ABSTRACT
INTRODUCTION
Functional status measures strongly predict hospital outcomes and mortality, yet teaching of these measures is often missing from medical schools’ curricula. To address this deficiency, we developed a Geriatric Home-based Assessment (GHA) module for third-year medical students. The module was composed of a workshop and two to three home visits.
OBJECTIVE
To determine whether the GHA module would improve students’ knowledge and proficiency in the functional status assessment.
PROGRAM EVALUATION
Students completed a validated questionnaire and evaluated a standardized patient in an Observed Structured Clinical Examination (OSCE). Scores from students completing the GHA were compared to the scores of students without this experience.
RESULTS
Thirty-one students participated in the GHA module, and 19 students were in the control group. The mean score on the written assessment was 87% among GHA students vs. 46% in the control group (p < 0.001). The mean clinical examination score of the intervention group was also better than that of the control group (76% vs. 46%, p < 0.001).
CONCLUSIONS
Our GHA module was effective in improving students’ knowledge and proficiency in the functional status assessment. “Hands on” experiences like the GHA allow students to develop a solid foundation for assessing functional status and mobility.
References
Adams P, Hendershot G, Marano M. Current Estimates from the National Health Interview Survey, United States, 1996, in Vital and Health Statistics. Hyattsville, MD: National Center for Health Statistics; 1999.
Stuck A, Walthert JM, Nikolaus T, Bula C, Hohmann C, Beck JC. Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med. 1999;484445–69.
Fried LP, Guralnik JM. Disability in older adults: evidence regarding significance, etiology, and risk. J Am Geriatr Soc. 1997;45:92–100.
Fried L, Kronmal RA, Newman AB, et al. Risk factors for 5-year mortality in older adults: the cardiovascular health study. JAMA. 1998;279:585–92.
Inouye S, Wagner DR, Acampora D, et al. A predictive index for functional decline in hospitalized elderly medical patients. J Gen Internal Med. 1993;8:645–52.
Bogardus ST, Towle V, Williams CS, Desai MM, Inouye SK. What does the medical record reveal about functional status. J Gen Internal Med. 2001;1611728–836.
The Education Committee Writing Group of the American Geriatrics Society. Core competencies for the care of older patients: recommendations of the American Geriatrics Society. Acad Med. 2000;75:252–5.
Penn M, Smucker W, Logue E. Functional and attitudinal outcomes of teaching functional assessment to medical students. Educ Gerontol. 2001;27:361–72.
Drickamer M, Levy B, Irwin KS, Rohrbaugh RM. Perceived needs for geriatric education by medical students, internal medicine residents, and faculty. J Gen Internal Med. 2006;21:1230–4.
Saliba D, Elliott M, Rubenstein LZ, et al. The vulnerable elders survey: a tool for identifying vulnerable older people in the community. J Am Geriatr Soc. 2001;49:1691–9.
Durning S, Pangaro LN, Denton G, et al. Intersite consistency as a measurement of programmatic evaluation in a medicine clerkship with multiple, geographically separated sites. Acad Med. 2003;7810S36–8.
American College of Physicians, The Advanced Medical Home” A patient-centered, physician-guided model of health care. American College of Physicians; 2006:1–21.
Coleman E, Smith JD, Frank JC, Min SJ, Parry C, Kramer AM. Preparing patients and caregivers to participate in care delivered across settings: the care transitions intervention. J Am Geriatr Soc. 2004;52:1817–25.
Reuben D, Roth C, Kamberg C, Wenger NS. Restructuring primary care practices to manage geriatric syndromes: the ACOVE-2 intervention. J Am Geriatr Soc. 2003;51:1787–93.
Acknowledgments
The authors would like to acknowledge Gregory J. Hanson, MD, for his guidance on this project. We would also like to thank Stephen Cha, MS, for his assistance with data analysis.
Conflict of Interest
None disclosed.
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Tung, E.E., Thomas, M.R. Use of a Geriatric Home Visit Experience to Teach Medical Students the Functional Status Assessment. J GEN INTERN MED 24, 244–246 (2009). https://doi.org/10.1007/s11606-008-0853-0
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DOI: https://doi.org/10.1007/s11606-008-0853-0