Implementation and Assessment of a Novel Family Medicine Residency Geriatrics And Palliative Care Selective Curriculum
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Publication Date
2025
Keywords
oregon, oaa 2025
Disciplines
Family Medicine | Geriatrics | Medical Education | Palliative Care
Abstract
Background: Family medicine physicians are integral to delivering personalized care for elderly patients and those with severe illnesses, who often encounter high symptom burdens, challenging treatment decisions, and end-of-life circumstances. The Geriatrics and Palliative Care Selective at Providence Oregon Family Medicine Residency is de-signed to enhance resident expertise in geriatric care by immersing them in multidisci-plinary settings. Through a blend of ambulatory clinical visits, home visits, and facility engagements, residents provide comprehensive palliative and hospice care. Educational components include practical experiences supplemented by online modules, articles, and videos. Methods: The selective aims to build competencies in several areas: prescribing appro-priate medications considering age-related changes, managing end-of-life symptoms, utilizing screening tools for delirium, dementia, depression, and substance abuse, fos-tering evidence-based practices, improving shared decision-making and patient advoca-cy, promoting professionalism, and enhancing communication skills. Residents engage in home visits, clinic sessions, and nursing home rotations, supported by online educational resources, fostering practical skills in real-world settings. The hypothesis posited that participation in the selective would enhance residents' compe-tency assessments in geriatrics and palliative care. Assessment methods include pre and post surveys for residents and qualitative evaluations after rotations. Results: Results showed residents who participated in the selective reported higher self-reported competency levels in specific geriatrics and palliative care topics. Statistical analysis revealed a significant improvement in confidence, with those having complet-ed the selective scoring an average of 59.4 compared to 47.7 for non-participants, (p-value of 0.0004). Pre and post survey comparisons of all residents indicated improve-ment, with scores increasing from 40.6 to 53.6, (p-value 0.01). Discussion: While the study demonstrated increased comfort and competence in geriat-rics and palliative care for participants, limitations included small sample size, non-randomized groups, and reliance on subjective survey data. The study scored 6 out of 18 on the Medical Education Research Study Quality Instrument (MERSQI), impacted by incomplete response rates and lack of matched survey data. Despite these con-straints, the selective shows promise as a model for enhancing family medicine residen-cy programs' approach to geriatric and palliative care training. Future improvements involve refining assessment methodologies to incorporate objec-tive evaluations, increasing response rates, and integrating randomized sampling to enhance statistical analysis rigor. Addressing these challenges with further study may help us to improve the selective's cultivation of residents' skills navigating geriatric and palliative care complexities.
Specialty/Research Institute
Graduate Medical Education
Specialty/Research Institute
Family Medicine
Specialty/Research Institute
Palliative Care
