Journal of the Scientific Society

REVIEW ARTICLE
Year
: 2022  |  Volume : 49  |  Issue : 3  |  Page : 221--222

Integrating geriatric competencies in the undergraduate medical education


Saurabh RamBihariLal Shrivastava1, Prateek Saurabh Shrivastava2,  
1 Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
MD, FAIMER, PGDHHM, DHRM, FCS, ACME, Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603 108, Tamil Nadu
India

Abstract

With the advancements in science and the field of medicine, it has become a reality that people are living longer in contrast to the earlier trends of life expectancy. The current review was carried out to explore the integration of geriatric competencies in the medical education curriculum. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of five articles were selected based upon the suitability with the current review objectives and analyzed. As it is quite obvious that in the years to come all the medical doctors will encounter a large number of elderly patients with physical, psychological, and other social concerns, it becomes indispensable to expose them to different geriatric competencies during the undergraduate period of training. We must also accept that elderly population requires a different approach and the better and long-term approach will be to expose the undergraduate medical students in this domain and prepare them for their future clinical practice. This integration into the existing curriculum has to start with the formulation of geriatric competencies that need to be covered in the undergraduation period followed by curriculum mapping. In conclusion, regardless of the rise in the number of the elderly, the medical education imparted to undergraduate medical students lacks alignment. This calls for the need to expose the medical students to different learning experiences in geriatrics and prepare them to not only meet the specific needs of the elderly but also address the concern of shortage of geriatricians.



How to cite this article:
Shrivastava SR, Shrivastava PS. Integrating geriatric competencies in the undergraduate medical education.J Sci Soc 2022;49:221-222


How to cite this URL:
Shrivastava SR, Shrivastava PS. Integrating geriatric competencies in the undergraduate medical education. J Sci Soc [serial online] 2022 [cited 2023 Jan 26 ];49:221-222
Available from: https://www.jscisociety.com/text.asp?2022/49/3/221/365171


Full Text



 Introduction



With the advancements in science and the field of medicine, it has become a reality that people are living longer in contrast to the earlier trends of life expectancy. In fact, it has been estimated that the number of elderly people will go beyond under-five children worldwide by the year 2020.[1] At the same time, it has been projected that the elderly population will increase to 22% (2 billion) by the year 2050, and that four-fifth of these people will be from low- and middle-income nations.[1] These are huge numbers and give us the signal that we have to prepare our health and social systems gradually to ensure that we are ready to respond to this demographic change as a nation.[1],[2] The current review was carried out to explore the integration of geriatric competencies in the medical education curriculum. Moreover, as only six research articles are available in the searched literature, it makes the present review, one of its first kind.

 Materials and Methods



An extensive search of all materials related to the topic was carried out in the PubMed search engine. Relevant research articles focusing on undergraduate medical education and geriatric curriculum published in the period 2004–2020 were included in the review. A total of six studies similar to the current study objectives were identified initially, of which one was excluded due to the unavailability of the complete version of the articles. Overall, six articles were selected based upon the suitability with the current review objectives and analyzed. Keywords used in the search include undergraduate medical education and geriatrics in the title alone only (viz. geriatrics [ti] AND medical education [ti]; geriatrics [ti] AND undergraduate medical education [ti]; and ageing [ti] AND medical education [ti]). Only the articles published in the English language were included for the present review. The collected information is presented under the following subheadings, namely necessity to meet the needs of the elderly, medical education and geriatrics, ground reality and expectations, integration of geriatric competencies, and learning opportunities, assessment, and evaluation.

 Necessity to Meet the Needs of the Elderly



From the health sector perspective, we can anticipate that there will be a significant rise in the prevalence of noncommunicable diseases among the elderly population groups worldwide. In other words, all the medical doctors are expected to encounter a large number of elderly patients with physical, psychological, and other social concerns.[2] We must also accept that elderly population requires a different approach owing to the age-related physiological changes or social concerns and the medical fraternity will find it extremely difficult to respond to these special needs, unless they are trained in the basic principles of gerontology and geriatrics.[2],[3]

 Medical Education and Geriatrics



On a positive note, acknowledging the need to cater to the needs of the elderly population, some of the regulatory bodies have initiated postgraduate courses in geriatric medicine, but the problem is that their number is very few and we just cannot make a significant difference with these specialized courses.[2],[3],[4] The better and long-term approach will be to expose the undergraduate medical students in this domain and prepare them for their future clinical practice.[2] It is high time that the undergraduate medical students are exposed to the competencies pertaining to the elderly people during their training period.[2],[3]

 Ground Reality and Expectations



Currently, most of the medical schools across the globe lack a specific curriculum targeting the needs of the elderly people and this makes the overall situation quite challenging.[3],[4] Even those institutions that are offering geriatric content, lack continuity, comprehensiveness, and the students are not often assessed for their knowledge. The ideal approach will be to gradually introduce geriatric training into the existing medical training spread across all the professional years and in the process provide adequate number of learning opportunities to prepare the medical students to diagnose, manage, and interact with the elderly while being aware about their special needs.[3],[4],[5]

 Integration of Geriatric Competencies



This integration into the existing curriculum has to start with the formulation of geriatric competencies that need to be covered in the undergraduation period.[2],[4] These competencies should deal with self-care capacity, management of medicines, psychological and behavioral illnesses, palliative care, health-care planning, elderly care in hospital settings, management of falls or balance, etc.[2],[3],[4] Upon formulation of the geriatric competencies and achieving concurrence of the faculty members, the next step will be to perform a thorough curriculum mapping (viz. deciding about which competencies will be covered when, teaching–learning method, an appropriate method for assessment, etc.). This step of curriculum mapping streamlines all the uncertainties and gives teachers a direction on how to go ahead with teaching important domains of geriatric care delivery.[2],[3]

 Learning Opportunities, Assessment, and Evaluation



The learning opportunities in geriatric training can include community postings, or devise an elective targeted geriatric population group, wherein the components of physical therapy, occupational therapy, pharmacy, nursing care, etc., are included.[3],[4] It has been observed that the University of Pittsburgh School of Medicine has initiated a geriatric posting of 1-week duration targeting students of the third professional year.[5] Further, the students during their internship can also be subjected to geriatric clerkship and thus improve their overall knowledge and skills in a multidisciplinary setting.[3],[5] It is a must to assess the learned competencies and this can be in the form of narratives, reflection writing, case presentation, exposure to a simulated patient, objectives structured clinical examinations, etc.[6] Finally, there has to be an inbuilt mechanism to evaluate all the planned initiatives, so that we are assured that we are moving on the right track and the students are being benefited.[2],[6]

 Conclusion



Regardless of the rise in the number of the elderly, the medical education imparted to undergraduate medical students lacks alignment. This calls for the need to expose the medical students to different learning experiences in geriatrics and prepare them to not only meet the specific needs of the elderly but also address the concern of shortage of geriatricians.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1World Health Organization. Ageing and Health-Key Facts; 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. [Last accessed on 2021 May 01].
2Tohme RA, Hajjar RR. Incorporating geriatrics into undergraduate medical education in Lebanon. J Med Liban 2015;63:15-20.
3Martinez IL, Mora JC. A community-based approach for integrating geriatrics and gerontology into undergraduate medical education. Gerontol Geriatr Educ 2012;33:152-65.
4Patel D, Prabhu AV, Agarwal N. Geriatrics week: A teaching opportunity to improve the medical education curriculum to care for an aging population. J Grad Med Educ 2017;9:669.
5Tersmette W, van Bodegom D, van Heemst D, Stott D, Westendorp R. Gerontology and geriatrics in Dutch medical education. Neth J Med 2013;71:331-7.
6Eleazer GP, Liken M, Hirth VA, Johnson D, Lucas A, Egbert J, et al. Assessing geriatrics in undergraduate medical education: Two different approaches. Gerontol Geriatr Educ 2004;24:1-8.