Overcoming barriers to interprofessional education in gerontology: the Interprofessional Curriculum for the Care of Older Adults

Figures & data

Table 1 Challenges in providing gerontology-focused interprofessional education

Lack of designated funding sources focusing on gerontology IPE initiatives^Citation21

Ensuring equal and appropriate representation and participation across professions^Citation21,Citation31,Citation32

Navigation of traditional health care hierarchy and “silo mentality”^Citation21,Citation31^–^Citation33

Addition of new or expanded content to already crowded curricula^Citation21,Citation31,Citation33

Pedagogical and theoretical framework challenges^Citation21,Citation31

Limited faculty experiences teaching interprofessional concepts and content^Citation21,Citation31

Logistical problems, including location of campuses, availability of space, appropriate selection of learner groups participating in educational activities, scheduling learning activities while considering a wide variety of programmatic schedules^Citation21,Citation31,Citation33^–^Citation35

Ensuring comprehensive evaluation^Citation21

Abbreviation: IPE, interprofessional education.

Table 2 Interprofessional domains, knowledge, and competencies

Domain area	Interprofessional knowledge base	Interprofessional competencies
	iCCOA will provide learning opportunities which develop knowledge, skills, and attitudes needed to do the following:	By the end of this curriculum, learners will be able to do the following:
Interprofessional collaborative practice	Work effectively with colleagues of multiple professions, across multiple settings	Work effectively with individual of other professions to maintain a climate of mutual respect and values Use the knowledge of one’s own role and of other professions’ role to appropriately assess and address the health care needs of the older adults Communicate with patients, families, communities, and other health professionals in a responsive and responsible manner that supports a team approach to the maintenance of health and the treatment of disease Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan and deliver patient-centered care that is safe, timely, efficient, effective, and equitable
Physical assessment, care, and evaluation	Provide effective physical care to address geriatric care needs	Assess the physical symptoms affecting the patient Formulate discipline-specific interventions addressing physical symptoms Construct an interdisciplinary plan of care for addressing physical symptoms Evaluate the interdisciplinary plan of care for addressing physical symptoms and adjust when appropriate
Psychosocial, spiritual, and cultural assessment, care, and evaluation	Provide patient/family-centered care that addresses their unique psychological, spiritual, social, and cultural orientation and needs	Assess the psychosocial, spiritual, and cultural needs and resources of the geriatric patient, caregiver, and family Formulate specific interventions addressing psychosocial, spiritual, and cultural needs of the patient and family Construct an interdisciplinary plan of care for addressing psychosocial, spiritual, and cultural needs of the geriatric patient, caregiver, and family Evaluate the interdisciplinary plan of care for addressing psychosocial, spiritual, and cultural needs of the geriatric patient, caregiver, and family and adjust when appropriate
Environmental risk assessment, care, and evaluation	Provide patient/family-centered care that addresses the environmental risks in the care of the older adults	Assess the environment within which the geriatric patient functions and determine risk factors Formulate specific community interventions addressing the risk factors Construct an interdisciplinary community plan of care addressing the environmental risk factors Evaluate the interdisciplinary community plan of care addressing the environmental risk factors and adjust when appropriate
Teaching/coaching	Provide disease management teaching and coaching to older adults, their caregivers, and families	Deliver quality interdisciplinary disease management education to older adults, their caregivers, and families
Ethical/legal	Identify and address ethical and legal issues impacting older adults, their caregivers, and families	Apply ethical and legal principles to the practice of geriatric care Recognize how one’s own values, beliefs, and feelings influence geriatric practice
Managing and negotiating health delivery systems	Provide effective care transition guidance to older adults, their caregivers, and families	Demonstrate the ability to navigate complicated systems of care to ensure the best care possible for older adults, caregivers, and families
Communication	Communicate effectively with patients, families, and colleagues	Demonstrate effective communication skills in interactions with older adult patients, families, caregivers, and colleagues

Abbreviation: iCCOA, Interprofessional Curriculum for the Care of Older Adults.

Table 3 Responses to formative feedback provided by expert reviewers and learners

Observations that warranted attention	Modifications
Online modules
Learners experienced difficulties in navigating the registration site for the online modules	Discipline-specific directions were written and revised to address best practices and frequently asked questions in the most simplistic terms
Modules included dense, complicated interdisciplinary content	Our adult learner experts suggested more white space and page breaks to reduce the visually, dense nature of the content
Students and other learners requested verification of completion of the modules and ICME	Certifications of completion were generated for each successfully completed online course and ICME
Professionals reported that the CEU/CME information was difficult to locate initially	CEU/CME information was placed on the first slide of each online module
Law students reported being overwhelmed with the medical content in online modules	Law faculty engaged to increase law-oriented content. Law students provided an in-class presentation of the content included in the online modules to highlight the patient’s legal/ethical needs and discuss legal remedies
Undergraduate- and graduate-level learners and practicing professionals completed the online modules for course credit, mandatory educational experience, or continuing education purposes with or without CME or CEUs. Scores on posttests tended to differ depending on discipline and level of education across the different online modules	The leadership team decided that the initial established aspirational posttest goals were set too high for all types of learners since they represented a broad range of disciplines, and because the learners ranged from undergraduate to graduate level to practicing professionals. Given the experts’ evaluations of the trainings prior to launch, the continued support of the faculty requiring the modules as course activities, and the evaluations offered by the learners, the curriculum design faculty have made only minor changes to the structure and content of the training modules and the ICMEs and reduced posttest targets
ICME
Students, learners, and professionals alike reported the value of having Area Agency on Aging representatives at each ICME	Area Agency on Aging faculty or representative from the Aging Resource Center is included in each ICME
Faculty communicated alternate perspectives on certain interdisciplinary aspects of a few of the video vignettes, for example, the seating arrangement present during an interdisciplinary case presentation and the use of white coats by some	Facilitator’s guides were modified to address these perspectives and have a brief critical reflection with the interdisciplinary learners during the ICME on the impact on the team interactions
Learners expected that the video vignettes used with the ICME were model portrayals of interdisciplinary interactions	A statement of acknowledgment was included stating the video vignettes are not stand-alone teaching tools, are not intended to be exemplary portrayals of interactions, and should be used with the related PowerPoint presentations and facilitator’s guide
The curriculum for medical learners is already very crowded, and any changes or additions to the curriculum are required to go to the medical school curriculum committee. There was much discussion about how the online modules could be included	It was determined that revising the medical school curriculum was not possible at this time. However, the ICME could be included during the learners’ AHEC rotation during the third year of medical school, if it was shortened. During the AHEC rotation, learners spend much of their time in a rural area, returning to campus for instruction during the rotation. The ICME was shortened and included in the curriculum
The video vignettes of the ICMEs emphasize different disciplines depending on the needs of the case. A few learners from different disciplines indicated that they did not have a role in a particular case	The video vignettes to be utilized in each ICME are chosen to be in alignment with the majority of the learners’ disciplines per each ICME session, to the extent possible
Critical reflection
In the critical reflection experience, learners observed the care of an older adult in a primary care setting, wrote a reflection, and discussed their experiences with an interdisciplinary team of learners. Many of them expected to witness the practice of care coordination as described in the online modules and were confused as to how to approach the writing task	The instructions to the learners were modified to acknowledge their observations may not adhere to best care coordination practices. They were also instructed to include not only a reflection of what was witnessed but also an assessment of aspects that could be included to improve the coordinated care of the older adults

Abbreviations: ICME, interprofessional case management experience; CEU, continuing education unit; CME, continuing medical education; AHEC, Area Health Education Center.

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