Bridging the Gap: A Competency Framework for Hospital Doctors Caring for Older Adults

Abstract

Abstract Background Our ageing population has resulted in an increasing number of older adults requiring healthcare services. This growing demand within a population of varying needs requires that all hospital doctors, regardless of specialty, possess fundamental Geriatric Medicine competencies. However, a consensus on these competencies is lacking with no overarching competency framework available. We aimed to address this gap by synthesising a competency framework for all hospital doctors caring for older adults. Methods Our first step involved a comprehensive scoping review of international literature identifying the proposed competencies for hospital doctors caring for older adults. These findings were validated and expanded through a national group concept mapping study inviting multiple stakeholders. An iterative process refined the identified competencies, categorising them into domains, and synthesising a final competency framework using Microsoft Excel. Results This study synthesised 110 Geriatric medicine competencies within seventeen competency domains. The scoping review highlighted medication, cognitive, and chronic disease management and the group concept mapping identified interpersonal communication, medicolegal, and delirium management as most critical. The iterative process further refined the framework, emphasising competencies pertaining to cognitive impairment, depression, falls, and acute inpatient management of older adults. Conclusion This synthesis highlights the broad range of competencies necessary for effective care of older adults by all hospital doctors. The identified competencies reflect the heterogeneous nature of the older adult population, encompassing both fundamental but also specialised skills. Further research is now essential to determine the optimal educational interventions for ensuring all hospital doctors are equipped with these essential competencies.