Preparing Clinicians for the Graying of America
Purpose: By 2030, it is estimated that there will be over 70 million adults over the age of 65.1,2 The healthcare workforce isn’t growing at a rate that can meet anticipated needs. There are expected shortages of dentists, nurses, physical and occupational therapists, pharmacists, physicians, and social workers.1 Additionally, by 2025, 25% of the workforce will be nearing retirement.3 A major obstacle in attracting providers to care for the elderly is a negative attitude toward aging seen across the professions.4,5,6 To manage the complexity presented by older adults, care must be coordinated. The 2008 IOM report spoke to the necessity of training providers to work in interdisciplinary teams (IDT).1 IDT training programs improve learners’ knowledge and attitudes about aging, geriatric care, team skills, interprofessional communication, and the benefits of collaboration.7,8,9 Traditional learning environments may reinforce the hierarchy of health professions. New training settings that are less hierarchical and more collaborative, with shared leadership across participating health professions, will need to be developed. Home-based care may provide for more meaningful clinical contributions from all disciplines. Research supports that educators play an important role in developing a positive attitude towards older people.10 This study examined the impact of utilizing a faculty-facilitated, home-based IDT intervention on the attitudes of students from seven professions towards working with the elderly.Methods/Description: 4 cohorts of the Interprofessional Geriatric Curriculum (IPGC) program were included in this analysis. The Geriatric Attitudes Scale (GAS), a reliable and valid, 14-item Likert-type measure of general attitudes towards older people was utilized pre and post participation in the program. In addition to producing an overall score, there are four attitudinal domains. Responses to questions in each domain are averaged to create the domain scores.Results/Outcomes: The average GAS was 3.85 at baseline and 3.91 at follow-up. At both baseline and follow-up, lower GAS scores were reported by male, Asian, and pharmacy and dentistry students. Students in the lowest two quartiles had significantly higher scores at follow-up (3.28 at baseline and 3.47 at follow-up, p<0.001), while those in the highest quartile had a significantly lower mean GAS score at follow-up (4.32 at baseline and 4.24 at follow-up, p=0.029). Other groups with statistically-significant changes from baseline to follow-up included younger students, females, and students in occupational therapy, pharmacy and social work.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: This combination of geriatrics and team training for health professional students in a community setting provides a unique and effective model for health professional education. Participation led to a statistically significant improvement in attitudes towards the elderly, with the greatest improvement in those students with the lowest attitude scores measured pre-participation.References: Institute of Medicine. 2008. Retooling for an Aging America: Building the Health Care Workforce. Washington, DC: The National Academies Press Vincent GK and Velkoff VA. The next four decades: The older population in the United States 2010-2015. Population reports, P25-1138,US Census Bureau, May 2010Bureau of Labor Statistics. Economic News Release--Employment Projects: 2016-2025. October 24, 2017. Available at: https://www.bls.gov/news.release/ecopro.nr0.htm Higashi, R., et al. 2012. “Elder Care as ‘Frustrating’ and ‘Boring’: Understanding the Persistence of Negative Attitudes Towards Older Patients Among Physicians-in-Training.” Journal of Aging Studies 26(4): 476–83. Stefanie S. Boswell (2012) Predicting Trainee Ageism Using Knowledge, Anxiety, Compassion, and Contact with Older Adults, Educational Gerontology, 38:11, 733-741, DOI:10.1080/03601277.2012.695997 Man Wai Alice Lun (2010) Student Knowledge and Attitudes Toward Older People and Their Impact on Pursuing Aging Careers, Educational Gerontology, 37:1, 1-11, DOI:10.1080/03601270903534770 Fitzgerald JT, Williams BC, Halter JB et al. Effects of a geriatrics interdisciplinary experience on learners’ knowledge and attitudes. Gerontol Geriatr Educ 2006;26:17-28. Coogle CL, Parham IA, Cotter JJ et al. A professional development program in geriatric interdisciplinary teamwork: Implications for managed care and quality of care. J Appl Gerontol 2005;24:142-159. Welleford EA, Parham IA, Coogle CL et al. Behind the scenes: Designing a long distance course on geriatric interdisciplinary teaming. Educ Gerontol 2004:30;717-732. Kydd, A., Touhy, T., Newman, D., Fagerberg, I., & Engstrom, G. (2014). Attitudes towards caring for older people in scotland, sweden and the united states. Nursing Older People (2014+), 26(2), 33. http://dx.doi.org/10.7748/nop2014.02.26.2.33.e547