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Geriatric Emergency Medicine with Integrated Simulation Curriculum
Author(s) -
Doty Chris,
Rinnert Stephan,
Gernshiemer Joel,
Gillett Brian,
Stetz Jessica
Publication year - 2009
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2009.00392_13.x
Subject(s) - medicine , curriculum , polypharmacy , medical education , geriatrics , triage , distress , intervention (counseling) , nursing , medical emergency , psychology , intensive care medicine , clinical psychology , pedagogy , psychiatry
Our initiative is a replicable model curriculum that teaches emergency geriatric care principles utilizing didactics and immersive simulation. Simulated scenarios encompass principles specific to geriatric care. Major curricular principles include: 1) respect for patients’ autonomy, 2) accommodating patients’ physical and cognitive limitations, 3) appropriate resource utilization, and 4) accurate symptom recognition and clinical decision‐making. These four basic principles are incorporated throughout the curriculum and specifically during three simulated scenarios: 1) a patient with respiratory distress in the setting of end‐stage cancer and end‐of‐life teaches topics pertaining to living wills, health care proxies and DNR orders; 2) a fallen patient requiring a trauma evaluation and safe discharge teaches resource utilization, complex evaluation of home environment, social support principles, access to medical care concepts, and utilization of institutional social services; 3) a patient with altered mental status caused by polypharmacy and sepsis teaches geriatric diagnostic and intervention challenges. Faculty teach specific clinical tactics such as minimizing distractions, frequent reorientation, minimal use of urinary catheters and “tethering” devices, prompt triage and medical screening exams, and coordinating disposition with family, nursing, and clerical staff. The curriculum also includes large classroom didactics incorporating active learning via live streamed simulation into the resident conference room. We developed an internet‐based tool to manage the curriculum and track resident participation. The tool stores and sends educational handouts via email and displays digital media (e.g., radiographs, EKGs) on screen during lectures and simulation sessions. Learning objectives are measured and reinforced with pre‐ and post‐curriculum test questions.