Here - American Geriatrics Society

P OSTER
A BSTRACTS
survey using the internal medicine evaluation system. Of 19 evaluations
received, 84% (16) of the internal medicine residents found the
tour of the facility informative; 42% (8) of the residents agreed or
strongly agreed that the service they performed expanded their
knowledge of senior health issues; 68% (13) of the residents agreed
or strongly agreed that this interaction with the seniors helped them
learn more about communicating with older patients. Themes from
open-ended questions included increased knowledge in senior community
resources and facilities, enjoyment of interactions and learning
from seniors outside a hospital setting.
Conclusion:
Overall, this pilot program of service-based community learning
provided residents with insight into the lived environment and
community resources available to seniors while increasing awareness
of the importance of effective communication with seniors. Future
directions include having all trainees perform an aging presentation,
expansion of topics, and obtaining evaluations from the seniors at
the sites.
D73
Pilot Formative Hybrid Simulation for Sub Interns.
S. McGee, 1 W. Gammon, 1 M. Keough, 1 C. Burnham, 1 S. Chimienti, 1
M. Yazdani, 1 J. Gallagher, 1 J. Reidy, 1 M. Zanetti, 1 A. Fabiny, 2
J. Gordon, 2 J. Gurwitz, 1 M. Pugnaire. 1 1. OEA, UMMS, Worcester,
MA; 2. Harvard Medical School, Boston, MA.
Supported By: A University of Massachusetts Medical School
(UMMS) initiative supported by the Donald W. Reynolds
Foundation
Background/Method: Building on the work of our Reynolds
partners at Harvard Medical School, this Pilot Formative Hybrid
Simulation OSCE experience was developed to incorporate more
formative clerkship experiences within the new UMMS curriculum.
This simulation, which utilizes both standardized patients and a mannequin,
involves a case of an elderly patient presenting to the ED in
respiratory distress with end stage COPD who no longer wishes life
prolonging interventions such as bipap or intubation. Students work
in teams of two: one student assesses the patient in the ED and then
completes a hand-off to the second student who assesses the patient
in the ICU . Students are assessed on their ability to conduct a focused
interview, develop an appropriate differential diagnosis and
identify the goals of care. The experience concludes with students debriefing
with 2 faculty, a geriatrician and a hospitalist or palliative
care specialist.
Methods: Medical sub interns at one UMMS clinical site participate
in this experience as part of the required 4 week medical sub internship.
Students complete an evaluation immediately following the
debriefing session.
Results: Fifty-eight sub-interns have participated in the experience
to date. Preliminary analysis of a small sample of learners
(n=10) demonstrated that: 1) 100% felt that the session was “presented
in a way that helped me integrate knowledge, ideas and skills
with other disciplines” and; 2) 90% found it “useful to debrief and review
[their] own performance.” Selected responses from students regarding
the strength of this experience included, “Challenging experience.
Worthwhile to see these kind of scenarios in a consequence free
environment” and “…practicing end of life discussions in a ‘safer’ setting
than the hospital”.
Conclusions: Sub-interns viewed the Pilot Formative Hybrid
Simulation OSCE experience as valuable. Preliminary data suggest
that they valued the opportunity to practice interviewing skills and
medical decision making at the end-of -life in the safe environment of
the UMMS Simulation Center.
AAMC Geriatric Competencies: #19 Assess and provide initial
management of pain and non-pain symptoms based on patient’s goals
of care
D74
Faculty Development Program for Non Geriatricians: Evaluation of
Gait and Fall Risk, Function and Cognition.
S. McGee, J. Gurwitz, C. Burnham, M. Keough, S. Pasquale,
B. L. Robuccio, M. Pugnaire. OEA, UMMS, Worcester, MA.
Supported By: A University of Massachusetts Medical School
(UMMS) initiative supported by the Donald W. Reynolds
Foundation
Background: As part of the UMMS Donald W Reynolds funded
initiative at UMMS a 60 min interactive faculty development program
was developed and piloted for a diverse group of faculty serving
as mentors/advisors to UMMS medical students. This program included
the Competency Certification in Gait and Fall Risk
Evaluation© workshop materials presented at the 2010 AGS Annual
meeting as well as commonly used functional and cognitive assessment
tools.
Methods: Faculty completed surveys rating their knowledge of
the importance and components of gait and fall risk assessment, functional
and cognitive assessment, and their confidence in performing
these assessments prior to and immediately following the faculty development
workshop. Self-selected into two groups, faculty attended
two sequential workshop presentations: Gait and Fall Risk Assessment,
and Functional Assessment and the Mini-Cog.
Results: Thirteen faculty attendees represented multiple specialties
and subspecialties including psychiatry, pediatrics, radiation oncology
and gynecology. Overall, faculty reported significantly increased
knowledge specific to the importance of performing gait and
fall risk assessment, and their confidence to do so, as a result of the
workshop session. Eighty-five percent of those in attendance reported
the session to be valuable to both their clinical and teaching
responsibilities.
Conclusions: A brief faculty development program for a diverse
group of faculty serving as medical student mentors/advisors was very
well received, and improved their knowledge and confidence in performing
commonly used assessment tools for older adults.
AAMC Geriatric Competencies: #7 Perform and interpret a
cognitive assessment, #9 Assess and describe baseline and current
functional abilities and #12 Ask about falls and watch a patient rise
from a chair and walk then record and interpret the findings.
D75
Frailty and Body Mass Index in Community Dwelling
Octogenarians, Nonagenarians and Centenarians.
J. Ceimo, 1 N. Bravo, 1 B. Leonard, 1 T. Minani, 1 K. O’Connor, 1
L. Evans, 1 D. Coon, 2 W. Nieri. 1 1. Center for Healthy Aging, BSHRI,
Sun City, AZ; 2. College of Nursing and Health Innovation, ASU,
Phoenix, AZ.
Background: Research in frailty has attempted to determine
both a consensual diagnosis and its component parts. Prior studies
show frailty associated with extremes of BMI (U-shaped curve). Not
everyone with BMIs < 20 or > 30 is frail. We propose that stable BMI
through mid- and late adult life (age 50 and up) may identify a subset
> 80 years in whom outlying BMIs were a less significant contributor
to frailty.
Methods: This cross-sectional study on community dwelling 80+
year olds is part of a larger longitudinal study on healthy aging (O’-
Connor et al, 2009). Participants lived in Arizona, were interviewed in
person, and had an MMSE >17.
Height/weight was taken from the initial and second annual
exams (year three). Height/weight data at age 50 was based on participants’
recall. Body Mass Index (BMI) was divided into four categories:
1) < 20, 2) 20-25, 3) 26-30, and 4) > 30. Frailty was determined
from 34 selected deficits associated with physiologic decline and increased
mortality.An individual’s total points divided by total number
of deficits yielded a Frailty Index (FI) from 0.0 to 1.0; higher scores in-
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AGS 2012 ANNUAL MEETING