Pressure Ulcer Education: A Pilot Study of the Knowledge and Clinical Confidence of Geriatric Fellows

Abstract

To assess the educational experiences of geriatric fellows on the subject of pressure ulcers and to begin validation of a survey that assesses pressure ulcer content knowledge of physicians in training. Pilot study using a prospective survey. 42 geriatric fellows in New York State. Likert scale ranking for self-reported feeling of preparation to manage geriatric patients with pressure ulcers and to teach other clinicians about the subject; knowledge test scores using a multiple choice, single-best-answer format. Geriatric fellows in New York State who participated in the survey felt "adequately" prepared to lead a team and teach about pressure ulcers. Sixty-nine percent reported having teaching responsibilities. Sources of information included bedside rounds (79%), nurses (71%) lectures (67%), textbooks (67%), and geriatric attendings (60%). Educational settings were nursing homes (86%) and hospital units (64%). Forty-eight percent of geriatric fellows surveyed correctly identified the Braden Scale as a screening tool. Sixty-seven percent identified a description of a Stage I pressure ulcer and 52% identified a description of a Stage IV pressure ulcer. The mean score on the knowledge test for the cohort was 58 +/- 18% (SD) correct (range, 20% to 80%); the range for the fellowship programs was 36% to 62% correct. Geriatric fellows need to improve their knowledge and confidence with regard to pressure ulcer care to become competent as clinicians and educators for this condition. Specific curricular guidelines and a validated knowledge assessment instrument on pressure ulcers are needed to improve the educational effectiveness of a geriatrics fellowship.