Keeping Granny Safe on July 1: A Consensus on Minimum Geriatrics Competencies for Graduating Medical Students
Keeping Granny Safe on July 1: A Consensus on Minimum Geriatrics Competencies for Graduating Medical Students
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DOI：
10.1097/acm.0b013e31819fab70
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发表时间：
2009-05-01
影响因子：
7.4
通讯作者：
Soriano, Rainier P.
中科院分区：
文献类型：
--
作者：
Leipzig, Rosanne M.;Granville, Lisa;Soriano, Rainier P.
以能力为基础的教育培养受训者在实践中执行任务。目前还没有老年人特定的，基于能力的共识性能standards for medical students.The作者提出了一个系统的，多方法的过程，以确定和定义的最低老年人特定的能力所需的新实习生充分照顾老年人的结果。阿尔法草案是由老年病学家精心制作的，确定了可衡量的绩效子任务，这些子任务与公认的循证老年病护理标准、患者安全以及第一年住院医师预期的实践范围内的“不伤害”相关。然后由关键利益攸关方和被调查者对这些能力的内容有效性进行评估。在315名受访者中，26%是老年病医生，21%是家庭医生，24%是普通内科医生，6%是神经病学项目主任，14%是外科项目主任，9%是其他。24人为院长。来自近一半（44%）美国医学院的教师和几个主要医学教育组织的代表出席了工作会议。最终文件包括26个能力，嵌套在8个内容领域：药物管理;自我护理能力;福尔斯，平衡和步态障碍;老年人的医院护理;认知和行为障碍;疾病的非典型表现;卫生保健规划和促进;以及姑息治疗：制定最低老年能力标准，为医学院毕业生作为第一年住院医生照顾老年病人建立了业绩基准。只是半开玩笑地，他们被称为“不杀奶奶”的能力。医学院学生达到这些最低能力，以老年人优质护理的循证原则为基础，将确保每年7月1日老年患者得到更安全的治疗。
Competency-based education prepares trainees to perform tasks occurring within the context of practice. There are currently no geriatrics-specific, competency-based consensus performance standards for medical students.The authors present the results of a systematic, multimethod process to identify and define the minimum geriatrics-specific competencies needed by a new intern to adequately care for older adults. An alpha draft was crafted by geriatricians, identifying measurable performance subtasks associated with accepted standards of evidence-based geriatric care, patient safety, and "do no harm" within the first-year resident's expected scope of practice. The competencies were then assessed for content validity by key stakeholders and informants. Of the 315 respondents, 26% were geriatricians, 21% family physicians, 24% general internists, 6% neurology program directors, 14% surgery program directors, and 9% other. Twenty-four were decanal appointees. Faculty from almost half (44%) of U.S. medical schools and representatives of several major medical education organizations were present at the working conference.The final document consists of 26 competencies nested within eight content domains: Medication Management; Self-Care Capacity; Falls, Balance and Gait Disorders; Hospital Care for Elders; Cognitive and Behavioral Disorders; Atypical Presentation of Disease; Health Care Planning and Promotion; and Palliative Care.Setting minimum geriatric competency standards establishes the performance benchmarks for medical school graduates who as first-year residents will care for geriatric patients. Only half-facetiously, they are referred to as the "Don't Kill Granny" competencies. Achievement of these minimum competencies by medical students, grounded in evidence-based principles of quality care for older adults, will assure that, each year, older patients are in safer hands on July 1.