Training In Old Age Psychiatry Research Articles

Graduate medical education in old age psychiatry: a scoping literature review

Gerontopsychiatry will become increasingly relevant as a discipline for primary care based on current demographic forecasts, destigmatization of mental illness and specific diagnostic and therapeutic developments. Hence, high quality graduate medical training in old age psychiatry is needed. Objectives The goal of this review was to summarize the literature on medical education relevant to residency training in old age psychiatry and to contrast the findings with international developments in competency-based medical education. The authors used the scoping review method of Arksey and O'Malley. The initial search yielded 913 hits. After full text screening, 20 original articles were used for data extraction. The study content was summarized under three categories: trainee recruitment, length and structure of graduate training curricula in old age psychiatry, and learning goals and competencies in old age psychiatry training. Surveys and expert consensus were mostly used as study methods. High-quality clinical training experience with gerontopsychiatric patients and supervision of residents was an important factor for stimulating interest in old age psychiatry. Few studies provided evidence for educational benefit of digital learning and teaching formats and simulation training in old age psychiatry. Overall, there were no studies in old age psychiatry with explicit reference to concepts of competency-based graduate medical education. Clinical rotations and mentoring foster interest of clinical residents in the discipline of old age psychiatry. Systematically introducing clinical rotations in old age psychiatry in general psychiatry residency programs seems necessary to enable residents to gain relevant knowledge and skills. Educational research in old age psychiatry considering patient outcomes seems to be a meaningful next step.

Qualitätsstandards in der Alterspsychiatrie

Quality Standards in Old Age Psychiatry Abstract: Quality standards and regulations are becoming increasingly important and are promoted in the context of the permission to treat, to bill and via financial incentives. In this context, the regulatory frameworks focus to varying degrees on structural, process or outcome criteria. On behalf of the Swiss Society for Old Age Psychiatry and Psychotherapy (SGAP), we summarize the quality elements in this document and group the requirements derived from them based on setting (outpatient, intermediate, inpatient) and structural quality criteria (staffing ratio, infrastructure). There is a very extensive requirements matrix, and its implementation requires considerable efforts, not least because of the shortage of specialists and limited financial resources of psychiatric institutions and medical practices. The criteria of the requirements matrix must be further developed and anchored in a "competence-based training in old age psychiatry".

Quality Standards in Old Age Psychiatry

Quality Standards in Old Age Psychiatry Abstract. Quality standards and regulations are becoming increasingly important and are promoted in the context of the permission to treat, to bill and via financial incentives. In this context, the regulatory frameworks focus to varying degrees on structural, process or outcome criteria. On behalf of the Swiss Society for Old Age Psychiatry and Psychotherapy (SGAP), we summarize the quality elements in this document and group the requirements derived from them based on setting (outpatient, intermediate, inpatient) and structural quality criteria (staffing ratio, infrastructure). There is a very extensive requirements matrix, and its implementation requires considerable efforts, not least because of the shortage of specialists and limited financial resources of psychiatric institutions and medical practices. The criteria of the requirements, matrix must be further developed and anchored in a "competence-based training in old age psychiatry".

Developing simulated training in old age psychiatry to recognise and assess medical problems in a psychiatric setting (RAMPPS)

IntroductionOlder people with mental ill health are more likely to receive lower quality of health care, inappropriate prescriptions and reduced access to services, leading to increased rates of mortality [1–3]. There is increase focus on supporting people with multiple long-term physical and mental health conditions, particularly by embracing opportunities created by technology [4] (references are not available for this abstract).ObjectivesTo identify the common medical comorbidities on the Old Age Psychiatry Wards.AimsTo develop simulation training from the medical scenarios.MethodWe audited all patients referred to the Liaison Geriatrician from 2008 to October 2015 from the Mount Hospital Leeds, which consists of 4 Old Age Psychiatry wards. Data was collected in October 2015 and included referral date, patients’ age and sex, number of referrals, reason for referral and the outcome.ResultsWe assessed 339 (142 F, 197 M) patients with a mean age of 77 (range: 56-94). The cardiovascular problems constituted the majority (34%) of the referrals, central nervous system (11%), respiratory (8%), gastrointestinal (8%), infection (8%), musculoskeletal (7%), renal (3%), others (19%) and the reasons were unknown in (2%) of the 440 referrals. Some unusual problems were diagnosed including a spontaneous pneumothorax, primary biliary cirrhosis.ConclusionThe audit highlights the essence for more training in recognising and assessing medical problems in psychiatric settings - the simulation programme (RAMPPS) in Old Age Psychiatry. As a result of the service model, we are developing a simulation-training course tailored to the mental and physical health needs of the elderly.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Harmonization of European training

Mental health disorders, especially dementia, mood- and anxiety disorders, are among the most prevalent diseases in later life. Due to a greying European society, numbers are expected to increase over the next decades. Consequently, there is a pressing need for well-trained specialists in geriatric psychiatry across Europe in order to meet the mental health needs and to deliver a high standard of care to the aging population. In the past decades, some countries have set up specific training programs for specializing in geriatric psychiatry, whereas others did not. In order to stimulate the development of high-quality services, harmonizing specialty training across Europe will be a first step forward.The EU stresses the need for standardizing qualifications of medical professionals to enable them to work across the EU. This workshop aims to work towards a consensus on the minimum training level required for geriatric psychiatry. We state that being able to work as an old age psychiatrist requires specific training in geriatric psychiatry and old age over and above general training in psychiatry. Therefore, discussion of opportunities to develop minimal criteria for training and practice across Europe is crucial. Taken the differences between countries into account (many countries do not provide specific training in old age psychiatry), we should finally agree on the minimal level of education and supervision, the minimum level of work experience and finally the minimal level of supervision in peer groups as a starting point.Disclosure of interestThe author has not supplied his declaration of competing interest.

Training in old age psychiatry: The 30 countries’ perspective

To improve the care of older people with mental health problems it is necessary to have a highly skilled workforce who is very well-trained in the diagnosis and management of the range of the psychiatric problems affecting older people including the dementias. Key to this is the need to have an adequate number of specialists in geriatric psychiatry and a wider recognition of geriatric psychiatry training across Europe including a broad agreement on training requirements. In 2012 the European Association of Geriatric Psychiatry (Toot et al.) published the results of a Europe wide survey on geriatric psychiatry training to scope current practice and develop recommendations to begin a debate on harmonization. Representatives from 30 out of 38 (79%) representatives responded including many from countries where old age psychiatry was not formally a specialty. Training programs and duration varied between countries. Eleven countries reported that they had geriatric psychiatry training programs and most of these required geriatric psychiatry trainees to complete mandatory training for two years within old age psychiatry. Representatives from ten countries reported having specific Continuing Professional Development (CPD) for old age psychiatrists at consultant level.The recognition of geriatric psychiatry as a specialist discipline in Europe is on the rise. The training procedures and processes in place vary considerably between and sometimes within countries. There are several options for harmonizing old age psychiatry training across Europe with advantages to each. However, support is required from national old age psychiatry bodies across Europe and an agreement needs to be reached on a training strategy that encompasses supervision, development, and appraisal of the knowledge and skills sets of old age psychiatrists. This workshop will look at options for harmonization and take first steps towards a consensus.Disclosure of interestThe author has not supplied his declaration of competing interest.

S37-03 OAP actual problems in European countries

Aging of the world population risks to be accompanied by an increase of chronic health problems, and most particularly of mental health problems. To face to these problems the organization of care and education in old age psychiatry is still quite insufficient worldwide. Like in all countries in this part of the world, the geriatric psychiatry is still not enough represented. Only in some countries in Europe old age psychiatry is a recognized specialty (18% of European region countries responded at a WPA survey of teaching and training in OAP). The number of professionals working in the field is still very low to satisfy the needs of care of elderly with mental disorders. There is inadequate training for formal caregivers and lack of support for informal ones. This is the reason to support the development of postgraduate education on old age psychiatry as a priority in Europe. We discuss about teaching and training in old age psychiatry, psychiatric and psychological expertise exams and the assessment of competence in dementia and ethical aspect of care and research in elderly demented people.We also present some aspects of elderly sexuality and abuse and about mental health from strategy to reality and dementia care in different Europe countries.Chairs: Horacio Firmino-Portugal, Nicoleta Tataru-Romania.Speakers:1.Alexandra Milicevic-Kalasic, Serbia: ‘Mental Health in Serbia-from Strategy to Reality’.2.Horacio Firmino, Portugal: ‘Education on Old Age Psychiatry at Europe: facts and proposals’.3.Ilkin Icelly, Turkey: ‘Elderly abuse in Turkey’.4.Jerzy Leszek, Poland: ‘Dementia care in Poland’.

Teaching and training in old age psychiatry: a general survey of the World Psychiatric Association member societies.

One of the main goals of the World Psychiatric Association (WPA) section on old age psychiatry is to promote its discipline and consequently to help member societies to promote and develop locally specific medical education programmes in old age psychiatry. In order to target its support to the needs expressed by the member societies, the section conducted a survey within the WPA during the year 2001. A questionnaire was sent to each of the 116 WPA member societies in 93 countries. It assessed the level of development of medical education in old age psychiatry in each country, as well as the perceived needs in educational material. Answers were obtained from 50 WPA member societies (response rate 54%) from 48 countries (response rate 52%). The existence of specific old age psychiatry services was reported in 40 (83%) countries, but the discipline is recognized as a subspecialty in only 13 (27%). Formal teaching in old age psychiatry was reported at the undergraduate level in 44 (92%) countries. Specific learning objectives for postgraduate training were reported in 30 (86%) of the countries where the discipline is not yet recognized as a subspecialty. Specific Continuing Medical Education (CME) programs were however reported in only 50% of the countries. Support for the development of educational material was mostly thought to be useful at the postgraduate level. Depression, dementia, psychopharmacology and psychotherapy were among the most frequently cited areas in which educational material might be usefully provided. Support for the development of postgraduate training is seen as the most pressing need by WPA member societies. Such support could help to increase the level of recognition of the discipline locally and hence provide more effective support to older people with mental disorders.

Trainees' attitudes to single and dual training in old age psychiatry

AIMS AND METHODSTo undertake a nationwide survey to find out the attitudes of old age specialist registrars (SpRs) towards single and dual training. A questionnaire was sent to all old age SpRs in the UK.ResultsTwo-thirds of SpRs were undergoing dual training. Most trainees favoured a flexible system that offers the choice of single or dual accreditation. Many trainees had concerns about single accreditation. Schemes vary in whether they encourage one type of training or another.Clinical ImplicationsTraining schemes appear to vary unacceptably in their attitudes to training. There needs to be a more consistent approach nationally. Clearer guidance from the College may help.

External placements: a potentially valuable addition to higher training in old age psychiatry

This article briefly describes the experience of two final year senior registrars visiting services in other regions. The potential training benefits of such external placements for higher trainees are outlined and practical suggestions are made on how to make them more widely available.

Physical illness associated with depression in the elderly in community based and hospital patients

The co-existence of physical and psychiatric illness in so much of the elderly population poses diagnostic and therapeutic problems for psychiatrists, geriatricians and general practitioners alike, with the presence of physical illness strongly influencing and sometimes limiting the options for treatment of the psychiatric illness. Recognition of this has resulted in the Section of Old Age Psychiatry of the Royal College of Psychiatrists recommending that senior registrar training in old age psychiatry should include a one month attachment to an approved geriatric medicine unit.

Higher training in old age psychiatry: a survey of senior registrars' experiences

If high quality services are to be provided for the elderly mentally ill throughout the country it is now recognised that specialist teams are needed, led by adequately trained old age psychiatrists (Wattis et al, 1981).

Reciprocal training in old age psychiatry and geriatric medicine in South Gwent

Skill in physical medicine is an often neglected area in psychiatric training. It is nonetheless very important, particularly in the care of the elderly. The need for reciprocal training in geriatric medicine and old age psychiatry was highlighted in Care of Elderly People with Mental Illness (1989), the Joint Report of the Royal College of Physicians and the Royal College of Psychiatrists on services for the elderly and medical training. It recommends that, “Higher professional training for specialisation in the psychiatry of old age should include at least two months experience in geriatric medicine”, and suggests that this previously optional experience should become an obligatory part of specialist training. It indicates the alternative ways of gaining such experience: a short secondment, a weekly sessional commitment or a direct exchange of posts.

Higher training in old age psychiatry

An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Senior registrar training in old age psychiatry in the United Kingdom

Senior registrar training in old age psychiatry in the United Kingdom

Senior Registrar Training in Old Age Psychiatry in the United Kingdom

The Joint Committee on Higher Psychiatric Training (JCHPT) requires senior registrars (SRs) training for special responsibility posts in old age psychiatry to spend between one year and 18 months in higher training posts in which psychiatry of old age forms the major part of the work. Although only about a third of consultants in a recent survey had such training, there was strong evidence that more recently appointed consultants were likely to have recommended training. The availability of suitable training ‘slots’ seems likely to play a major role in how quickly specialised psychiatric services for old people can develop in response to the rising challenge posed by demographic changes. Jolley has already demonstrated how developments have been delayed by a shortage of properly trained candidates. Despite this the situation has now been reached where over two-thirds of the elderly population of the UK are served by specialised consultants albeit sometimes at inadequate manpower levels.

Senior Registrar Training in Old Age Psychiatry in the United Kingdom

Senior Registrar Training in Old Age Psychiatry in the United Kingdom