Geriatrics Recruitment Resources

at the David Geffen School of Medicine at University of California, Los Angeles

Program Overview

The UCLA Multicampus Program for Geriatric Medicine and Gerontology integrates geriatrics into all four years of the medical school curriculum. The overall goal is to provide medical students with the foundation for competent, compassionate care of older patients, regardless of what specialty the student pursues. This increased exposure to geriatrics training and positive geriatrician role models also serves to interest more medical students in careers in geriatrics.

The curriculum learning objectives were derived from the American Geriatrics Society's Areas of Basic Competency for the Care of Older Patients for Medical and Osteopathic Schools. The competencies cover attitudes, knowledge, and skills that are needed to care for older people, such as:

• basic science knowledge—epidemiology, physiology, pathology, pharmacology
• clinical knowledge—risk, signs, symptoms, diagnosis, work-up, prevention of common geriatric syndromes
• skills—geriatric and pre-operative assessments
• attitudes—awareness of myths about aging, appreciation of individual differences, compassionate care.

Program Operations

A variety of teaching methods have been developed and are utilized across the four-year curriculum, including:

• didactic lectures
• small-group discussions
• case-based exercises
• CD-based learning exercises
• video-based case examples
• web-based exercises
• innovative educational games
• large-group audience participation formats.

A complete list of curriculum learning objectives can be found in the Available Materials.

Staffing Requirements

The curriculum is provided largely through problem-based learning in small groups of 4-8 students with two preceptors. They meet for 2-4 hours twice a week during the fall and spring semesters for both first- and second-year curriculums. Approximately 75 faculty preceptors from all specialties (including geriatrics) and basic science departments contribute to the learning groups. Geriatric cases are included throughout this curriculum along with all other medical school content. Detailed tutor notes, teaching suggestions and content background are provided. Students change groups about every 6-9 weeks to insure consistency of content and exposure to a large number of excellent preceptors.

A complete list of staffing requirements for the geriatrics curriculum can be found in the Available Materials.

Program Costs and Funding Sources

In 2000, UCLA received a grant from the Association of American Medical Colleges (AAMC) and the John A. Hartford Foundation to develop and support multimedia resources for undergraduate medical education in geriatrics. This was supplemented by a grant from the US Department of Education's Fund for the Improvement of Postsecondary Education (FIPSE).

Funds from these small grants were used to develop specific problem-based learning cases related to geriatrics; multimedia program development such as Geriatric Jeopardy; video-enhanced learning modules; and Audience Response Systems programs. Funds also provided a small amount of faculty support and enabled consultations for specific content areas.

Process and Outcomes Data

The content developed has been enhanced and maintained by a small committee of geriatrics faculty since its inception. These efforts have led to geriatrics faculty appointments to the larger UCLA curriculum committees for the preclinical years and for the clinical years, which meet on a monthly basis.

A variety of formal methods are utilized to evaluate each component of the curriculum.

Direct student evaluations are required at the end of each lecture, block, clerkship and workshop. These are usually conducted online through the Dean's office and then forwarded to the Geriatrics Education Program Director in the Division of Geriatrics.

Objective Structured Clinical Examination (OSCE) cases specific to geriatrics are required at the end of year two and year three. Class means and item analysis are discussed in the curriculum committee meetings and distributed to the Geriatrics Division.

AAMC Senior Questionnaire results include approximately 10 questions on geriatrics content each year.

Outcomes from fourth-year student surveys indicate that students have recognized an increase in exposure to geriatrics content since about 2003-04, which has been sustained. In addition, student performance in geriatrics, based on AAMC national senior content examinations, has also improved.

Many of the multimedia teaching tools developed at UCLA have been exported extensively to other levels of training, to other disciplines, and to other universities across the country.

Implementation Lessons

• Multimedia presentations, web-based programs, and patient demonstrations require tremendous preparation, attention to technical limitations, and often labor-intensive efforts to ensure a good presentation. These methods should be reserved only for content areas that require the advantages of this methodology and should not be used without substantial forethought and preparation.
• Once curricular elements are developed, tested, and proven to be successful, substantial effort is needed to maintain them in the curriculum from year to year. In an over-crowded curriculum, problem-based cases, small-group discussions, and even core lectures are often lost to other content areas if there is no strong advocacy for maintaining them in the curriculum and the elements are not updated frequently.
• Get the Dean's office involved in recruiting faculty from other departments to incorporate geriatrics curriculum and handle the small teaching groups.
• Using funds to support non-geriatrician faculty to insert more geriatrics into the core courses can be an effective strategy.

Available Materials

Tools/Resources

• Table of Medical Student Geriatrics Curriculum Learning Objectives, Teaching Methods, and Staffing Requirements

Publications

• Multidimensional attitudes of medical residents and geriatrics fellows toward older people.
  Lee M, Reuben DR, Ferrell BA.
  Journal of the American Geriatrics Society
  2005;53(3):489-94
• Development and validation of a geriatrics knowledge test for medical students.
  Lee M, Wilkerson L, Reuben DB, Ferrell BA.
  Journal of the American Geriatrics Society
  2004;52(6):983-8.

Website

• A catalog of UCLA educational products created for Medical Student Geriatrics Education, including ordering information, is available at:
  http://www.medsch.ucla.edu/public/geriatrics/orderform.htm

  For a CD of additional curriculuar materials, please contact:

  Ann C. Hu
  Donald W. Reynolds Program Coordinator
  David Geffen School of Medicine at UCLA
  10945 Le Conte Avenue, Suite 2339
  Los Angeles, CA 90095-1687
  (310) 312-0531
  achu@mednet.ucla.edu

For More Information

Bruce A. Ferrell, MD
Professor of Medicine
Associate Chief of Education
Division of Geriatrics
David Geffen School of Medicine at UCLA
10945 Le Conte Avenue, Suite 2339
Los Angeles, CA 90095-1687
(310) 825-8253
bferrell@mednet.ucla.edu