Minimum Geriatric Competencies - All disciplines | POGOe - Portal of Geriatric Online Education

Minimum Geriatric Competencies - All disciplines

Citation URL: http://www.pogoe.org/productid/20480Searchable Product ID: 20480

URL where the product can be viewed:

None

Documents associated with this product:

You must login to view documents and videos

Description of the product:

“Competency-based education prepares trainees to perform tasks occurring within the context of practice. Teaching to competency differs from traditional instruction. It begins by stating the performance we expect of our graduates in the workplace and then designing the medical school curriculum to prepare our learners to achieve that performance through deliberate practice in applying the underlying knowledge, skills, and attitudes.”

As the elderly population in America "booms," medical education must address the issue at hand and modify their curriculum and teaching practices to give credence to geriatric principles within medical care. It is imperative for many reasons (socially, financially, etc.) that we ensure competency in the care of older adults for every physician. To help achieve this lofty goal, the Minimum Geriatric Competencies have been developed for Medical Students and are in the process of being developed for multiple residency disciplines.

The files within this product showcase the Medical Student Minimum Geriatric Competencies (published in Academic Medicine, May 1st), Internal Medicine – Family Medicine Resident Minimum Geriatric Competencies (nearing completion), and Emergency Medicine Resident Minimum Geriatric Competencies (in development).

Describe any special implementation requirements or guidelines:

The "Side-by-Side" document shows the progression from Medical Student Competencies into resident education.

List any publications from, presentations from, and/or citations to this product:

Leipzig RM, Granville L, Simpson D, Brownell Anderson M, SauvigneK, Soriano RP. Keeping granny safe on July 1: consensus on minimum geriatric competencies for graduating medical students. Acad Med. 2009;84:604–610
http://journals.lww.com/academicmedicine/Fulltext/2009/05000/Keeping_Gra...

Date posted:

Thu, 01/01/2009

Date last updated:

Fri, 08/07/2009

CME credits available:

No

Do you or any of the authors have any significant financial interest or commercial support?:

No

Has this product been peer reviewed?:

No

Geriatrics topic areas:

Aging Principles

Geriatric Psychiatry

Approach to the Geriatric Patient

Geriatric Syndromes

Chronic Illness

Models of Care

Communication

Geriatric Assessment

Transitions of Care

Geriatric Conditions, Diseases and Disorders

Discipline/specialty:

Emergency Medicine

Family Medicine

Geriatrics

Internal Medicine

ACGME competency checklist:

Interpersonal and Communication Skills

Practice-Based Learning and Improvement

Medical Knowledge

Professionalism

Patient Care

Systems-Based Practice

Intended learner audience:

Medical Student Pre-Clerkship

Resident

Medical Student Clinical

Minimum geriatric competencies:

1. Explain impact of age-related changes on drug selection and dose based on knowledge of age-related changes in renal and hepatic function, body composition, and Central Nervous System sensitivity.

2. Identify medications, including anticholinergic, psychoactive, anticoagulant, analgesic, hypoglycemic, and cardiovascular drugs that should be avoided or used with caution in older adults and explain the potential problems associated with each.

3. Document a patient’s complete medication list, including prescribed, herbal and over-the-counter medications, and for each medication provide the dose, frequency, indication, benefit, side effects, and an assessment of adherence.

4. Compare and contrast among the clinical presentations of delirium, dementia, and depression.

5. Formulate a differential diagnosis and implement initial evaluation in a patient who exhibits delirium, dementia, or depression.

6. In an older patient with delirium, urgently initiate a diagnostic work-up to determine the root cause (etiology).

7. Perform and interpret a cognitive assessment in older patients for whom there are concerns regarding memory or function.

8. Develop an evaluation and non-pharmacologic management plan for agitated demented or delirious patients.

9. Assess and describe baseline and current functional abilities in an older patient by collecting historical data from multiple sources, making sure to include instrumental activities of daily living and activities of daily living, and performing a confirmatory hearing and vision examination.

10. Develop a preliminary management plan for patients presenting with functional deficits, including adaptive interventions and involvement of interdisciplinary team members from appropriate disciplines, such as social work, nursing, rehabilitation, nutrition, and pharmacy.

11. Identify and assess safety risks in the home environment, and make recommendations to mitigate these.

12. Ask all patients > 65 y.o., or their caregivers, about falls in the last year, watch the patient rise from a chair and walk (or transfer), then record and interpret the findings.

13. In a patient who has fallen, construct a differential diagnosis and evaluation plan that addresses the multiple etiologies identified by history, physical examination and functional assessment.

14. Define and differentiate among types of code status, health care proxies, and advance directives in the state where one is training.

15. Accurately identify clinical situations where life expectancy, functional status, patient preference or goals of care should override standard recommendations for screening tests in older adults.

16. Accurately identify clinical situations where life expectancy, functional status, patient preference or goals of care should override standard recommendations for treatment in older adults.

17. Identify at least 3 physiologic changes of aging for each organ system and their impact on the patient, including their contribution to homeostenosis (the age-related narrowing of homeostatic reserve mechanisms).

18. Generate a differential diagnosis based on recognition of the unique presentations of common conditions in older adults, including acute coronary syndrome, dehydration, urinary tract infection, acute abdomen, and pneumonia.

19. Assess and provide initial management of pain and key non-pain symptoms based on patient’s goals of care.

20. Identify the psychological, social, and spiritual needs of patients with advanced illness and their family members, and link these identified needs with the appropriate interdisciplinary team members.

21. Present palliative care (including hospice) as a positive, active treatment option for a patient with advanced disease.

22. Identify potential hazards of hospitalization for all older adult patients (including immobility, delirium, medication side effects, malnutrition, pressure ulcers, procedures, peri and post operative periods, transient urinary incontinence, and hospital acquired infections) and identify potential prevention strategies.

23. Explain the risks, indications, alternatives, and contraindications for indwelling (Foley) catheter use in the older adult patient.

24. Explain the risks, indications, alternatives, and contraindications for physical and pharmacological restraint use.

25. Communicate the key components of a safe discharge plan (e.g., accurate medication list, plan for follow-up), including comparing/contrasting potential sites for discharge.

26. Conduct a surveillance examination of areas of the skin at high risk for pressure ulcers and describe existing ulcers.

Authors:

Multiple

Login or register to post comments