In this issue of Gerontology and Geriatrics Education there is a focus on the ever-expanding activities in clinical education and training in geriatrics. In order to have the best prepared health care workforce, attention towards the unique needs of older adults has become a cornerstone of today’s health professions curricula and continuing education. A strong emphasis in teaching has recently been placed on post-hospital discharge planning and navigating the complexities of transitions of care. This issue has three unique projects focusing on transitions. Linda Pang and colleagues worked with medical students in a reflective exercise on transitions to literally “bridge the gap” in assessing how patients cared for in the hospital made the journey to home. Pavon and colleagues developed a transitions of care curriculum for internal medicine interns covering the ACGME core competencies which can allow residency programs to hit the mark in multiple domains for learner assessment. Chapman and colleagues from Wisconsin immersed resident physicians in a real life peri-hospital experiential learning focused on transitions of care. These three trainings, while each unique, are especially important in helping participants understanding the role of the clinician as a stakeholder within the interprofessional team assisting older patients and their families navigating the complexities of the modern health system.
Ross and colleagues contribute an important systematic review of educational interventions aimed at improving student attitudes towards aging. Importantly this review underscores the powerful learning experiences of students obtained through the interactions with real patients. With such a focus in modern medical education on simulation, online training, and standardized patients for evaluation, it is important not to forget the end result of clinical training is to take care of real people. Mary Camp and colleagues contribute a poignant perspective on the patient interactions during training with analysis of the self-reflections in student essays related to geriatrics. The experiences with older adults during training, including moral distress experienced by students and the common challenges of aging encountered, likely contribute to the core professional identity development and attitudes of these students.
A framework of learning is explored by Yanamadala and colleagues in this issue through use of problem-based formats and by novel online “mini” e-learning modules to engage students as reported by Garside and colleagues. Beverly Lunsford and Laurie Posey outline a novel multimodal educational approach of “Geriatric education utilizing a palliative care framework” to enhance disease and symptom management and communication to provide compassionate care. A short-term research training program framework including didactic, clinical and methodology is described by Jeste and the team from the University of California. This program significantly and positively impacted medical students’ attitudes toward aging. Programs which change perspectives in areas like research and palliative care may serve as powerful catalysts for creating a “pipeline” of students who embrace aging as a central theme of their work.
Geriatric fellowship training is also an important area for this issue. Mark Brennan-Ing and colleagues challenge the preconceptions that geriatric fellows may have regarding sexuality and sexual health in older age. In a powerful intervention directed towards geriatric fellows the team was able to alter perceptions about sexuality, health, and aging. Fellows were able to identify gaps in their own practices to better support older adults in sexual health. Finally, Ronald Maggiore and his colleagues in geriatric oncology also focused their work on geriatric fellows. A national survey of U.S. geriatrics fellowship program directors revealed strong support from programs in the principles of specialized cancer care for older adults but few have reported an operationalized geriatric oncology curriculum. This important identified gap creates ample opportunity for improving education especially when faced with the growing demographic imperative of an aging population with increasing prevalence of cancer.
It is a pleasure to have received such excellent submissions for this issue of Gerontology and Geriatrics Education. Health care workforce development is a critical issue in sensitizing clinicians to the needs of older adults. I would even propose instead of the term “development” we should refer to it as workforce “transformation” or “enhancement” with the goal to make health care more age-friendly. As demonstrated by these authors of articles related to clinical education, both innovation and trusted approaches in clinical teaching has the power to influence positive perspectives of students who will be at the forefront of this change in health care.