Gerontological Competence Research Articles

2251 Geriatric medicine competencies required by all hospital doctors caring for older adults: a scoping review

Abstract Introduction An ageing population globally has created an escalating demand for age-attuned healthcare services. Most older adults will continue to receive their medical care from doctors without specialised geriatric medicine training. It is important therefore that all doctors possess fundamental gerontological competencies. Which specific competencies and how they might best be integrated into medical education remain unclear. Our aim was to summarise the literature on the geriatric medical competencies required by all doctors caring for older adults. Methods We undertook a scoping review following Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR). We systematically searched the electronic databases PubMed, Cochrane, Cinahl, PsycInfo, ERIC and Embase for eligible records from January 2012 to December 2022. Studies related to physician or doctor or resident and competencies or curriculum or education and geriatric medicine or gerontology were included. We also searched the websites of included countries’ medical specialty professional bodies for relevant competency frameworks. Results Eighty-seven sources were included in the review. The most common competencies identified were medication management, recognition and management of cognitive impairment and management of chronic disease and co-morbidities. Considerable heterogeneity existed among the remaining competencies identified including interprofessional communication skills, advanced care planning and discharge planning. Competencies addressing subspecialty areas including stroke, orthogeriatrics, movement disorders were less prominent. Conclusion Multiple attempts to create and implement competency frameworks on local, national, and international levels in addition to educational interventions to address competency gaps locally reflect the wide-ranging challenges faced by healthcare systems in caring for an ageing population. Significant variation in competencies exists among the sources included in this scoping review. An overarching competency framework is now necessary to define the required competencies for all hospital doctors caring for older adults.

THE VALUE OF INTERNSHIPS IN CREATING AN AGE-SAVVY WORKFORCE

Abstract As the 65+ population continues to grow, so too does the need for an age-savvy workforce. There is not a field or profession that will not intersect in some way with older adults (Karasik, Donorfio, & Greenberg, 2023). Current work shortages and forecasts, however, raise considerable concern for a sustainable and adequately prepared workforce. With regard to preparation, gerontological field placements, internships, and practicums are becoming increasingly instrumental to workforce development. Both the Gerontology Competencies for Undergraduate and Graduate Education (2020) and AGHE’s Gerontology and Geriatric Curricular Standards and Guidelines (2021) strongly recommend internship, practicum, and/or field work experiences for students at all levels. Fostering a successful intergenerational experience, however, can be challenging. In this presentation, key components, core elements, necessary steps, best practices and logistical considerations will be discussed. For example, who are the key players and what are their roles in such experiences? What needs to happen at the programmatic and curricular levels? In addition to exploring the various facets of gerontological field placements, attention will be given to utilizing AGHE’s Standards and Guidelines and Gerontology Competencies to help identify several “interactional competencies” that relate to internships, practicums, and field experiences. This session also serves as an introduction to the range of perspectives (student, faculty, community agency) that follow.

347 Competency frameworks for non-geriatric medicine physicians caring for older adults: a scoping review

Abstract Background The scale of our ageing demographic is such that specialist geriatric medicine services are unable to keep pace with the growing demand. An exclusive reliance on geriatricians to treat older adults is not always appropriate as their care may necessitate the involvement of other specialties. Consequently, many of the interactions with frail older adults will be carried out by professionals who have not received specialised training in gerontological principles. There is an urgent requirement to ensure that all physicians are trained in the competencies to care for older adults. We aimed to summarise the available literature on the competencies required by non-geriatric medicine physicians caring for older adults. Methods We undertook a scoping review following Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR) as a guide. We systematically searched the electronic databases PubMed, Cochrane, Cinahl, PsycInfo, ERIC and Embase for eligible records from January 2012 to December 2022. Studies related to physician or doctor or resident and competencies or curriculum or education or entrustable professional activities and geriatric medicine or gerontology were included. Results We identified 5,177 records. Four hundred and forty-six full texts were screened for eligibility. Thirty sources of evidence were included in the review. Most studies were from the United States and used quantitative methods. Competency frameworks primarily focused on internal medicine trainees with few targeting other specialties. Seventeen cited the purpose as addressing a specific competency. The most common competencies explored related to medication management, palliative care and cognitive impairment followed by bone health, transitions of care and falls and syncope. Conclusion Many frameworks attempt to outline gerontological competencies for specific specialties. However it is evident that a dedicated competency framework is necessary to define the required competencies for all non-geriatric medicine physicians caring for older adults.

An environmental scan of aging-related micro-credentials: implications for gerontology and gerontologists

ABSTRACT The purpose and rise of formal academic programs in gerontology at colleges and universities has been well documented over the last fifty years. What has been less well-documented is the rise of alternative pathways to gerontology training and gerontological competence, including micro-credentialing. Micro-credentials (MCs) are intended to provide quick-to-complete, competency-based education around specific topics to demonstrate relevant skills to employers. Little is known about the prevalence of micro-credentialing related to gerontology. To address this gap, we conducted an environmental scan of existing aging-related micro-credentialing opportunities. We identified 89 MCs with an explicit aging focus, applied strict inclusion criteria (narrowing the sample to 54 MCs included in the analysis), and examined the characteristics of the MCs’ scope and nature. Most MCs focused on aging-related health/disease conditions, highlighting the decline mentality underlies such training. Future efforts should entail analysis of the competencies addressed by MCs as it is critical to ensure alignment between gerontological MCs and established gerontological competencies and standards and to differentiate MCs from formal academic programs.

Older adults who prefer aging in place and corresponding challenges to social workers: the impact of smartphone-based interventions

ABSTRACT This paper reports a study on the impact of a smartphone meditation app (M-App) in building resilience and competencies among social workers with aging in place (AIP) initiatives. Compared to a control group who used the leisure app (L-App), M-App users reported greater resilience and gerontological social work competencies 6 months posttest (T2). Women social workers, Christians, who specialized in home-based care, and whose core clientele comprised older adults with acquired disability and long-term illness, reported greater resilience at T2. Women social workers and those who specialized in home-based care exhibited greater gerontological competencies at T2. Disciplined M-App usage and self-practice mediated the association between socio-demographic moderators and outcomes. Clients of women and Christian social workers, home-based care specialists and those who diligently adhered to the intervention reported higher satisfaction. The interesting finding was that this satisfaction was reported by Christian clients and those who lived with family members as compared to Hindu and Muslim clients and those who lived alone with formal caregivers. For gerontological social workers with AIP initiatives, the M-App could be used in a continuing education training with some refinements for men, non-Christian social workers and engaged in AIP programs through community and neighborhood support practice.

Teaching Gerontology in Transcultural Academics: A Phenomenographic Study of Thai and Swedish Nurse Educators' Conceptions of Gerontological Nursing.

Introduction:There is an urgent need for registered nurses with gerontological competence within long-term care (LTC) of older adults. Despite increases of life expectancy, LTC for older adults is not emphasized in nursing curricula in neither Sweden nor Thailand. Thus, the aim was to explore conceptions on gerontological nursing (GN) among Swedish and Thai nurse educators.Method:A qualitative phenomenographic method, based on open-ended interviews with five Thai and nine Swedish nurse educators was conducted.Results:The results indicate a paradox between the educators’ knowledge about the implications of global aging, their hope of own aging, and LTC. The ethical responsibility of being credible and a source of inspiration in teaching about aging are focused, while GN seem to be less important.Discussion:To increase students’ interest in GN, measures need to be taken within the educational arenas, where the educators’ own conceptions toward GN, cultural aspects of aging, and LTC are discussed.

Social Challenges and Social Gerontology Competencies

The trend toward an aging population observed in Slovenia is one of the major problems as in other developed countries within the European Union. The goal of the paper was to analyse the state of the art of the field, and suggest a potential set of variables for measurement instruments with appropriate Social Gerontology (SG) competencies for educational programs. Using the mixed method approach, the aim of the paper was to observe and suggest the most (1) needed, (2) desired, and (3) obtained SG competencies for Higher Education Institutions. The results of analysis and measurements indicate how the opinion of our respondents intersects with 40 national factors recognized by gerontological social workers. We than categorized geathered data into ten factors, which represent potential set of variables for a new measurement instrument, showing frequencies that are proportional to the importance perceived by our respondents. Our preliminary research questions are: (1) Which (social and non-social) competencies are included in existing study programmes in Slovenia? (2) Which competencies are recognized by experienced workers as most important for enabling (future) students to effectively work with the elderly?

Alternative Pathways: The Use Of Field-Specific Micro-Credentials in Aging Services

The rise of formal academic programs in gerontology at colleges and universities has been well documented over the last fifty years. Organizations such as AGHE and AGEC have been established to provide guidance, foster consistency, and advance formal gerontology education programs. Broadly, the purpose of these programs has been to develop a pipeline of trained gerontologists for the aging services workforce. What has been less documented is the rise of alternative pathways to gerontology and gerontological competence, including micro-credentialing. Micro-credentials are intended to provide quick-to-complete competency-based education around specific topics to demonstrate relevant skills to employers. To date, little is known about the prevalence of micro-credentialing in gerontology. Still, it may be that micro-credentials are sought in place of formal academic preparation due to their reduced cost, ease of completion, recognizability, and opportunity to quickly train employees in specific skills. To address this gap, we conducted a review of existing gerontological micro-credentialing opportunities. We identified a total of 51 micro-credentials with an explicit aging-focus and searched for associated competencies for these micro-credentials. In this poster, we describe findings on the emphases of micro-credentials, including dementia and care coordination, and review the programs' scope and nature of competencies. We argue that micro-credentialing can offer value for employees unable or unwilling to pursue formal academic training but should be differentiated from such training. Moving forward, it is critical to ensure alignment between gerontological micro-credentials and established gerontological competencies and standards and to differentiate micro-credentials from formal academic programs.

ESPO and Academy for Gerontology in Higher Education Section Symposium: A New Normal in Teaching? Incorporating Unconventional and Creative Ideas Into Gerontology Curriculum

This symposium is intended to highlight novel, applied examples and classroom activities in gerontology curriculum. In accordance with the AGHE gerontological education competencies, these authors will provide insightful and fun connections to arts/humanities, popular culture, technology, and current events to inspire conversation, interest, self-reflection, and empathy in the classroom. The first author will discuss social media (e.g., TikTok) as a segue to difficult classroom conversations regarding negative stereotypes and ageism in society. Presenter two will discuss cross-field educational connections between music education and gerontology. Next, presenter three will put present a unique activity regarding technology, homeownership, and retirement with a competitive flair. Presenter four utilizes documentary to encourage empathy in nursing. Finally, presenter five will present a timely class debate regarding United States political office and ageism that is sure to create lively and relevant conversation.

(Re)Introducing the Gerontology and Geriatrics Curricular Standards and Guidelines in Higher Education

The lecture will be given by the 2020 recipient, Sara Czaja, PhD, FGSA of Weill Cornell Medicine. The 2021 M. Powell Lawton Award recipient is David Roth, Phd, FGSA, of Johns Hopkins University. The M. Powell Lawton Award is presented annually to an individual who has made outstanding contributions from applied research that has benefited older people and their care. The Lawton Award is generously funded by the Polisher Research Institute of Abramson Senior Care.

(Re)Introducing the Gerontology and Geriatrics Curricular Standards and Guidelines in Higher Education

The Academy for Gerontology in Higher Education (AGHE), the education member group of GSA, is the only national institutional membership organization devoted primarily to gerontology and geriatrics education. Its mission provides for development and sponsorship of initiatives to advance the field of aging through its focus on education in gerontology/geriatrics. AGHE first published the Gerontology and Geriatrics Curricular Standards over three decades ago – a document that has been an integral resource for implementing/revising programs in liberal arts, the sciences, and more recently, health professions. To meet the needs in the field for increased breadth and depth of content, the new 7th edition of the educational guidelines fully embraces competency-based education for gerontology, as the health professions programs have for years. Our first presenter will provide an overview of the new edition. The second presenter will focus on associate degree programs in gerontology and their unique contribution to higher education. The third will present on undergraduate programs in gerontology explaining how these programs give students an edge in today’s job market. The fourth presenter will address graduate programs in gerontology, describing master’s degree programs and doctoral degree programs in gerontology and aging studies. The fifth presenter will discuss health professions programs including geriatrics curricula for osteopathic medical education, gerontology/geriatrics curricula for health-related programs and the doctor of pharmacy degree programs. Presentations will provide expert recommendations for program development through mapping AGHE’s Gerontology Competencies for Undergraduate and Graduate Education to programs in higher education. Nina Silverstein will serve as discussant.

Standards and Guidelines for a New Decade

As the field evolved, so too, has the Gerontology and Geriatrics Curricular Standards and Guidelines in Higher Education. The 7th edition is focused on the integration of the highly vetted AGHE Gerontology Competencies for Undergraduate and Graduate Education. Through this work we establish a set of standards and guidelines that provides the foundation for excellence in gerontology and health professions education at various levels and across a range of programs in the US and globally. The document provide a model for institutions of higher education in the development of new programs, a basis for program assessment and evaluation, guidance for academic or institutional reviews in existing programs, and a platform for what constitutes a program of study in gerontology/geriatrics or health professions programs for students, the public, and employers. An overview of the development of the 7th edition and suggestions for its use will be provided.

Bachelor programs in gerontology offered in Mexico: An analysis from the perspective of the competencies recommended by the Academy for Gerontology in Higher Education

ABSTRACT Gerontology programs in higher education are needed and offered all around the world. In the past two decades, in Mexico there has been a rapid spread of bachelor programs in gerontology, and the number of programs continues to increase. The aim of this paper is to analyze the orientation of the bachelor programs in gerontology offered in Mexico from the perspective of the competencies suggested by the Academy for Gerontology in Higher Education (AGHE) for bachelor programs in gerontology. Seventeen bachelor programs in gerontology officially recognized by the Secretary of Public Education were analyzed, their curricula were classified into the categories and domains of the gerontology competencies recommended by the AGHE. As a result, it was found that programs were mainly oriented to contextual competencies across fields of gerontology, specifically in domains related to health, mental health, social health, and well-being. The understanding of gerontology as a broader scientific field, the need for recognition of the gerontologist as a professional, and the relevance of education in the field of gerontology is discussed.

Values, Ethics and Theoretical Perspectives of the Hartford Social Competency Scale-II: Factorial Structure and Reliability of a Portuguese Version

Abstract Social work practice with the older population demands assessing gerontological competencies, for which values and ethics are central. This study aimed to test the adjustment of the Portuguese version of the Hartford Geriatric Social Work Competency Scale II subscale—values, ethics and theoretical perspectives (GSWCS-II-VEPT) to a bifactor structure and to analyse its reliability in a sample of social workers. The study enrolled 534 social workers employed in older adults’ care organisations. The confirmatory factorial analysis showed that the items presented factorial loads more than 0.60, and the bifactorial component model fitted well with the data. The two components consisted of ‘nuclear competencies’ and ‘specialised skills’. The GSWCS-II-VEPT presented excellent reliability (Cronbach’s α = 0.90). However, high interfactor correlations demanded the test of a single-factor solution. The single-factor model did not fit the data as well as the two-factor solution, and the Akaike information criterion value was smaller in the two-factor model, indicating a superior fit. The results support adequate psychometric properties of GSWCS-II-VEPT in evaluating ethical skills, values and theoretical perspectives in Portuguese social workers and can be used as a tool for self-evaluation of these professionals’ ethical behaviour.

Incorporating Guided Autobiography, Portfolios, and SoulCollage Into Undergraduate Gerontology Courses

Although undergraduates don’t eagerly choose gerontology classes first, a hefty number of students have enjoyed content they have explored as they were enrolled in “Aging and Spirituality” and “Therapeutic Arts with Older Adults” courses. The ten universal life themes that help people tell their stories, through the empirically validated methodology of Guided Autobiography (GAB) are incorporated in classes designed for an inter-generational group (older adults and students). Student assembled portfolios created from activities connected to ‘the arts’ and spiritual literacy have enhanced the acquisition of gerontological competencies. Also, through the use of SoulCollage® (developed in the late 1980s by Seena B. Frost, M. Div.) students of all ages, with and without artistic abilities, use a creative collaging process to get in touch with their ego integrity—the eighth stage of development conceptualized by Erik Erikson. Over three years, students have grown in their knowledge of aging and artistic processes.

77 Developing and Testing An Education-Career Pathway in Healthcare for Older People (ECHO) to Promote Retention in Early-Career Gerontological Nurses

Abstract Background The NHS Long Term Plan (2019) sets specific targets for multidisciplinary services for frail older people over the next ten years. Delivery and sustainability is crucially dependant on the capability and capacity of gerontological nursing. High cost cities such as London experience high staff vacancy rates in acute care older adult services. Aim The study took a regional approach, working with NHS Trusts to develop a multicomponent intervention to increase retention and competencies of early career nurses working in gerontological services. The study examined the acceptability and feasibility of the intervention and tested a quasi-experiential evaluation design. Ethical approval was obtained from the University Ethics committee. Methods A co-design approach with stakeholders, early career nurses, educationalists and nurse managers, produced a multicomponent intervention: education module (masters level), gerontological competency booklet, external clinical learning opportunities, career coaching and mentorship delivered over a six-month period. The evaluation involved a mix-methods pre-post survey and focus group interviews. Results Twenty-nine early career nurses were recruited from five Trusts. The multicomponent intervention was well received, but there were difficulties facilitating external learning opportunities and providing career mentors. The primary outcome was intention to remain in gerontological nursing (measured using a point Likert scale). Pre-post the intervention this remained high (mean score 6 IQR 5-7), p=0.78. There was a significant increase in gerontological knowledge: at baseline the median score was 87 (IQR 81-102) compared to 107 (IQR 98-112) post-intervention, p=0.006. In focus groups participants identified three main mechanism of action for ECHO: building gerontological knowledge and skills; professional identity as older adult nurse; and networking to broaden horizons. Conclusions The study has demonstrated the potential of Trusts to work collaboratively with education providers to deliver a model of career-education pathway that may help attract and retain early career nurses to work in gerontology.

PRESIDENTIAL SYMPOSIUM: EDUCATION NETWORKS: STRENGTHENING GERONTOLOGY AND GERIATRICS THROUGH CONNECTIVITY

The AGHE Presidential Symposium, related to the theme of the annual scientific meeting, underscores the importance of networks, collaborations and partnerships in advancing education in gerontology and geriatrics. AGHE has been at the forefront of many innovative programs since it was founded in 1974, contributing to the growth of the field and the recognition of education as one pillar of the field of gerontology and geriatrics, along with research, policy and practice. This symposium highlights three ongoing initiatives that promote connections and collaborations. The first paper discusses the Age-Friendly University (AFU) network which is made of institutions around the globe who have committed themselves to becoming more age-friendly in their programs and policies. AGHE endorses the AFU principles and invites its members and affiliates to call upon their institutions become part of this pioneering initiative. The AFU initiative is one of several international activities that AGHE, global leaders in education on aging, has engaged in. The second paper describes international networking activities such as collaborations with international organizations including the World Health Organization and connecting international and US students. In the third paper, initiatives to connect disciplines and professions through competency-based education and curricula are discussed. For instance, the Gerontology Competencies for Undergraduate and Graduate Education and the Program of Merit promote competency-based gerontology education across disciplines and professions.

ASSESSMENT OF THE AGEC STANDARD DEMONSTRATING STUDENT LEARNING

Addressing the gerontology program’s experience in measuring and integrating the competencies in their curricula is a fundamental challenge in program evaluation. Using the AGHE Gerontology Competencies for Undergraduate and Graduate Education is the key. We will demonstrate how one identifies the learning outcome measures across the curriculum based on the competencies by adumbrating a four-step process. First, it entails developing a written statement of the key learning outcomes, expressing them in objective, measurable terms. Second, the learning outcomes are assessed. Third, the results of the assessments are posted in a matrix format across a four or five year period. Fourth, the results of the learning outcome assessments are discussed, evaluated, and implemented in a formative process to improve teaching and learning. In addition, the results can be applied in a summative way to evaluate and improve the gerontology program.

AGHE PROGRAM OF MERIT: GERONTOLOGY DEGREE PROGRAMS, MINORS, AND CERTIFICATES

The Executive Committee of the Academy for Gerontology in Higher Education (AGHE), formerly known as the Association for Gerontology in Higher Education, approved a proposal to establish and implement a voluntary program of evaluation known as the Program of Merit (POM). The POM designation provides gerontology programs with an AGHE “stamp of approval,” which can be used to verify program quality to administrators, to lobby for additional resources to maintain a quality program, to market the program, and to recruit prospective students into the program. In 2014, AGHE Gerontology Competencies for Undergraduate and Graduate Education© were established and have been integrated into this process. This session will outline the Program of Merit process and present the opportunities for gerontology program leaders to advance gerontology education.

ASSESSING AT-RISK OLDER ADULTS THROUGH THE RAPID GERIATRIC ASSESSMENT

With the need to increase gerontological competency among all health/social service professions, the Rapid Geriatric Assessment (RGA) (Morley, 2017) is a tool that can be used in most healthcare settings. Designed as a rapid screening, the validated RGA assesses frailty, sarcopenia, anorexia, cognitive function, and advance care planning. Developed in 2015 through the Geriatric Workforce Enhancement Program (GWEP), 3,489 students and 5,643 faculty and practitioners have been trained in its use and have completed 10,881 RGAs in case-finding, screening, nursing home, PACE, and hospital and residential settings. Non-population-based findings show higher-then-national prevalence in all four health condition areas across settings: frailty (n=3,140; 30%), sarcopenia (n=4,458; 42.1%), weight loss risk (n=3,012; 28.4%), and cognitive impairment (n=2,509; 23.7%). Only 34.8% of the total sample had completed advance care plans. Data comparing results by gender, age, race/ethnicity, and setting will be presented along with strategies for curricular and practice integration.