Vol. 12 No. 2 - September, 2009

Advancing Geriatric Education

Reynolds
UMMS Technology and Media Services
Romulo Celli, MS2 talks with an older women about the Navigator Program at Centro Las Americas in Worcester

 In 2008, UMass Medical School received a prestigious $2 million award from the Donald W. Reynolds Foundation to dramatically enhance the training of medical students, residents and practicing physicians in geriatrics by supporting the implementation of a comprehensive geriatrics curriculum across the span of training for physicians. The Medical School committed additional funding in excess of $1 million to support this important educational initiative.

Since the grant was received last year, the UMMS Reynolds Grant team has launched a four-year process to integrate a comprehensive geriatrics curriculum. This transformative undertaking, spanning learner levels and specialties, sets out to incorporate the care of the elderly patient and the theme of aging into the training and education of UMMS medical students, house officers and faculty members.

The grant comes at an opportune time, coinciding as it does with the enormous enthusiasm generated by the Medical School’s LInC curriculum redesign. With multiple academic collaborations and a detailed blueprint in place, the geriatrics curriculum integration is beginning to be implemented at both the undergraduate and graduate medical education levels, as follows.

• The brainchild of Bonnie Vallie, SOM ’11, the Navigator Program pairs elderly patients with volunteer medical and graduate nursing students who accompany a patient into the exam room during their doctor’s office visit. Afterward, the student “navigator” meets with the patient to review and clarify key points about the medical visit. Designed to facilitate patient comprehension of complex health conditions and enhance patient–physician communication, the Navigator Program is currently being used with geriatric patients seen in the cardiovascular clinic, under the leadership of Dennis Tighe, MD, professor of medicine.

• A range of innovations are in development in collaboration with course directors in the four-year Medical School curriculum. For example, in Human Anatomy, groundwork is being laid for an integrated thread on aging, featuring a treasure hunt. Students will channel their “CSI: Worcester” detective impulses to identify and discuss geriatric issues that might have affected their anatomy lab subjects, including disabilities or functional impairments. Faculty from the Division of Geriatric Medicine will partner with Human Anatomy faculty to provide guidance in the lab.

• A formative OSCE (objective structured clinical exam) has been designed using standardized patients to assess students’ clinical skills pertinent to the care of geriatric patients. This OSCE was unveiled over the summer in the internal medicine clerkship. Plans are under way for further OSCE development utilizing our standardized patient program and the UMMS Simulation Center.

• The Reynolds team is also targeting chief residents, those clinician-educators ideally situated to influence residents and students. Future chiefs from departments throughout UMMS will be invited to attend a weekend retreat in Maine in the spring of 2010. This interactive program, based on a national model called CRIT (Chief Resident Immersion Training),  will focus on the competencies necessary to provide high-quality care to an aging populations.