GeriWard was piloted from June through November 2010 in six separate 2-hour workshops. A total of 26 third-year medical students, 13 fourth-year pharmacy students, and 12 graduate nursing students participated during the six-month pilot. The third-year medical students and fourth year pharmacy students were included if they were rotating through the inpatient medicine service at the hospital during the pilot period. Graduate nursing students working towards their ANP, GNP or Geriatric CNS certification and MS degree were recruited by nursing faculty to participate in the course as part of an elective.
Fifty students completed surveys (98% response rate). All students showed improvement in attitudes toward interprofessional education pre and post-curriculum (p= 0.001) using the Attitudes Towards Health Care Teams scale (ATHCTS). Students rated knowledge and self-efficacy on the competencies higher after participating in the curriculum. After the program 88% of participants felt confident identifying indications for bladder catheters and risk factors for pressure ulcers, compared to only 60% before the curriculum. Using a 5-point Likert scale, over 90% of students agreed that they learned skills they would apply to future patient care.
Hospitalist faculty on service during the pilot months evaluated several of the medical students’ presentations using an observation rubric to rate and comment on content, knowledge, and application to systems-based practice (n=13). The presentations were rated highly in the areas of definition of the problem and the identification of potential interventions (>80% students met or exceeded expectations). Faculty praised the students’ ability to identify geriatric problems and offer opportunities for improvement with the potential for a direct impact on patient care.
GeriWard is a novel interprofessional curriculum that structures bedside care of the hospitalized older adult by combining team-based learning with a patient encounter. Students actively engage in the learning process by presenting the patient case back to their peers and faculty supervisors. Those direct experiences can increase students' self-assessed ability to care for the hospitalized older adult within a team dynamic to address how systems issues can directly affect patient care.
GeriWard has been highlighted as an example of a high impact and sustainable interprofessional curriculum by the Center for Innovation in Interprofessional Education and by the American Medical Association-funded Bridges Curriculum at UCSF Medical Center.
Results of the GeriWard Pilot have been presented at several local and national conferences:
Rennke S, Mackin L, Moylan A, Wallhagen M, Jue V, Lam E, Lai C. GeriWard: An Interprofessional Curriculum on Care of the Hospitalized Older Adult. Abstract poster session. Society of Hospital Medicine Annual Meeting and Society of General Internal Medicine Annual Meeting. May, 2011.
Rennke S, Mackin L, Moylan A, Wallhagen M, Jue V, Lam E, Lai C. GeriWard: An Interprofessional Team-Based Curriculum on Care of the Hospitalized Older Adult. Poster session. AAMC Western Regional Conference (WGEA/WGSA/WAAHP/WOSR). April 30-May 3, 2011.
- The overarching goal of the curriculum is to provide skills, knowledge and a team-based experience to ensure that graduating students are able to approach the care of older adults in the hospital from a systems-based perspective.
- Identify key geriatric competencies pertaining to the hospital setting as applied to a patient: 1) bladder catheter use and misuse (geriatric competency #23); 2) restraint use in the hospital setting (geriatric competency #24) and 3) skin assessment and pressure ulcer staging (geriatric competency #26).
- Work collaboratively as a team consisting of health professions students from different fields to complete a clinical exercise emphasizing the importance of an interprofessional approach to patient care and systems-based practice in the hospital setting.
- Discuss the roles and contributions of each student as a health professional within the team dynamic.
- Facilitate a discussion with patients and hospital staff emphasizing patient-centered language, peer-to-peer feedback and discussion with both to patients, caregivers and hospital-based providers.
- Present a patient case emphasizing the importance of systems-based practice with evaluation and feedback from a faculty supervisor.
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Rennke S, Mackin L, Moylan A, Wallhagen M, Jue V, Lam E, Lai C. GeriWard: An Interprofessional Curriculum on Care of the Hospitalized Older Adult. Abstract poster session at: Society of Hospital Medicine Annual Meeting and Society of General Internal Medicine Annual Meeting; May 2011.
Rennke S, Mackin L, Moylan A, Wallhagen M, Jue V, Lam E, Lai C. GeriWard: An Interprofessional Team-Based Curriculum on Care of the Hospitalized Older Adult. Poster session at: AAMC Western Regional Conference (WGEA/WGSA/WAAHP/WOSR); April 30-May 3, 2011.
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