TEACHING PSYCHIATRY RESIDENTS TO RECOGNIZE AND RESPOND TO ELDER ABUSE THROUGH A STANDARDIZED PATIENT ENCOUNTER

Abstract

Introduction It is estimated that 10% of older adults in the United States experience elder abuse. There are several types of elder abuse, including physical abuse, financial abuse, and neglect. One form of neglect, self-neglect, accounts for over 40% of elder abuse cases reported to Adult Protective Services. Studies on elder abuse have highlighted the need to train physicians in the detection and reporting of abuse in the older adult population. Methods We piloted an elder abuse training with PGY-3 and PGY-4 general psychiatry residents at Baylor College of Medicine. The residents were emailed two PowerPoint presentations; the first was an introduction to elder abuse and the second focused on capacity assessment of financial decision-making in older adults. One week after receiving the training materials, the residents participated in a standardized patient (SP) encounter. The case featured a 75-year-old individual presenting with signs of self-neglect, including weight loss and poor medication adherence. The older adult was accompanied by a neighbor who was present during the encounter. The residents were paired, with one playing the role of a psychiatrist and the other playing the role of a social worker. The residents completed a knowledge assessment prior to the encounter and a post-encounter evaluation. Results 18 resident physicians participated in the encounter. On average, participants agreed or strongly agreed that identifying and reporting elder abuse were important aspects of their roles as psychiatrists, but were less confident in their abilities to recognize the signs of elder abuse based on physical examination and psychological presentation. In the post-encounter survey, 72% of participants felt that the SP encounter enhanced their ability to detect and report elder abuse. There was a significant improvement in self-reported comfort with performing these skills after completing the encounter (p = 0.01). Conclusions SP encounters can effectively teach the detection of elder abuse and increase learners’ confidence in their skills. Using feedback from this pilot study, future SP scenarios can be expanded to other groups of medical learners, including medical students. This research was funded by: This work was funded by the Norton Rose Fulbright Educational Grant Fund of the Academy of Distinguished Educators at Baylor College of Medicine.