Teaching Frailty to Medical Residents: A Needs Assessment Among Geriatrics Faculty.

Abstract

Knowledge of frailty is essential for meeting the Accreditation Council for Graduate Medical Education core competencies for US trainees. The UK General Medical Council requires that frailty be included in undergraduate and graduate medical education curricula. Trainees are expected to appropriately modify care plans and help make patient-centered decisions, while incorporating diagnostic uncertainty, such as frailty, in older adults. Little is known about current needs for frailty instruction in graduate medical education in the US and beyond. We sought to capture faculty perceptions on how frailty should be defined and identified, and what aspects and level of detail should be taught to residents. The authors developed a 4-item short response questionnaire, and faculty had the option to respond via electronic survey or via semi-structured interviews. Respondents included 24 fellowship-trained geriatricians based at 6 different academic medical centers in a single urban metropolitan area. An invitation to participate in either an electronic survey or semi-structured virtual interview was e-mailed to 30 geriatricians affiliated with an academic multi-campus Geriatric Medicine fellowship. Responses were transcribed and coded independently by two authors. Responses were received from 24 geriatricians via a combination of digital questionnaires (n=18) and semi-structured online interviews (n=6), for a response rate of 80%. Responses revealed significant diversity of opinion on how to define and identify frailty and how these concepts should be taught. As frailty is increasingly incorporated into clinical practice, consensus is needed on how to define and teach frailty to residents.