and resources needed to complete the project, as well as the barriers. Comparisons were made between residents who presented a research abstract and those who exhibited a clinical vignette.Seventy-three residents (53%) completed the questionnaire. Thirty-nine residents presented a clinical vignette and 34 displayed a research abstract. Residents participated in research for a variety of reasons, including intellectual curiosity (73%), career development (60%), and to fulfill a mandatory scholarly activity requirement at their residency program (32%). The most common barriers were insufficient time (79%), inadequate research skills (45%), and lack of a research curriculum (44%). Residents who had presented research abstracts devoted more time (median, 200 vs 50 hours;P<.05) to their project than those who exhibited clinical vignettes. Sixty-nine percent of residents thought research should be a residency requirement.The majority of respondents reported that their scholarly project was a worthwhile experience despite considerable barriers. Teaching research skills more explicitly with a focused curriculum and providing adequate protected time may enable residents to be successful. [ABSTRACT FROM AUTHOR]

Purpose: Physicians have a professional responsibility to engage in lifelong learning. Some of this lifelong learning is required to maintain licensure and certification. Yet, this conceptualization captures only a small portion of the content areas and learning processes that physicians need to engage with to ensure quality patient care. Additionally, purposes beyond regulatory requirements and professional obligations likely drive physicians lifelong learning, though these purposes have not been explored. Given the centrality of lifelong learning to quality patient care, our study explores how physicians conceptualize and engage in lifelong learning., Method: We conducted a qualitative interview study using an interpretivist approach. In 2019, we recruited 34 academic physicians from one institution. We analyzed our data to identify themes related to conceptualization of purposes, content areas, and processes of lifelong learning and actual lifelong learning practices., Results: We interpreted participants' descriptions and examples of lifelong learning as serving three purposes: maintaining competence, supporting personal growth and fulfillment, and engaging in professional stewardship. Much of participants' discussion of lifelong learning centered around keeping up to date with medical knowledge and clinical/procedural skills, though some also mentioned efforts to improve communication, leadership, and teamwork. Participants engaged in lifelong learning through contextual, social, and individual processes., Discussion: Academic physicians engage in lifelong learning for reasons beyond maintaining competence. Medical knowledge and clinical/procedural skills receive most attention, though other areas are recognized as important. Our findings highlight opportunities for a broader, more comprehensive approach to lifelong learning that spans all areas of medical practice., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)