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FC8: Revising Competencies in Geriatrics for Canadian Medical Students: Adding a Mental Health Perspective
- Cindy J. Grief, Thirumagal Yogaparan
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 70-71
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In Canada, adults 85 years and older represent one of the fastest growing segments of the population1. Mood disorders and chronic illness often intersect, worsening health outcomes in late life2. In view of demographic trends, medical schools should ensure trainees are equipped with the knowledge, skills and attitudes to work with older adults. However, there continues to be much variation in how medical schools incorporate geriatric content into their curricula.
In 2009, the Canadian Geriatrics Society (CGS) outlined 20 competencies in geriatrics to inform medical school curricula, but uptake was minimal. Of note, there were significant gaps in these competencies, which omitted mention of late-life depression. Geriatric mental health experts did not provide input.
The objective of this project was to address gaps in geriatric competencies for medical students through an expert review process involving a biopsychosocial approach.
Methods:
The CGS established a 15-member national working group with representation from geriatric psychiatry, family medicine, a 95-year-old senior, geriatrics and medical trainees. Potential competencies were derived from existing Canadian geriatrics frameworks [Geriatrics 5M, CanMEDs] and 2009 competencies. A modified Delphi process yielded rankings for each competency using a 7-point Likert scale.
Results:
Between 2019 and 2021, 3 successive national surveys were completed. In the first (n=66), 34 competencies were identified. Agreement in the final survey was 87-95% (mean 90%). 51 participants completed all three. Significant topic omissions in the 2009 list of competencies were frailty, end-of-life care, delirium prevention, health promotion and the assessment and management of depression.
Conclusions:
Three national surveys expanded the core competencies in geriatrics for medical school curricula from 20 to 31. Expert consensus was high. Themes mapped along existing geriatrics frameworks and incorporated a holistic lens incorporating the perspectives of an older adult and geriatric psychiatrist. In addition to late-life depression, the importance of addressing ageism was also highlighted.
Learning objectives for each competency are modifiable for level of training and individual program, offering flexibility. The CGS will continue to advocate for inclusion of updated, expanded competencies into training and licensure in geriatrics.
1) Statistics Canada 2021, Canadian Government, accessed 1 January 2023, <. Accessed 20/01/23 <https://www12.statcan.gc.ca/census-recensement/2021/as-sa/98-200-X/2021004/98-200-x2021004-eng.cfm>
1) Hall CA, Reynolds III CF. Late-life depression in the primary care setting: challenges, collaborative care and prevention. Maturitas. 2014 Oct; 79(2):147-52.
431 - Establishing a Canadian National ECHO Educational Program focused on Mental Health of Older Adults
- David Conn, Lisa Sokoloff, Claire Checkland, Jasmeen Guraya, Vivian Ewa, Sid Feldman, Cindy Grief, Andrea Hunter Navena Lingum, Ian MacKay, Kiran Rabheru, Anna Santiago, Dallas Seitz, Devin Sodums, Laurel Steed
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- Journal:
- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, pp. 50-51
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Background
Project ECHO is a virtual, case-based capacity-building education program for healthcare providers. It was developed in New Mexico, USA but, due to its effectiveness, the model has now spread to 40 countries around the globe. Baycrest, the Canadian Coalition for Seniors’ Mental Health and the Canadian Academy of Geriatric Psychiatry collaborated to launch a national ECHO for mental health and aging. This partnership, coordinated by a cross-Canadian Steering Group, allows for broad reach, including registration of learning partners from almost all Canadian provinces and territories. The program was funded by the RBC Foundation.
MethodsECHO COE: Mental Health pilot consisted of 2 cycles:
6 weekly sessions focused on broader mental health topics (e.g., delirium, mood disorders)
10 weeks with more specific topics (e.g., substance use disorders, sleep disorders)
Needs assessments of healthcare providers and older adults informed the program curricula. Evaluation included weekly satisfaction surveys, and pre and post evaluations.
ResultsParticipants:
154 healthcare providers participated in the 6-week session
39% of registrants were nurses or nurse practitioners, 35% allied health professionals, 14% physicians and 12% others
9 out of 10 provinces, 1 territory represented
Preliminary findings (based on the first 6 sessions):
High overall satisfaction (average of 4.5 out of 5).
99% would recommend the program to others
67% had already shared information with team members and colleagues.
ConclusionA national ECHO program is an effective way to bring together clinicians who work with and are interested in the mental health and wellbeing of older adults for education sessions, collaborative and mutual learning as well as for cross-jurisdictional knowledge transfer. Collaborative, cross-professional learning supports the exchange of best practice in mental health for older adults, supports the development of collegial national professional support and can address health system inequities. An international ECHO through IPA would be an exciting and valuable next step.