Infusing geriatrics in Indian Health Service general primary care clinics: Extending VA workforce development training

ABSTRACT

As federal partners, the Veterans Health Administration (VA) and the Indian Health Service (IHS) agreed to share resources, such as education. The VA Geriatric Scholars Program, a workforce development program, provides one of its training programs on team-based primary care of elders to clinicians working in IHS and Tribal Health Programs. The practical impact of that training is described. A mixed methods approach was applied to the course’s evaluation survey at five clinics in the Northwestern Plains, Southwest, Pacific Coast, and Alaska. Quantitative approaches assessed participants’ self-reported intention to improve recognition and assessment of common geriatric syndromes. A qualitative approach applied to open-ended text responses revealed intensions to improve team-based care. Among the 51 respondents in our sample, we found significant improvements in self-reported ability to recognize previously unfamiliar potential risks to elders’ health and safety, t(49) = 8.0233, p < .001, as well as increased comfort with conducting geriatric assessments and increased confidence in interprofessional team-based communication. Improvements to team-based care included enhanced clinical skills, organizational factors and the need to train additional employees. This evaluation demonstrates the value of sharing resources among federal partners and its value for participants in IHS and Tribal Health Programs.

KEYWORDS:

• Interprofessional Education
• VA
• Indian Health Service
• Rural

Acknowledgments

The curriculum, which was built on the VA Rural Interdisciplinary Team Training (RITT) program, was developed over time by Judith L. Howe, PhD, MPA (GRECC at Bronx VA, Icahn School of Medicine at Mount Sinai) in collaboration with subject matter experts at the VA and affiliated universities. We acknowledge the contributions of the following: Steven Barczi, MD (GRECC at Madison VA, University of Wisconsin), Kenneth Boockvar, MD, MS (GRECC at Bronx VA, Icahn School of Medicine at Mount Sinai), Eileen Callahan, MD (Icahn School of Medicine at Mount Sinai), Thomas Caprio, MD, MPH (Canandaigua VA, University of Rochester Medical School), Elizabeth Clark, MD (formerly GRECC at Bronx VA, Icahn School of Medicine at Mount Sinai), Eugenia Dorisca, (GRECC at Bronx VA), Carmen Fernandez, PsyD (GRECC at Gainesville VA, University of Florida), Helen Fernandez, MD, MPH (Icahn School of Medicine at Mount Sinai), Eve M. Gottesman, MBA (GRECC at Bronx VA), William Hung, MD, MPH (GRECC at Bronx VA, Icahn School of Medicine at Mount Sinai), B. Josea Kramer, PhD (GRECC at Greater Los Angeles, David Geffen School of Medicine at UCLA), Emily Trittschuh, PhD (GRECC at Puget Sound, University of Washington), Nancy Weintraub, MD (GRECC at Greater Los Angeles, David Geffen School of Medicine at UCLA)

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author Contributions

As corresponding author, I affirm that I have listed everyone who contributed significantly to the work. There are no other contributors who are not co-authors.

B. Josea Kramer, PhD: Concept and design, acquisition of data, analysis and interpretation of data, manuscript preparation. Regina A. Lagba Richter, PhD, Design, analysis and interpretation of data, manuscript preparation. Nancy T. Weintraub, MD: Acquisition of data, manuscript preparation.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the VA Office of Rural Health [Promising Practice] and Health Resources and Services Administration [UIQHP28725].