Geriatric Education Research Articles

Exploring the optimization path of rural geriatric education under the threshold of empowerment: An empirical study in Zhejiang Province

Synchronizing the improvement of rural elders' happiness with economic and social development has become an urgent issue driving rural construction, comprehensive rural revitalization, and the decisive victory in building a moderately prosperous society. The enhancement of rural elders' spiritual satisfaction, as a systematic project,requires high attention and concerted efforts for exploration and resolution. This study aims to assess the significant opportunity presented by actively responding to the aging population strategy through empowerment and enhancement, thereby optimizing the development of elderly education in rural China. This study delves into the optimization path of rural elderly education. It systematically evaluates the existing problems and development status of elderly education in rural areas, proposes improvement measures, and constructs a path for the development of rural elderly education, analyzing and assessing the current implementation status and shortcomings in sample villages. Through the comprehensive empowerment and enhancement education theory, it summarizes the optimization path for rural elderly education. Through empirical analysis result show that three key findings emerge. Firstly, cognitive needs exert a direct positive influence on the level of elderly education. The perception among the elderly regarding the necessity of elderly education significantly impacts their participation and subsequently influences the overall level of elderly education. Moreover, enhancing the elderly' s sense of self-efficacy holds considerable importance in this regard. Secondly, geographical transportation emerges as a critical determinant, positively affecting cognitive needs and the level of elderly education. Proximity to educational institutions, coupled with efficient transportation options, significantly influences the willingness of the elderly to engage in educational activities, thereby elevating the overall level of elderly education. Lastly, the quality of curriculum setting is identified as another crucial factor affecting cognitive needs and the level of elderly education. Aligning course offerings with the demands of the elderly population enhances their satisfaction with elderly education. By integrating insights from successful practices in both rural and elderly education, particularly from developed countries, this study offers a specific path for rural elderly education, thereby guiding the educational development in rural areas, such as Zhejiang Province. This paper focuses on the actual situation in Zhejiang Province and holds practical significance.

“I feel more in control of my learning experience:” ungrading as an empowering approach to competency-based gerontological teaching and learning

ABSTRACT Ungrading is a constellation of pedagogical practices that seek to recenter the educational experience of learners as individuals by using detailed feedback rather than grades to assess the achievement of learning competencies. Ungrading practices have been employed in multiple disciplines in response to various concerns about traditional grading, including the tendency of grades to signal the end of learning, the ineffectiveness of grades in assessing competencies, and equity concerns. While the use of ungrading in gerontological teaching and learning appears to be largely unknown, it may offer a potentially powerful and innovative way to support students in attaining and demonstrating AGHE’s gerontological competencies. This should be a key concern of all gerontology educators as the main goal is to develop a qualified workforce who can be employed across the aging services sector. A form of ungrading known as grade anarchy was piloted in three master’s level gerontology courses and student and instructor feedback was gathered to assess reactions to the pilots. Students were mostly supportive, reporting that they felt less stressed and more motivated to learn, while some preferred traditional grading as they perceived its structure was clearer. The instructor experienced a steep learning curve followed by the observation that ungrading was freeing for the instructor as well, allowing a more individualized approach to student learning that resulted in greater clarity with regard to learners’ mastery of the selected AGHE competencies and the course learning objectives.

Enhancing the diversity and productivity of scientists in aging research: contributions of the Resource Centers for Minority Aging Research, 2018–2023

ABSTRACT The Resource Centers for Minority Aging Research (RCMAR) is a flagship education, training, and development program of the National Institute of Health (NIH), and the National Institute on Aging (NIA) focused on increasing the number and diversity of researchers in aging. We sought to assess the program’s contributions to geriatric and gerontology education by examining the scientific productivity of 294 RCMAR scientists who received pilot funding from the program during the last complete grant cycle, 2018 to 2023. Across the 18 funded sites, the scientists obtained 53 NIH grants and 29 NIA-specific grants. They published 281 manuscripts, of which 141 were noted as direct outcomes of the pilot funding and support received through the program. Findings indicated that the RCMAR program in its last cycle succeeded in promoting education and scientific career development of researchers from diverse backgrounds and researchers focused on health disparities to conduct transdisciplinary social and behavioral aging research.

Becoming community researchers: The development and implementation of a competency-based program enabling older adult learning of qualitative research in a public health setting

ABSTRACT Partnering a local nonprofit social agency, the authors developed and implemented a learning program for a group of older persons preparing them to conduct qualitative research within a healthcare setting as community researchers in Singapore. This paper illustrates how learning for new occupations, job identities, and work can be supported via a competency-based approach that enables and clarifies links between research work, older adult learning, and assessment. It demonstrates how learning processes and contexts matter as much, if not more than outcomes, skills, and tasks typical of conventional competency-based training. Thus, the paper builds upon but also challenges the paradigm of competency-based training. It offers a more developmental approach or strategy for older adult learning that promotes dialogic, reflexive, and hands-on/applied learning, corresponding with educational gerontology principles.

Older Adult Education in the Context of Psychological Theories of Ageing

In gerontology, the essence of ageing is traditionally equated with decline and degradation, it is considered a purposeful process of loss of the body's adaptive capacity. Psychologists, in particular representatives of behaviorism, deny this position, instead they consider ageing to be an integral part of the general process of human development. Theories of ageing have progressed from focusing on individuals’ declines and losses in later phase of their life course to considering ageing as a continuous process of human development. Psychological theories of ageing are crucial to understanding older adults as learners ‒ their needs, abilities, motivation of learning and expectations from educational activity. They help us to develop comprehensive approaches to building an effective educational environment and improving the learning process of that age and social group aiming to adapt that environment to the needs of older adult learners. The article analyzes the main provisions of psychological theories of ageing, which substantiate the importance and even the necessity of involving older adults in educational activities, because firstly, mental activity contributes to the preservation and even development of a person’s intellectual capabilities until old age; secondly, in older people (compared to young people), changes in the ability to learn are insignificant and relate rather to the sphere of perception, attention, motivation, and the physiological state of the body; and thirdly, older people have a growing need for a sense of security, which has a significant impact on their quality of life and is largely realized through communication and learning activities. Based on the main tenets of psychological theories of ageing, in our research we consider older adults as a resource and human capital. We believe that the approach to the problem of ageing and old age from the resource perspective, which is based on the ideas of theories of activity and lifelong personality development, allows us to justify the need for education of older adults and is the basis of educational gerontology.

Design and Development of Virtual Reality Application Implementing Age-Friendly Care and the 4Ms: A Quality Improvement Project.

With an increase in the aging population, the application of evidence-based practice in geriatric education can strengthen knowledge, skills, and clinical experience for healthcare students caring for older adults. The Age-Friendly Health System (AFHS) is one of the frameworks founded on providing evidence-based and low-risk care centered on what matters most to older adults, their families, and caregivers. Virtual reality (VR) platforms are gaining popularity due to their ability to provide an immersive, hands-on learning experience resembling an actual medical practice or care setting. Immersive learning enhances students' sensory perceptions, promoting an innovative and engaging way of acquiring concepts that are difficult to teach in real life. This study aimed to design, develop, implement, and evaluate a case-based training module highlighting AFHS and educating medical students on the 4Ms approach in geriatric care (What Matters, Medication, Mentation, and Mobility). The project was a feasibility study completed in two phases. Phase one included planning and developing a case-based scenario incorporating the 4Ms of AFHS. Phase two included implementing and evaluating the VR training module into the geriatric curriculum for medical students. The final VR case displays a hospital and post-acute setting where an elderly patient is admitted for a hip fracture. Students learn how to triage and treat patients from admission to discharge while demonstrating their knowledge of AFHSs. Approximately 10% of students completed the evaluation survey, and preliminary results indicate significant knowledge change in pre-post scenario-based training on an AFHS. The VR education platform and embedded scenario promise an innovative adaptation of technology in learning the concepts of the 4Ms of AFHSs. However, future studies should explore VR education with clinical assessment evaluation to ensure competence in providing age-friendly care.

Integrating Geriatrics and Lifestyle Medicine: Paving the Path to Healthy Aging.

Aging is a lifelong process, and many chronic diseases and geriatric syndromes are influenced by lifestyle factors. Here, we discuss the benefits of integrating education in geriatrics and lifestyle medicine to not only improve competency of health professions learners in each area, but also so that learners can promote healthy aging in the clinical care of their future patients. We review the current state of geriatrics education, the role of lifestyle medicine in aging, and strategies to bridge the gaps between geriatrics and lifestyle medicine.

A scoping review of reviews on helping professionals’ attitudes toward older adults

To examine helping professionals’ attitudes toward older adults is of critical importance in improving the quality of gerontological care and promoting a longevity society. The objective of the present study was to examine the current state of knowledge regarding helping professionals’ attitudes toward older people. This has been done through a review of recent systematic reviews. We used ten databases to search for systematic reviews published on peer-reviewed platforms from 2000 to September 2023. Initially, 730 articles were retrieved, of which 14 were found to be eligible for inclusion. Current evidence primarily focuses on three aspects of helping professionals’ attitudes toward older adults: (1) cognitive, affective and behavioural manifestations of ageist attitudes; (2) professional/educational and non-professional/non-educational factors that influence these attitudes; and (3) education-based and experience-based interventions targeting these attitudes. While it is difficult to synthesise the level of positivity or negativity in helping professionals’ attitudes, we found evidence of stereotypes of older people as incompetent and difficult, and passive emotions and behaviours when providing care. Gerontological knowledge, professional values and exposure to older adults are critical factors shaping helping professionals’ attitudes. Interventions based on positive gerontological education and improving intergenerational relationships have shown promising benefits. Our review identifies notable research gaps in current literature, namely the under-representation of non-Western regions and the lack of valid and culturally sensitive instruments for ageism-related concepts. It provides valuable insights for future research, practice and policy on ageism to improve the quality of gerontological care.

The development of educational gerontology in Ukraine under martial law

The full-scale military invasion of the Russian Federation aggressor country into Ukraine has led to the mobilisation of Ukrainian citizens of the draft age and caused a reduction in the labour market of young and middle-aged specialists. To support the labour market and economy of Ukraine, the need arose to introduce elderly people into the educational system. Therefore, the main aim of this article was to determine the specific grounds for developing educational gerontology during the full-scale military invasion of Ukraine. The data for the research were assessed using quantitative and qualitative methods, including questionnaires, observation, and analysis of data and documents. The study of the main fields of educational gerontology chosen by elderly people revealed the following: digital technology, management, health and wellness, language and culture, creative arts, engineering and infrastructure, agriculture, and logistics and supply. Researchers of educational gerontology in the USA and European countries (including Ukraine up to February 2022) identified the main reasons for the need to include elderly persons in the educational process, namely: loneliness, mental health support, and socialisation. After February 2022, the main reasons for including the elderly in the educational process expanded to include the shortage of specialists in various fields of the economy due to the mobilisation of young and middle-aged adults into the Armed Forces of Ukraine, the tragic loss of life from the bombings of Ukrainian cities and villages, and the outflow of human resources abroad. These circumstances necessitate the development of adult learning strategies and the establishment of a network of educational gerontology institutes, which will provide mental health support for the elderly and include them in the socio-economic environment

Maximizing Learning in Caring for Older Patients Through a Multi-Specialty Simulation Approach

Background: Simulation-based learning has been utilized in medical education and studied to enhance its educational impact since the 1960s (Hallinger, & Wang, 2020). However, there is a lack of multispecialty simulations in the literature (Fisher, & Walker, 2014; Age UK. 2023; NHS England, 2021; Romero-Ortuno, Stuck, & Masud, 2022; Keijsers, et al., 2016). We developed and delivered simulations on Orthopaedics and Geriatric topics. Simulation mannequins, role players, imaging, and simulated clinical documentation were incorporated into scenarios. We evaluated the effectiveness of this approach on students’ knowledge and confidence when caring for older patients. Methods: Fourth-year medical students at the University of Nottingham received simulation-based teaching during their Geriatrics placement at Queens Medical Centre. Their knowledge and confidence levels were assessed before and after the simulations. We utilized six knowledge-based and six confidence-level questions mapped to their learning outcomes for hip fractures, pressure ulcers, and discharge planning stations. In addition, we asked students to provide scenario-specific feedback and their thoughts on whether the simulation workshop was pitched at the right level. Results: Students’ knowledge and confidence levels improved significantly following the simulation workshop. About 75% of the students displayed enhanced results in the knowledge-based category. In terms of their confidence level, there was improvement seen across all simulation stations, with most learners feeling four times more confident when comparing proportions pre and post-simulation. Furthermore, 99% of the students thought the simulations had positively impacted their learning. Conclusion: Our findings demonstrate the effectiveness of the multispecialty simulation approach in undergraduate geriatrics teaching. Given significant improvements in students’ knowledge, confidence levels, and positive feedback, we aim to continue delivering this multispecialty simulation-based teaching to our students. To measure the long-term efficacy of this approach, we can perhaps re-evaluate students learning after a month to assess the efficacy of this simulation workshop.

Translating relational theories into dementia care using research-informed drama

ABSTRACT Culture change initiatives in older adult and dementia care have called for a new care paradigm informed by a relational ontology and relational theories. Yet translating these humanizing principles into practice has proven difficult; traditional approaches to knowledge translation have not had a sustained impact. One of the most significant impediments to transforming the culture of care has been the lack of understanding of what it means to be and act relational in practice. A growing body of research is demonstrating the potential of critical arts-based inquiry/pedagogy (CABI/P) for translating theory in accessible and relevant ways for diverse audiences and for shifting images, understandings and actions in healthcare in more effective ways. As part of a larger longitudinal project, this paper explores the immediate impacts of a research-informed drama called ‘Cracked: new light on dementia,’ and how it might enhance understandings of relational caring for staff working in long-term care (LTC) homes. Data from post-performance focus group/interview discussions with staff working in two different LTC settings point to the effectiveness of Cracked in translating key principles of relational theories into older adult and dementia care and the possibilities of CABI/P in gerontological education more broadly. Although organizational and broader system change is needed to achieve sustained impact of relational caring practices, CABI/P, such as Cracked, has the potential to expose and challenge entrenched assumptions, policies, practices, and to imagine and effect more compassionate, humane, and equitable care.

Ageism in dental students - a multicentric study in southern Brazil.

Gerontological education and intergenerational contact are proven strategies for effectively combating ageism. In this context, this study investigates the association between gerontological education, intergenerational contact, and ageism among dental students. Gerontological education from students' perspective, intergenerational contact, and ageism were assessed using a questionnaire containing sociodemographical aspects and an ageism scale (ASDS-Braz). The sample included students enrolled in the final year of dental programs at three public universities in southern Brazil. A multilevel Poisson regression was conducted to assess factors associated with ASDS-Braz scores. A modest correlation was identified between dental schools in terms of reducing ageism, and a weak correlation was found between self-reported race and ageism. Notably, statistically significant findings were observed across family relationship with older individuals: students who reported having a poor relationship with older adults in their families presented 45% higher ageism scores than did those with an excellent relationship. The results suggested that while some gerontological education was reported by the participants, it may not be sufficient to prepare dental students to provide effective oral healthcare to older adults and to reduce ageism among them. Additionally, reinforcing positive aspects of intergenerational relationships may be an additional strategy in combating ageism within this population.

A Survey of the Turkish Oncology Group (TOG): Are the Oncologists Trained for Decision Making on Geriatric Cancer Patients?

Most newly diagnosed cancers occur in older adults, and it is important to understand a patient's underlying health status when making treatment decisions. Therefore, clinicians need enhanced competencies and skills to effectively care for this population. However, most clinicians receive minimal to no training in geriatrics. This study aims to evaluate the education and training levels in geriatric oncology among Turkish physicians and to understand the factors influencing oncologists' treatment decisions for geriatric cancer patients. A 24-question survey was prepared to obtain the participating physicians' demographic information, as well as to inquire whether they had received training during their medical education and residency on how to approach geriatric patients, in what process(es) they had received the training, whether they were currently treating geriatric patients, what they focused on when evaluating geriatric patients, and what they thought about their training and preparedness for approaching geriatric patients. The questionnaire was sent online to radiation and medical oncologists, and the link was published on the Turkish Society of Radiation Oncology and the Turkish Society of Medical Oncology websites. Two hundred and three physicians participated in the survey, 131 of whom were women. The median age was 41.66 years (24-69 years). One hundred and fifty-six physicians (76.1%) received specialty education at the university hospital. One hundred and three of them were radiation oncologists, and 80 were medical oncologists. Of the physicians, 19.7% received education in geriatrics before they specialized in oncology, and 6.9% said they were educated after specialization. When determining suitability for radiotherapy, 10.7% of radiation oncologists said that they use geriatric assessment tools. Similarly, 13.8% of medical oncologists claimed that they used geriatric assessment tools in determining suitability for chemotherapy. Of the physicians, 177 (86.3%) thought that geriatric evaluation could independently increase patient survival rate. Furthermore, patient cognitive status, functional status, physiological age, polypharmacy, geriatric specialist recommendations, inpatient services, patient relatives, and similar factors were found to be useful in treatment decisions. Finally, 92.7% of the participants believed that receiving education would have changed their perspectives on treating geriatric patients. Our results provide perspectives on developing knowledge on and skills in geriatric training among oncologists. Learning new approaches is necessary for oncologists who more frequently confront geriatric patients with cancer.

A thematic analysis of social work students’ assignments of reflection on interviews with older adults

ABSTRACT There is an increasing need of gerontological education in social work to enhance the knowledge of aging and interests in senior care among students. This study is conducted based on an experiential-learning strategy with a combination of having an ethnographic interview with an older adult and writing a reflection paper afterward as an assignment embedded in a Gerontology course of the Bachelor of Social Work program in western Canada. Thematic analysis was applied to eight reflection papers in which a consent was obtained from 2020 to 2021 cohorts of social work students. Three key themes emerged: connection between learned knowledge and interview topics, resonation interview content with personal experiences, and a positive perception of aging and a positive attitude toward working with aging populations. The findings support the combination of ethnographic interview and reflection paper as a pedagogical approach in gerontological education not only for improving students’ learning experience and knowledge but also for establishing a positive perception of aging and older adults. The study also reveals the necessity of more interaction between students and older adults to enhance a better understanding of aging-related issues and promote willingness to work with older adults.

Current status and the urgent need for a geriatric healthcare system in a super-aged society

Background: The Korean healthcare system is ill-equipped to manage geriatric diseases, even though we are on the verge of becoming a super-aged society.Current Concepts: In Korea’s delivery of healthcare system, which is centered on subspecialty care from primary to tertiary care, older adults with multiple chronic diseases are forced to receive fragmented care from multiple doctors. In medical education and residency programs, even the most fundamental concepts of geriatrics are misunderstood, and geriatricians receive inadequate training. Consequently, along with the rapidly growing elderly population, elderly patients with complex health problems, frailty, and dysfunction are deprived of the opportunity to achieve healthy aging by taking multiple medications and suffering from geriatric syndromes caused by fragmented medical care.Discussion and Conclusion: Establishing a system for training geriatricians and strengthening geriatric education is necessary to ensure existing specialists can assign them the role of primary care geriatricians. Additionally, person-centered, integrated geriatric care that requires appropriate management of various complex diseases, as well as maintenance of function and frailty prevention, will be possible by establishing a geriatric healthcare system that ranges from frailty prevention, polypharmacy management, and home visits in primary healthcare to multidisciplinary geriatric care and transitional care in tertiary healthcare. Implementing this strategy as early as possible will help older adults age well and reduce the caregiving burden in later life. This could also ease concerns regarding physician shortages induced by the rapidly growing elderly population.

Stakeholder perceptions of gerodontology education for final year Australian dental school curricula.

The study explored the perceptions of final-year Australian dental students, directors of nursing, and consumer representatives toward geriatric education provided at Australian undergraduate dental schools. Findings will strengthen and inform future curricula design for dental schools. Semi-structured interviews and focus groups were conducted through videoconferencing and in-person interviews, and analyzed using thematic analysis. Thematic analysis found the major themes to include relationships, curriculum variation, resources, and in-service learning experiences. The participants found gaps in the current delivery of undergraduate dental education. Solutions included greater resourcing through funding and time allocated to supervisors and a curriculum dedicated to gerodontology. Healthcare professional curriculum design must consider the needs of the learners and stakeholders involved in the health of older people. The focus group participants found multiple barriers and gaps to achieving what is required to adequately prepare dental graduates for an older, frail, and care-dependent population. For curricula to be successful, policymakers and education providers must find solutions to ensure that the oral health needs of older Australians are addressed and managed appropriately.

New horizons in undergraduate geriatric medicine education.

Current projections show that between 2000 and 2050, increasing proportions of older individuals will be cared for by a smaller number of healthcare workers, which will exacerbate the existing challenges faced by those who support this patient demographic. This review of a collection of Age and Ageing papers on the topic in the past 10years explores (1) what best practice geriatrics education is and (2) how careers in geriatrics could be made more appealing to improve recruitment and retention. Based on these deeper understandings, we consider, as clinician educators, how to close the gap both pragmatically and theoretically. We point out paradigm shifting solutions that include innovations at the Undergraduate level, use of simulation, incorporation of learner and patient perspectives, upskilling professionals outside of Geriatrics and integration of practice across disciplines through Interprofessional Learning. We also identify an education research methodological gap. Specifically, there is an abundance of simple descriptive or justification studies but few clarification education studies; the latter are essential to develop fresh insights into how Undergraduate students can learn more effectively to meet the needs of the global ageing challenge. A case of improving understanding in delirium education is presented as an illustrative example of a new approach to exploring at greater depth education and outlines suggested directions for the future.

Reflection on Geriatric Education to Build a Dynamic Health Workforce

Reflection on Geriatric Education to Build a Dynamic Health Workforce

Agents of Change: Geriatrics Workforce Programs Addressing Systemic Racism and Health Equity.

Many factors affect how individuals and populations age, including race, ethnicity, and diversity, which can contribute to increased disease risk, less access to quality healthcare, and increased morbidity and mortality. Systemic racism-a set of institutional policies and practices within a society or organization that perpetuate racial inequalities and discrimination-contributes to health inequities of vulnerable populations, particularly older adults. The National Association for Geriatrics Education (NAGE) recognizes the need to address and eliminate racial disparities in healthcare access and outcomes for older adults who are marginalized due to the intersection of race and age. In this paper, we discuss an anti-racist framework that can be used to identify where an organization is on a continuum to becoming anti-racist and to address organizational change. Examples of NAGE member Geriatric Workforce Enhancement Programs (GWEPs) and Geriatrics Academic Career Awards(GACAs)activities to become anti-racist are provided to illustrate the framework and to guide other workforce development programs and healthcare institutions as they embark on the continuum to become anti-racist and improve the care and health of vulnerable older adults.

Application, knowledge and training needs regarding comprehensive geriatric assessment among geriatric practitioners in healthcare institutions: a cross-sectional study

BackgroundThis study aimed to investigate the actual application, knowledge, and training needs of comprehensive geriatric assessment (CGA) among geriatric practitioners in China.MethodsA total of 225 geriatric practitioners attending the geriatric medicine or geriatric nursing training were recruited for this cross-sectional study. The questionnaire included demographics, healthcare institution characteristics, the actual application, knowledge, training needs, and barriers to CGA and geriatric syndromes (GS).ResultsPhysicians and nurses were 57.3% and 42.7%, respectively. 71.1% were female, with a median age was 35 years. Almost two-thirds (140/225) of geriatric practitioners reported exposure to CGA in their clinical practice. The top five CGA evaluation items currently used were malnutrition risk (49.8%), fall risk (49.8%), activity of daily living (48.0%), pain (44.4%), and cognitive function (42.7%). Median knowledge scores for the management procedures of GS ranged from 2 to 6. Physicians identified medical insurance payment issues (29.5%) and a lack of systematic specialist knowledge and technology (21.7%) as the two biggest barriers to practicing geriatrics. Nurses cited a lack of systematic specialist knowledge and technology (52.1%) as the primary barrier. In addition, physicians and nurses exhibited significant differences in their knowledge of CGA-specific evaluation items and management procedures for GS (all P < 0.05). However, there were no significant differences in their training needs, except for polypharmacy.ConclusionsThe rate of CGA application at the individual level, as well as the overall knowledge among geriatric practitioners, was not adequate. Geriatric education and continuous training should be tailored to address the specific roles of physicians and nurses, as well as the practical knowledge reserves, barriers, and training needs they face.