UNC Chapel Hill Reynolds Curriculum

Alliance for Geriatric Education in Specialties (AGES)

Abstract:

The Alliance for Geriatrics Education in Specialties (AGES) consists of 8 interactive core curriculum modules: iatrogenic injury, delirium, dementia, polypharmacy, transitions of care, basics of geriatrics assessment and levels of care, physiology of aging, palliative care communication and medications. These 8 modules have been designed to teach specialty faculty, at all levels of their career, how to increase effectiveness and quality of care for their older adult patients. In 2009, the University of North Carolina School of Medicine at Chapel Hill conducted a needs assessment to evaluate the potential for improvement of UNC Healthcare System specialty/subspecialty faculty regarding geriatrics care through training. Based on the assessment results, the AGES curriculum was developed, implemented, evaluated, and now available for use through POGOe. The AGES curriculum can be taught as an entire course or each module can be taught as a separate training session. The UNC Healthcare System is currently using all 8 modules for training its non-geriatrician specialty faculty. Each of the 8 module PowerPoint presentations will take approximately 60 minutes per training session. *This curriculum may also be applicable to internists and family medicine practitioners.
Educational objectives:

Objectives by Module

Module 1: The Physiology of Aging

• Learners will be able to describe the normal changes that occur with aging

• Learners will be able to identify the common age-related changes that occur in the following systems: cardiovascular, respiratory, renal,

hematology/immune, gastrointestinal, endocrine, neurologic, musculoskeletal, and reproductive

Module 2: Dementia

• Learners will be able to define dementia

• Learners will be able to name risk factors/causes for dementia

• Learners will be able to discuss why delirium and depression are predictors/red flags for dementia

• Learners will be able to discuss assessment tools/strategies for identifying dementia

• Learners will be able to name at least 5 types of dementia

• Learners will be able to discuss the treatment options for dementia

Module 3: Delirium

• Learners will be able to define delirium and describe its cardinal features and underlying pathophysiology

• Learners will be able to recognize that delirium is common, under-diagnosed, and associated with significant morbidity and mortality

• Learners will be able to, regarding delirium, identify ways to:

» prevent

» diagnose

» evaluate

» manage

• Learners will be able to teach key concepts in < 1 minute

• Learners will be able to define delirium and describe its cardinal features and underlying pathophysiology

Module 4: Transitions of Care

• Learners will be able to define transitional care

• Learners will be able to identify barriers to providing improved transitional care to patients

Module 5: Basics of Geriatric Assessment & Levels of Care

• Learners will be able to illustrate the importance of physical, cognitive, and psychosocial assessments for older adults

• Learners will be able to describe Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)

• Learners will be able to demonstrate gait assessment and falls risk assessment with an older adult

• Learners will be able to demonstrate cognitive and depression screening with an older adult

Module 6: Iatrogenic Injury

• Learners will be able to list the most common types of iatrogenic injuries

• Learners will be able to identify the most common cause of nosocomial fever in the hospital

• Learners will be able to identify the reasons for use of restraints and how to avoid using them

• Learners will be able to list the appropriate use of urinary catheters

Module 7: Palliative Care Communications

• Learners will be able to address Palliative Care misconceptions: What, Why, Where, Who

• Learners will be able to review outcomes of Palliative Care

• Learners will be able to present general communication strategies

• Learners will be able to discuss pain assessment and management principles for older adults

Module 8: Polypharmacy

• Learners will be able to identify risk factors for Adverse Drug Events (ADEs) in older adults

• Learners will be able to identify the physiologic changes associated with normal aging that influence pharmacokinetics and pharmacodynamics

• Learners will be able to recognize ADEs when an older adult presents with a new clinical condition or complaint

• Learners will be able to avoid potentially harmful medications for older adults

• Learners will be able to utilize strategies for shortening medication lists and carefully introducing new medications