Gerontology Course Research Articles

SERVICE LEARNING AS A MEANS TO ENHANCE CONNECTIONS TO OLDER ADULTS

Aging is a distinct part of the life cycle. College students enrolled in courses in gerontology often have difficulty relating to aging, that part of life not yet experienced. They may not fully appreciate that adults become more unique, not more similar, as they age. We describe courses in an undergraduate gerontology certificate program that incorporate experiential learning activities with older adults across a hierarchical sequence of courses. These courses feature service learning opportunities focused on increased understanding of course content, broader appreciation of the discipline and improved sense of civic responsibility. Much like the course content of the curriculum, the incorporated experiential learning opportunities for each course level fit a hierarchy leading to student competence and skills development needed for success in the final independent practicum. For the described courses, students provided community service, experienced direct contact with older adults and used reflective practices to integrate course content into service learning activities. We report on qualitative data obtained from students enrolled in the foundational course, Biophysical Aspects of Aging and the third level course, Aging and Mental Health. Content analyses of reflective essays identified five themes: (a) insights about the realities of aging in America (b) perceptions concerning personal negative stereotypes about older adults; (c) feelings of accomplishment/awareness of new skills in providing community services; (d) understandings related to the importance/value of community service; and (e) successes in integrating the course work on aging into service-learning experiences. Other experiential learning activities incorporated into this gerontology certificate program are highlighted.

OVERVIEW: THE VA GERIATRIC SCHOLARS PROGRAM FOR PRIMARY CARE WORKFORCE DEVELOPMENT

The VA has invested in developing the skills of its primary care workforce through the longitudinal Geriatric Scholars Program. The program consists of core components --- intensive course in geriatrics, intensive workshop in quality improvement (QI) and initiation of a micro QI projects in the Scholar’s clinic; electives allow learners to tailor the program to self-identified gaps in knowledge, skills and competencies. The program has demonstrated direct impacts of continuing education through a workforce development process that enhances skills and competencies at a pace and selection that meets clinicians’ self-identified gaps in training. Now in its 11th year, the program has been shown to increase career satisfaction and job retention, standardize provider behaviors, improve clinical decision-making and reduce dispensing of potentially inappropriate medications. This symposium further explores the impact of the program on individual clinicians and on clinical teams.

GRECCS AS A NETWORK TO ENHANCE THE VA PRIMARY CARE WORKFORCE

The VA Geriatric Scholars Program is a workforce development program to integrate geriatrics into primary care in all VA clinics. The program has increased career satisfaction among clinicians, improved quality of care for aging Veterans, changed provider prescribing behaviors and improved patient outcomes. The core curriculum is an intensive course in geriatrics, an intensive workshop in quality improvement (QI) and a micro QI project to demonstrate application of new knowledge to local needs of patients and clinic processes; this is a longitudinal program and alumni continue to develop skills over time through a series of elective activities that tailor learning to self-identified gaps in career development and training. The program is a collaboration among the Geriatric Research Education and Clinical Centers (GRECC), centers of excellence that have been leveraged to create a network of expertise and creativity to develop the core and elective educational activities. This symposium focuses on recent outcomes of three educational components that improve quality of care for older Veterans. The Palo Alto GRECC developed an intensive course in gerontological psychology to enhance the skills and competencies of psychologists leading to greater job effectiveness. The Bronx GRECC developed an interdisciplinary training program for all clinical and non-clinical staff in rural clinics, leading to improved recognition of functional and safety concerns among older veterans. The Tennessee Valley GRECC developed the core QI component and many of these micro-QI projects have been sustained, spread or recognized by VA as Promising Practices.

TWO STEPS FORWARD AND THREE STEPS BACK: STUDENTS’ PERSPECTIVES ON LIVING AND WORKING WITHIN AN AGING SOCIETY

Each day, 10,000 Americans celebrate a 65th birthday, but there are still many young adults not choosing to enter a field that focuses on working with the older population. As part of a continued effort to understand low enrollments in a minor in aging studies and a graduate certificate program in gerontology, focus groups were held with students to explore why they are not choosing to learn more about one of the fastest growing sectors of the U.S. population. A total of 21 students participated in two focus groups. Students’ majors varied but included social work, public health, nursing and communications. All of the students were between the ages of 18 and 22 except for one student who was 68 years old. Only 6 students had taken an aging class, but every student indicated that they were close to a family member, 60 years old or older. Two researchers coded and analyzed the focus group data for themes. Examples of the themes about older adults included being unwilling to change, having negative views toward millennials, and being hampered by technology. Themes relative to student perspectives included needing empathy and patience to work with older adults, assuming decline and lacking opportunities within their majors to take gerontology courses. Comparing views and perspectives of older adults decades ago by traditional college-aged students to current day perspectives resulting from this data will be discussed as well as successful strategies for increasing enrollments in gerontology programs.

USING AN INTERGENERATIONAL RELATIONSHIP TEACHING STRATEGY AND REFLECTION IN ON-GROUND AND ONLINE COURSES

Contact or experiences with older adults by college-level students is varied in nature and duration but is often reported as minimal and negative. By pairing groups from different generations, these relationships may influence established attitudes, beliefs, and behaviors of the groups. Research has shown that intergenerational relationships between older adults and college students through interviews within gerontology courses may influence college students’ views on aging and older adults towards the more positive. Specific steps in the development of an intergenerational relationship teaching strategy begin with locating an elder to interview and guidance for how relationship development can change from beginning to end. Role play may help prepare for first interview. Interview questions correspond to course content. Reflections are represented via discussion board if online, and group process forums if on-ground. Intergenerational relationship strategies can be flexible in the amount of contact time with the elder and the student. Reflection strategies can be utilized in several ways: discussion board, journal entries, presentations to classmates, and a culminating paper/PowerPoint. The opportunity for students to tell stories of their own past experiences, relationships with their elders, care and concerns for their elders, and how personal views about older adults and aging may be changing supports the effectiveness of this teaching strategy. Further research into the amount of time needed for effective intergenerational relationship development between student and elder may assist in course planning. Need clearer understanding of the benefits for the elder mentors and if their views about young people have been altered.

PHYSICAL THERAPY STUDENTS' ATTITUDES TOWARDS WORKING WITH PEOPLE WITH DEMENTIA AFTER VARIOUS LEARNING EXPERIENCES

Working with people with dementia (PWD) can be challenging even for the most seasoned health professionals. Hence, teaching health professional students how to effectively work with this patient population is of importance. Two cohorts (n=43; aged 23-36 years) of Graduate Physical Therapy students participated in multi-modal learning experiences geared towards working with PWD within a geriatrics course. Modules included: 1) online lectures and readings followed by a team based learning activity, 2) 3 hours of ‘positive approaches to care’ along with a simulated experience of performing Activities of Daily living and Instrumental Activities of Daily Living of PWD, and 3) one-on-one interactions during both lunch and dinnertime with at least three PWD residing in a state veteran’s home. The Dementia Attitudes Scale (DAS) was used to measure attitudes of students at baseline and following each activity. Repeated measures analysis of variance revealed a significant increase in positive attitudes of students working with PWD across each activity (98.2 +/- 10.5 baseline) with the most positive attitudes noted after interactions with PWD in a state veteran’s home (111.2 +/- 15.0), [F (2.0, 83.8) = 19.4, p < .01, partial eta^2 = .32]. However, this difference was not significant when controlling for students who had previous experience interacting with PWD . In conclusion, Doctor of Physical Therapy students’ attitudes towards PWD improve with different learning experiences, with the greatest improvements after one on one interactions with PWD if the student did not have prior experience interacting with PWD.

MINORITY AGING BEYOND THE CLASSROOM

Service-learning is the pedagogical approach of integrating classroom learning objectives with community-based experiences. In gerontology education, service-learning is one way educators can collaborate with their respective communities to expose students to topics in minority aging. This paper presentation describes students’ experiences in a service-learning gerontological social work course embedded in a university-community partnership that took students beyond the classroom and into the community to learn about minority aging. In-classroom topics included social injustices in aging, caregiving in African American families, culturally-tailored caregiving interventions, and health disparities. In the community, students conducted in-home visits engaging persons with dementia in a tailored activities, thus freeing caregivers to engage in self-care activities. Classroom and community experiences were connected through ongoing reflection, critical thinking, and problem solving activities. Survey data revealed students experienced increased gerontological self-efficacy and increased knowledge and attitudes about dementia. This study has implications for future course design around minority aging.

MIGC 2019 SYMPOSIUM: STRENGTH IN CREATING DIVERSIFIED SPACES IN EDUCATION AND RESEARCH ON AGING

Populations of minority older adults will continue to increase at an accelerated pace in the coming decades. As such, it is increasingly important to disseminate minority aging education and research topics in spaces that will prepare gerontology scholars to address the needs of diverse elders. This symposium will highlight efforts to diversify academic spaces by scholars engaged in minority aging education and research. The first presentation describes a service-learning pedagogical approach to teaching minority aging topics to graduate students. It will discuss how a gerontological social work course seeks to offer real-world learning experiences through community partnership. The second presentation discusses an experiential learning pedagogical approach to teaching social determinants of health to graduate students at a historically Black university and highlights how to apply theoretical concepts to creating community needs assessments and health promotion programming for the local community. The third presentation discusses efforts to teach undergraduate students about older LGBT individuals, who represent a growing group of minority elders. This presentation advocates for the use of various strategies for integrating both research and pedagogical approaches to increase knowledge and awareness of LGBT aging topics. The last presentation focuses on the promotion and dissemination of scholarship produced at minority-serving institutions (MSI) through the creation of a new open-source journal. This presentation describes publication challenges for tenure-track MSI faculty and developed opportunities for inclusiveness of such scholarship. The symposium discussant will summarize these challenges, opportunities, and implications to promote minority-focused gerontological topics in academia.

Creating a Gerontological Nursing Digital Repository Within a Learning Management System.

Faculty who teach gerontological nursing are challenged to deliver competency-based baccalaureate nursing education. Because our courses are divided into multiple sections and taught by a variety of faculty, the need for a peer-reviewed, curated repository of gerontological learning materials was conceived. Syllabi for prelicensure and RN-to-baccalaureate nursing (BSN) degree gerontological courses were reviewed. Stufflebeam's Content, Input, Process and Product (CIPP) model of program evaluation provided a framework to guide the process of identifying existing resources and gaps in eLearning materials. Using the Learning Object Review Instrument, faculty determined the relevance and applicability of eLearning materials. A crosswalk between the syllabi and the American Association of Colleges of Nursing-recommended geriatric nursing competencies was completed to evaluate eLearning materials identified as valuable. Consensus was reached, and content was placed in the learning management system. This project can serve as a model for other course faculty and faculty in other specialty areas to enhance the curriculum by providing readily available, multifaceted instructional resources. [J Nurs Educ. 2019;58(10):607-610.].

Capacitação, conhecimentos e crenças de médicos da Atenção Primária à Saúde relacionados ao envelhecimento

O aumento da população idosa, com os complexos problemas de saúde que a envolvem, evidencia a necessidade do uso da Atenção Primária à Saúde (APS), que deve ser a porta de entrada para a atenção à saúde dos idosos. Espera-se que a APS exerça ações curativas e, principalmente, de prevenção e promoção à saúde para este grupo etário. O objetivo deste estudo foi avaliar, em 49 médicos que atuam na APS de Anápolis, estado de Goiás, a formação profissional na área do envelhecimento, os conhecimentos básicos sobre a velhice e as crenças relacionadas aos idosos. Foram aplicados os seguintes questionários: formação acadêmica na área do envelhecimento; Questionário Palmore-Neri-Cachioni, a fim de avaliar os conhecimentos básicos sobre a velhice; e Escala de Neri, para verificar as crenças relacionadas aos idosos. Os médicos mostraram carecer de formação acadêmica e conhecimentos básicos na área gerontológica. Entre eles, 22,4% deles não cursaram a disciplina Geriatria e Gerontologia na graduação, 71,4% não tinham qualquer tipo de especialização, 91,8% não fizeram residência médica. Nos últimos cinco anos, somente 38,8% participaram de cursos de Geriatria e Gerontologia, 10,2% fizeram pesquisa na área, e 59,2% leram algum artigo sobre envelhecimento. Na avaliação dos conhecimentos básicos sobre a velhice, os maiores números de acertos, 91,8% e 83,7%, surgiram nas duas questões que tratam de aspectos físicos do envelhecimento. A questão que recebeu menor número de acertos (6,1%) aborda o aspecto social do envelhecimento; e as duas questões que tratam de aspectos psicológicos tiveram menos de 20% de acertos. Quanto às crenças relacionadas à velhice, a tendência geral das respostas foi negativa. O domínio com avaliação mais positiva foi Agência e o com avaliação mais negativa foi Relacionamento Social. O item com crença mais positiva foi o relacionado à sabedoria. Concluiu-se que é necessária educação continuada para os médicos que atuam na APS, focada nos diferentes aspectos do envelhecimento, incluindo os psicossociais, assim como a adoção de crenças positivas relacionadas aos idosos.

Exploration of influencing factors for comprehensive geriatric assessment carried out in geriatric departments of comprehensive hospitals in Sichuan province

Objective To investigate influencing factors for comprehensive geriatric assessment carried out in geriatric departments of comprehensive hospitals in Sichuan province and its influential factors, in order to verify whether education affects CGA and to raise medicine quality of senile disease. Methods The self-designed questionnaires were distributed to 40 hospitals in difference downs and cities in Sichuan province.The data were collected, including items of CGA carried out in each hospital, structure of staff, scale, bed distribution, numbers of bed in geriatric department, etc.The correlations of CGA items with the related factors were analyzed by using multiple linear regression analysis. Results The items of CGA carried out was positively related with hospital grade(β=-5.4, P=0.03), the staff-attending three times or more of geriatric training course(β=0.2, P=0.05), the number of nurses per bed(β=15.6, P=0.03), the number of physicians with master's degree(β=-0.2, P=0.04), and the lower average age of medical staff(β=-0.6, P=0.05). Conclusions The grade of hospital, attending actively geriatric training course, the number of the nurses per bed, the number of physicians with master's degree, and the younger average age of medical staff were positively associated with the items of CGA carried out in hospitals. Key words: Comprehensive geriatric assessment; Geriatric department; Questionnaire survey; Risk factors

Using intergenerational relationship teaching strategies in a college-level online gerontology course

ABSTRACTSociety members educated in gerontology are needed to care for older adults in the United States. Young people may have misconceptions and lack of awareness about aging and older adults, which may influence choosing jobs working with elders. However, research has shown that on-ground courses using intergenerational relationships as a teaching strategy have proved to be effective in changing the views of students. This article reports on the experiences of college-level students in an online gerontology course that used an intergenerational relationship teaching strategy. Through journal entries and discussion board postings, students shared new understandings about aging, elders, and themselves. Data were analyzed using narrative inquiry and the threedimensional (3D) inquiry space. Findings showed students’ views could be changed through intergenerational relationships with reflection in an online course.

The teaching of gerontology: Seven years of course design, redesign, and assessment in a multigenerational classroom

ABSTRACT Intergenerational teaching using a multigenerational course design is certainly not a new pedagogical technique. However, the longitudinal assessment and redesign of three gerontology courses described here can offer educators and professionals insights into reflection as a requirement not only within the course but also about the course itself. Since 2009, the Gerontology Program at Nazareth College has collaborated with the St. John’s Senior Living Communities to offer college-level courses comprising both Nazareth students and elder residents. In these courses, the elders not only participate on an equal basis with the students but also, together with the students, engage in regular course assessments. This article offers a review of course designs, assignments linked to student-learning outcomes, service-learning projects, and the numerous opportunities created for both personal and professional growth. Utilizing three different courses, this comprehensive study of intergenerational and multigenerational learning provides examples of different forms of engagement between students and elders and serves as a model for course design.

The use of personas in gerontological education

ABSTRACTUsing mechanisms of active learning, we developed a Persona project for our undergraduate Introduction to Gerontology course. We conceive of Personas as fictional characters that are created through the amalgamation of physical, social, and psychological traits and have unique lived experiences. This article details the development of this innovative pedagogical tool and describes how Personas are used as part of an experiential learning assignment over the course of a semester. Student-generated Personas act to contextualize the broad course material, ranging from physical and mental health to environments and financial well-being in later life. Student feedback of the Persona project highlights what they learned, how this project was helpful for them, and suggestions for enhancing the experience for students in subsequent semesters. We conclude by recommending that other gerontological and social science educators incorporate Personas into their coursework to provide students an interactive tool to apply information learned through class lectures and readings.

“So we basically let them struggle”: Student perceptions of challenges in intergenerational Service-Learning

ABSTRACTService-learning is a widely used pedagogical practice that integrates community involvement and civic engagement into the classroom. Benefits of service-learning in gerontology include an increased sense of personal growth, greater knowledge of aging, and enhanced interest in aging-related careers. However, relatively little research has specifically explored the challenges associated with intergenerational service-learning. A focus group documented the experiences of 19 students who were required to participate in at least 20 hours of intergenerational service-learning for an introductory gerontology course. Because an administrative error prevented students from knowing about the service-learning requirement until they were enrolled, these participants were well qualified to discuss the challenges and positive aspects of their experiences. In addition to confirming known benefits of service-learning, three major themes regarding challenges emerged: lack of communication, the need for guidance, and creating meaningful relationships. This study provides suggestions for further development of “best practice” guidelines unique to intergenerational service-learning.

Students' Knowledge of and Interest in Older Adults: Impact of a Geriatrics Course

The number of older adults living with chronic conditions is steadily increasing, so nurses must be prepared to care for the needs of this population. However, only one third of nursing education programs include a stand-alone geriatrics course. A cross-sectional mixed-methods design was used to compare two cohorts of 46 nursing students. Knowledge, attitude, and interest in older adults were examined using an online survey. The control cohort did not complete the geriatric course. No demographic differences were found between groups. Completing the geriatric course was not correlated with having greater aging-related knowledge. Decreased interest in working with the older adult population was found. Findings from this cross-sectional pilot study suggest that previous experience with an aging relative was associated with better aging-related knowledge. Further research exploring students' perceptions is needed to understand the relationship between the geriatric course and attitudes toward aging. [J Nurs Educ. 2018;57(2):106-109.].

Integrating Gerontology and Community Concepts Through Simulation.

This article describes an innovative simulation experience for nursing students. Faculty from a community health nursing course and a course in gerontology worked together to provide a comprehensive simulation experience that combined low-fidelity and high-fidelity experiences that provided an integrated learning experience and gave faculty with an opportunity to collaborate to improve outcomes. Student and faculty feedback was overwhelmingly positive. Future plans include incorporating a third didactic course, Leadership and Management, and working with other disciplines to demonstrate interprofessional collaboration.

Exercising with Veterans: How Social Interaction with a Pharmacy Student Improves Patient Care.

With the baby boomer population anticipated to explode between 2010 and 2030, it is essential that student pharmacists learn how to properly care for older patients. One way for pharmacy students to prepare for providing health care to the elderly is to partake in an Advanced Pharmacy Practice Experience (APPE) elective course in geriatrics. Pharmacy students, and health care professionals in general, have an immense amount of information available to them that is not found in a patient's chart or textbook, but can be uncovered through increased social interaction with patients, promoting the best possible care. Although these are not novel ideas, this article describes a unique experience I recently had with the veterans at the Alvin C. York Campus of the Veterans Affairs (VA) Tennessee Valley Healthcare System. While completing an APPE elective in geriatrics, I was given the opportunity to attend twice-weekly exercise classes with the veterans. When my preceptor first told me about this project, I was both excited and intrigued because I thought it would be an interesting way to interact with my patients, but I never imagined how much the relationships I formed would positively impact my ability to care for my patients.

Educating the next generation of family caregivers through the use of dynamic case studies

ABSTRACTBetween 2008 and 2016, students in an Introduction to Gerontology course were required to complete a dynamic case study project simulating caregiving arrangement decision making. Students were divided into groups representing typical multigenerational families and were required to determine how to develop caregiving arrangements to respond to an older family member’ s changing levels of need. The assignment concluded with students writing a final paper summarizing what they learned. This study examined the themes emerging from student group case study papers to gain an understanding of the challenges students face in understanding the dynamics of making family-based caregiving decisions. This is of particular importance as many students were seeking careers in human services and would be assisting clients in such decision-making processes, as well as involvement in decision making for their own family members. Themes that emerged from group papers and the implications related to gerontology education and policy are discussed.

Teaching gerontology in globalized academics: a qualitative study of Thai nursing students’ views on ageing when studying abroad

Background: Negative views towards ageing and older adults may be a reason why nurses do not choose to work in gerontological nursing. Studying in another cultural context can challenge these views. The Objective was to explore nursing students’ views on ageing and older adults before and after a gerontology course held abroad. Design and method: A qualitative approach based on content analysis of responses to open-ended questions by 30 Thai nursing students studying a gerontology course in Sweden. Results: Three main categories: positive imprints of ageing, ageing takes its toll, and knowledge leading to action, emerged through sub-categories carrying a view of older adults as not only in need of care, but also as resourceful and competent. Professional healthcare, besides family was seen as potential caregivers in old age. Conclusions: Studying gerontology abroad can widen views towards ageing and older adults, inspiring nurses to work in gerontological nursing.