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Evaluation of an Elderly Faller by Medical Students and Rehabilitation Residents
Author(s) -
Rolita Lydia,
Ark Tavinder K.,
Moroz Alex,
Lanyi Valery,
Southwell Julianne,
Sutin David
Publication year - 2009
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2009.02187.x
Subject(s) - medicine , rehabilitation , orthostatic vital signs , cronbach's alpha , physical therapy , formative assessment , competence (human resources) , physical examination , medical prescription , blood pressure , objective structured clinical examination , physical medicine and rehabilitation , nursing , surgery , psychology , psychometrics , clinical psychology , pedagogy , social psychology , radiology
As part of the development of a curriculum for medical students and rehabilitation residents at New York University School of Medicine, an Objective Structured Clinical Examination (OSCE) station was developed for formative evaluation. The goal was to determine the existing knowledge and competence of medical students and rehabilitation residents in the analysis and treatment of a geriatric patient with a history of falls. This OSCE station was designed to focus on three specific clinical skills needed in assessing the elderly faller. The OSCE station was a standardized patient (SP) encounter with a 75‐year‐old man presenting with falls. Seventy‐five medical students and 41 rehabilitation medicine residents participated in the study. There was high agreement between the SP and a geriatric physician used to assess performance on gait (Cronbach alpha=0.918) and orthostatic blood pressure (Cronbach alpha=0.887) assessment. Of the medical students, 43.5% did not check orthostatic blood pressure, 56.8% did not evaluate gait, and 92.0% did not consider assistive device prescription. Only 20.0% checked both orthostatic blood pressure and gait. Likewise, 73.8% of residents did not check orthostatic blood pressure, 38.1% did not evaluate gait and 92.9% did not consider assistive device prescription. Only 19.0% checked both orthostatic blood pressure and gait. The results of this examination are alarming and suggest that education regarding the approach to an elderly person who falls is inadequate, leaving students and residents poorly prepared to take care of the “silver tsunami.”