The Portal of Geriatrics Online Education

Facilitator's Guide

A guide created to provide educators with hints, techniques or teaching ideas in a particular area. More comprehensive than a curricular material, including detailed lesson content.

Frailty Interactive Cases and A Facilitator’s Guide

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
view reviews
Other Sponsors: 
This educational activity was produced by the Miami geriatrics research
education and clinical center (GRECC) with support from the Miami VA Healthcare System and special educational funding from the Department of Veterans Affairs
Veterans Integrated Service Network (VISN)
Product Information
Abstract: 

Introduction: Frailty is a diagnosable and treatable medical condition. It is a common syndrome in older adults, characterized by: physiological decline, marked vulnerability to adverse health outcomes, increased healthcare utilization, disability, high risk of falls, multiple comorbidities, and mortality. Our goal was to create a case-based educational resource in frailty for medical and other healthcare students.

Methods: A multidisciplinary team at the Miami VAHS, Geriatric Research Educational and Clinical Center, designed and implemented an 8-module educational resource on frailty: An Introduction and 7 cases covering screening, diagnosis, management, and comorbidities. This curriculum was used and evaluated by 4th-year medical students from the University of Miami Miller School of Medicine. Evaluation included a pre-/post-test and a curriculum evaluation with questions on content, learning objectives, value of the learning, and multimedia module usability. The Wilcoxon signed rank test was used with unilateral Monte Carlo significance to compare pre-/post-test performance, significant at p<.05.

Results: Fifty-one students completed 4 modules and the pre-/post-test from November 2020 to March 2021. Students’ post-test performance demonstrated significant improvement (p<.05) in knowledge of frailty. Fifty-five percent agreed the multimedia educational activity enhanced their knowledge of frailty and will include frailty assessment in their future practices. The combined “Good + Excellent” rating from evaluations of content linked to learning objectives ranged from 82.3-94.2%. Overall, written comments were positive regarding multimedia usability.

Conclusion: These case-based modules on frailty were highly rated and positively critiqued by students. Pre-/post-test evaluations demonstrated an increase in knowledge of frailty.

Keywords

Frailty, sarcopenia, comorbidities, multimedia, case-based learning

Educational objectives: 

There are twelve (12) learning objectives for the seven (7) cases; two learning objectives repeat for multiple cases. The number(s) in parentheses at the end of each learning objective below designates the cases in which the learning objective applies. All learning objectives start with the statement, “After viewing this module, learners will be able to describe.”

  1. Frailty can be diagnosed using accepted criteria and available tools (1)
  2. Frailty can be managed with literature-based interventions that include exercise nutritional support and optimized treatment of comorbid conditions (1)
  3. Frailty is a multifactorial illness with contributions from many domains of well-being: medical, psychological, social and functional (2 through 7)
  4. Frailty is often associated with a reduction in socialization that is often remediable with optimized care across all domains as well as care coordination (2)
  5. As is often the case in caring for patients with complex disease, it takes a team (2, 3, 6, 7)
  6. Frailty is often associated with cognitive deterioration that is often remediable with optimized care across all domains (3)
  7. Frailty is often associated with dependency and the need to recommend palliative care (4)
  8. Frailty is often associated with depression because both are common diseases (5)
  9. Depression can affect frailty by amplifying the symptoms of co-morbid conditions (5)
  10. Frailty coexisting with cognitive impairment need to be recognized early because of their mutual deleterious impact on function (6)
  11. The need to customized cancer care in frail patients based on comorbidities, function and prognosis (7)
  12. The importance of the social domain in care planning for patients with frailty and cancer (7)
Additional information/Special implementation requirements or guidelines: 

 

Facilitator’s Guide

Understanding Frailty: Screening, Diagnosis and Management

Authors

Lubna A. Nasr, MD

Department of Public Health, University of Miami Miller School of Medicine

Bruce W. Carter Miami VAMC, Miami, FL, USA

Raquel Aparicio-Ugarriza, PhD

ImFINE Research Group. Faculty of Physical Activity and Sport Science-INEF

Universidad Politécnica de Madrid, Madrid, Spain

Douglas Salguero, MD

Mount Sinai Medical Center, Miami, FL, USA.

Michael J. Mintzer, MD, AGSF

Director and Associate Director for Education & Evaluation

Miami Geriatric Research, Education and Clinical Center (GRECC), Miami, FL, USA

Acknowledgements

The authors would like to thank:

Rose van Zuilen, PhD, and Corinne B. Ferrari for their help in reviewing the modules and including this frailty training as a component of the MS4 geriatrics clerkship

 

Overview

Frailty is a term widely used in clinical medicine but often ill-defined. The primary purpose of these modules is to teach learners the definition, screening modalities and diagnostic methods for frailty. In addition, the secondary purpose to is display healthcare issues of older adults commonly associated with frailty. These include comorbid conditions, social disruptions, end-of-life care, etc.

This training is composed of eight PowerPoint narrated and animated presentations. PowerPoint was chosen because of its ubiquitous availability to virtually all learners. The introduction presents the basics of frailty definition, screening and diagnosis. The subsequent seven case-based modules ask students to apply their knowledge. We recommend that learners complete a minimum of four modules starting with the introduction and ending with Case 7; learners are free to choose two modules from cases 1 through 6 and are welcome to complete all these optional cases. Finally, case 7 is the most complicated and longest module; if a learner uses the fully narrated and animated features, it will run approximately 25-minutes. To meet individual needs, learners have the option to disable audio (narration and dialog) on some or all of the screens. (These PowerPoint-based modules do not provide the option of varying the speed of audio tracks as in some programs). Most students can complete the minimum of 4 modules in 60-75 minutes; all the modules can be completed in 2-2.5 hours. The list of module titles is included in Learning Objectives below.

All cases use a standardized template. Navigation instructions are included in the Introduction; all cases follow the same instructions. Learners must start with the Introduction followed by cases in numerical sequence; cases become more complex with progression. In evaluating this curriculum, we used: Introduction, followed by Case 1, Case 5 and Case 7. Students can return to the Introduction module at anytime to review terms and definitions.

Materials and Supplies

Access to a computer with Microsoft PowerPoint or other compatible software is required. Headphones or earbuds may be needed if learning is occurring in a congregate environment or because of learner preference. This training requires no other special instructions, materials or supplies. The PowerPoint presentations can be easily uploaded to the school’s learning management system for assignment to learners.

Learning Objectives

Learning objectives are included in each case. These objectives also act as a “preview” for the content within the animated and interactive modules. The introduction has no learning objectives because it is a “definition of terms” module for frailty, sarcopenia, and frailty screening, diagnosis and management. These topics are specifically addressed within the learning objectives of the cases. There are 12 unique learning objectives. Some of the learning objectives appear in more than one case. This is intentional. It allows learners to apply their learning to a new clinical circumstance or a new domain of care. The learning objectives follow the statement, “After viewing this module, learners will be able to describe:” and are listed here by case:

Case 1: Mild Frailty

  • Frailty can be diagnosed using accepted criteria and available tools
  • Frailty can be managed with literature-based interventions that include exercise, nutritional support and optimized treatment of comorbid conditions

Case 2: Moderate Frailty and Falling

  • Frailty is a multifactorial illness with contributions from many domains of well-being: medical, psychological, social and functional
  • Frailty is often associated with a reduction in socialization that is often remediable with optimized care across all domains as well as care coordination
  • As is often the case in caring for patients with complex disease, it takes a team

Case 3: Frailty and Cognitive Symptoms

  • Frailty is a multifactorial illness with contributions from many domains of well-being: medical, psychological, social and functional
  • Frailty is often associated with cognitive deterioration that is often remediable with optimized care across all domains
  • As is often the case in caring for patients with complex disease, it takes a team

Case 4: Severe Frailty, Dependency and Palliative Care

  • Frailty is a multifactorial illness with contributions from many domains of well-being: medical, psychological, social and functional
  • Frailty is often associated with dependency and the need to recommend palliative care

Case 5: Frailty and Depression

  • Frailty is a multifactorial illness with contributions from many domains of well-being: medical, psychological, social and functional
  • Frailty is often associated with depression because both are common diseases
  • Depression can affect frailty by amplifying the symptoms of co-morbid conditions

Case 6: Frailty and Major Neurocognitive Disorder

  • Frailty is a multifactorial illness with contributions from many domains of well-being: medical, psychological, social and functional
  • Frailty coexisting with cognitive impairment need to be recognized early because of their mutual deleterious impact on function
  • As is often the case in caring for patients with complex disease, it takes a team

Case 7: Frailty and Cancer

  • Frailty is a multifactorial illness with contributions from many domains of well-being: medical, psychological, social and functional
  • The need to customized cancer care in frail patients based on comorbidities, function and prognosis
  • The importance of the social domain in care planning for patients with frailty and cancer
  • As is often the case in caring for patients with complex disease, it takes a team

Evaluation

During this curriculum evaluation, we used identical pre- and post-tests, containing seven questions with twenty correct answers, to measure learning. This pre-/post-test is available upon request. All questions were effective in discriminating an increase in learning. Learner comments on content, presentation and usability of the modules were overwhelmingly positive.

Use of These Modules

These modules are free for use for all teachers, instructors and trainers. They can be used as produced and be incorporated into an existing curriculum, in part or in full. When these frailty modules are used or included in another curriculum, questions from the pre-/post-test may be adapted for assessments of students’ learning. As with all student assessments, these questions would likely require revision after several years of use. If adapted versions of this curriculum, or parts of this curriculum, are published, attribution to original authors must be included and these new materials must be equally accessible to teachers, instructors and trainers as are the original materials. These materials may not be used or adapted for commercial purposes. (See Creative Commons criteria: CC BY-NC-SA [Attribution-NonCommercial-ShareAlike]).

Date posted: 
Wed, 08/11/2021
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 06/09/2021
Contact Person/Corresponding Author:



Suggested Citation:
Frailty Interactive Cases and A Facilitator’s Guide. POGOe - Portal of Geriatrics Online Education; 2021 Available from: https://pogoe.org/taxonomy/term/292

Medication Safety: A Key Ingredient to Your Health

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Estimated time to complete: 
1
Abstract: 

'Medication Safety' is a training module designed to education older adults, caregivers, and healthcare students on key issues related to geriatric pharmacy. Topics include polypharmacy, over-the-counter products, health literacy and communication with healthcare providers. Training materials include a brochure and facilitator's manual.

Educational objectives: 

Participants will understand how age-related changes impact the effects of medications.

Participants will understand the dangers of adverse drug interactions.

Participants will be able to identify questions to ask a healthcare provider when new medications are prescribed.

Date posted: 
Tue, 10/18/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 10/18/2016
Contact Person/Corresponding Author:



Suggested Citation:
Medication Safety: A Key Ingredient to Your Health. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/292

Advance Care Planning and POLST Conversation Guide

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
view reviews
Other Sponsors: 
VA National Center for Ethics in Health Care
Product Information
Estimated time to complete: 
3
Abstract: 

This is an educational product to teach health care providers how to conduct goals of care conversations with patients and caregivers

Educational objectives: 

1. Recognize and respond to emotional cues during challening conversations  2. Demonstrate how to elicit patient perception of illness and goals of care 3. make a recommendation about code status based on patient's goals 4. Provided a basic description of CPR avoiding medical jardon 5. Discuss possible outcomes of CPR including survival percentages and possible risks.

 

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Advance Care Planning and POLST Conversation Guide. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/292

Barney Smith - A Progressive Palliative Care Standardized Patient

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Other Intended Learner Audiences: 
Graduate Health Profession Students
Product Information
Abstract: 

This six part progressive standardized patent serves re train medical students to care for an older adult with a life limiting condition, including making the diagnosis of multiple myeloma, breaking bad news, transitions of care from the hospital to home and curative care to palliation, through advance directiive discussions, and eventually into hospice and his death. The six encounters occur from Year 2 through Year 4 of the medical school curriculum , with a scripted five year span of patient care. Educational modalities include standandized patients, simulation, web-based modules, and small group discussions. 

Educational objectives: 

1) Provide medical care for an older adult with a life limiting condition from their diagnosis through their death

2) Understand the roles of the medical provider and other health care disciplines, as individual providers and as a team, in caring for an older adult with a life limiting diagnosis as they transition from the hospital to home and from curative care to palliation

3) Assist family caregivers in identifying caregiver responsibilities and potential caregiver burden

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Barney Smith - A Progressive Palliative Care Standardized Patient. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/292

Interprofessional Geriatric Education and Training in Texas: Seniors Assisting in Geriatric Education - Interprofessional Team-Based Training, Assignments & Grading

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Other Intended Learner Audiences: 
Dietetics Students
Social Work Students
Physician Assistant Students
Physical Therapy Students
medical students
Health Professions Faculty
Product Information
Abstract: 

The Seniors Assisting in Geriatric Education (SAGE) program consists of an educational curriculum and community based outreach program aimed at increasing student opportunities for early exposure to older adults and issues of geriatrics. The program strives to create meaningful relationships for the interprofessional teams of students while gaining knowledge about today’s senior population and their needs. The educational component involves health care profession students interacting with each other and their senior mentor through structured assignments delivered in the home environment.

Student teams are paired in groups of 3-4 healthcare profession students. The student teams are then matched with a community-dwelling senior who receives services from Meals on Wheels or a senior volunteer from the local community. The program includes 6 visits over a 2 year period providing students an opportunity to apply their classroom education in the context and care of an older adult. Students practice and demonstrate basic clinical skills; including taking histories, interviewing, conducting examinations and cognitive assessments, and advising clients on nutrition, home safety, community resources and advance care planning.     

Educational objectives: 
  • Health professions students will develop competency with older adults;
  • Strengthen health care students clinical applications of medical education through an Interprofessional team experience in the SAGE Program;
  • Health professions students learn from each other and appreciate each others professions.
Publications from, presentations from, and/or citations to this product: 

SAGE Presentations

Marquez-Hall, S. (2015). Interprofessional practice: Seniors assisting in geriatric education. A round table presentation at the Interprofessional Practice Symposium, University of North Texas Health Science Center in Fort Worth, TX.

Marquez-Hall, S. Lane, Y. (2014) seniors assisting in geriatric education (SAGE): Reynolds program address the lack of training in geriatrics and provides a model for interprofessional education. Jefferson Center for Interprofessional Education Annual Conference, Jefferson Medical College, Philadelphia, PA.

SAGE Poster Presentations:

Marquez-Hall, S., Pitts-Lane, Y. Knebl, J., (2015). Seniors assisting in geriatric education (SAGE): Reynolds program addresses the lack of training in geriatrics and provides a model for interprofessional education. Poster presentation at Research Appreciation Day, University of North Texas Health Science Center, Fort Worth, TX.

Marquez-Hall, S., Lane, Y., Smith, R. (2014) Survey of medical students in a geriatric training program. Poster presentation at the American Geriatric Society Annual Scientific Meeting, Baltimore, MD.

SAGE Awards:

2013 Mae Cora Peterson Senior Spirit Award in recognition of the Seniors Assisting in Geriatrics Education (SAGE) Program, Senior Citizens of Tarrant County, Texas.

2011 AACOM Excellence in Communications Award. Second Place - Best Community Service Program-Serving Fewer Than 1,000. SAGE Program; University of North Texas Health Science Center at Fort Worth, Texas College of Osteopathic Medicine.  

Date posted: 
Thu, 10/13/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/13/2016
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Geriatric Education and Training in Texas: Seniors Assisting in Geriatric Education - Interprofessional Team-Based Training, Assignments & Grading. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/292

IMPROVE Polypharmacy Clinic Resource Site

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Other Learning Resource Type: 
Website
Product Information
Estimated time to complete: 
3
Abstract: 

Polypharmacy and inappropriate prescribing are common among older adults. Polypharmacy is associated with a variety of adverse outcomes in older adults including falls, adverse drug events, hospitalization, mortality, and measures of function and cognition. The Initiative to Minimize Pharmaceutical Risk in Older Veterans (IMPROVE) is an interprofessional polypharmacy clinic within an academic patient-aligned care team at the VA Connecticut Center of Excellence in Primary Care Education. The clinic consists of a pre-clinic conference, shared medical appointment, individual visit, and team precepting. The team consist of a pharmacist, geriatrician, primary care provider, and health psychologist and involves medicine residents, nurse practitioner residents, pharmacy residents, and psychology residents. This website describes the clinic design and provides the resources and links helpful for starting an IMPROVE Polypharmacy Clinic including forms, short topic discussions in polypharmacy, and various other resources helpful for deprescribing.

Educational objectives: 

This website:

1.  Describes the IMPROVE Polypharmacy Clinic design

2.  Provides resources needed to implement an IMPROVE Polypharmacy Clinic

3.  Provides handouts for short topic discussions on various polypharmacy-related topics and deprescribing

Date posted: 
Thu, 10/13/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/13/2016
Contact Person/Corresponding Author:



Suggested Citation:
IMPROVE Polypharmacy Clinic Resource Site. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/292

Interdisciplinary Experience on ACE Unit

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Abstract: 

During a 2- or 4-week elective geriatric rotation for medical students and month-long required rotation for Family Medicine residents, learners spend time as part of the ACE Unit Interdisciplinary Safety Team. One to two half days are spent working alongside patient care aides, physical therapy, occupational therapy or nursing to be exposed to a typical day for each team member. The experience allows learners to see the unqiue ways each discipline addresses the safety and works to maintain function of vulnerable, hospitalized older adults. Learners also participate in interdisciplinary rounds with their designated team members. 

Afterward, learners complete a written, personal reflection on the experience. Reflective ability is an important skill for practicing physicians but is rarely taught or encouraged through medical school or residency training. Furthermore, reflection is an important step in cementing new learning. 

Attached is a sample of the 2-week curriculum, a list of resources used with learners and overall description of the ACE rotation. Samples of these reflections are also included. Please contact me if you would like more information on the overall structure of these rotations. 

 

 

Educational objectives: 

1. Describe and participate in roles filled by physical therapy, occupational therapy, nursing and patient care aides as part of an interdisciplinary safety team caring for vulnerable, hospitalized older adults. 

2. Reflect on the experience to apply to future practice as a clinician. 

Date posted: 
Fri, 10/21/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 10/21/2016
Contact Person/Corresponding Author:



Suggested Citation:
Interdisciplinary Experience on ACE Unit. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/292

Geriatric Interprofessional Teaching Clinic (GITC)

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
view reviews
Other Learning Resource Type: 
Clinic model
Other Intended Learner Audiences: 
Physical Therapy Students
Occupational Therapy Students
Dietetics Students
Social Work Students
Product Information
Estimated time to complete: 
1
Abstract: 
•Collaborative interprofessional practice and care are essential to the complex healthcare needs of a rapidly growing older adult population.
•Interprofessional collaboration (IPC) occurs when various health care practitioners, clients and/or caregivers work together to improve a client’s overall health.
•Teaching an IPC model continues to be a major gap in every health professionals’ education.
•To address this gap, the Geriatrics Interprofessional Teaching Clinic (GITC) at the University of Kansas Medical Center's Landon Center on Aging was created. It incorporates six professions: Students and faculty from  Physical Therapy, Medicine, Pharmacy, Social Welfare, Dietitics/Nutrition and Occupational Therapy.
•It is scheduled one half day a week with four patients scheduled on a "rolling" basis allowing for interprofessional teams of three to see patients in a staggered fashion. On average, each visit takes approximately 60-90 minutes.
•Logistically, students from 3 professions review the medical record together, discuss what they want to accomplish in the room, and how they will approach the patient encounter as a team. The students then see the patient and report back to the attending physician and other health professions faculty as a team. The assessment and plan for the patient is developed by the team.
•Team members are asked to define their roles by what the patient needs at that particular visit, starting with their own professional training and scope of practice, but then encouraged to allow themselves to participate in new ways. The interprofessional clinic faculty assist the learners by facilitating reflection on their clinical performance as individuals and as a team at the time of the clinic visit, incorporating their reflections into their next clinical encounter and through debriefing.
•To quantify interprofessional collaboration, evaluation tools are being piloted to assess for team dynamics, and surveys are sent out to each individual learner to assess for behavior and attitude changes. These are both done at the "beginning" and "end" of their GITC experience.
 
 
Educational objectives: 
•Create an interprofessional (IP) clinic involving multiple learners, emphasizing the national interprofessional competencies (values/ethics, roles/responsibilities, interprofessional communication and teams/teamwork).
•Train students in IP teams to evaluate their communication with the patient and with other team members following a patient encounter in GITC using a validated rubric. 
•Monitor changes in IP team behavior through individual learner evaluations.
Date posted: 
Mon, 10/10/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/10/2016
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Interprofessional Teaching Clinic (GITC). POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/292

Building Caregiver Partnerships Through Interprofessional Education

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
view reviews
Other Intended Learner Audiences: 
Health professions faculty and health providers of all levels
Other Sponsors: 
Arthur Vining Davis Foundations
Product Information
Estimated time to complete: 
1
Abstract: 

Family caregivers are on the frontlines managing complicated chronic illnesses, assisting with day-to-day functioning, and providing direct care to manage symptoms and improve the quality of life of their loved ones. Yet, health professions students, medical/surgical residents, and care providers receive little, if any, training on the vital role that caregivers play on the healthcare team and how, effective partnering optimizes patient care throughout the illness trajectory and at end-of life.

The goal of Building Caregiver Partnerships through Innovative Interprofessional Education is to create effective partnerships between healthcare providers and family caregivers to reduce the burdens, ease suffering, and enhance the meaning of the caregiving experience for the patient, family and health care providers.  The project centers on a 20-minute film, No Roadmap: Caregiver Journeys, which features the compelling stories of four caregiving families. The film and companion discussion guides as well as resources for case-based learning and structured clinical encounters are freely accessible on the website. http://www.neomed.edu/medicine/palliativecare/building-caregiver-partnerships/

The website is designed so that faculty can easily select the materials that best fit their learners’ needs and the time constraints within their programs. The curricula is appropriate for medical, pharmacy, nursing, and other health professions educational programs at both undergraduate and graduate levels. Additionally, tools have been developed for interdisciplinary team-based forums and health provider training.  For medical/surgical residency programs, relevant ACGME milestones are identified. 

Educational objectives: 

The objectives of the educational tools are to prepare learners to:
• Describe home-based eldercare as a shared experience and the importance of building a relationship with family caregivers and care recipients based on trust, compassion and open communication; 
• Describe the vital role of family caregivers as important, but under recognized, members of the health care team;
• Discuss the meaning and challenges of family caregiving;
• Engage caregivers in meaningful discussions to identify the needs, values and goals of their caregiving family;
• Identify resources to address caregiver concerns and provide ongoing support; and
• Provide holistic team-based care to family caregivers that improves the quality of life for the care recipient and the caregivers. 

 

Publications from, presentations from, and/or citations to this product: 

~~Date/Location Meeting/Forum Presentation Title Presenter(s)
Jan 28-31, 2016, Phoenix, Arizona; Society of Teachers of Family Medicine; 45 min presentation;  Exploring Caregiver Journeys: A Curricular Tool for Family Medicine Clerks;  D. Sperling; J.T. Thomas

March 10-13, 2016; Chicago, Ill;  American Academy of Hospice and Palliative Medicine;  60-min workshop; Using Film to Foster Empathetic Partnerships between Care Providers and Family Caregivers;  J. Drost; E. Scott; M. Scott; D. Damore; S. Radwany

May 19-21, 2016; Long Beach, Ca; American Geriatrics Society; Poster; Building Caregiver Partnerships Through Innovative Health Professions Education; E. Scott, S. Radwany, D. Drost, K. Baughman, B. Palmisano, M. Sanders

May 19-21, 2016; Long Beach, Ca; American Geriatrics Society; Educational Product Session; Building Caregiver Partnership Through Innovative Health Professions Education; J. Drost; B. Palmisano

May 25, 2016; NEOMED Department of Family and Community Medicine Resident Scholarship Day; 15 min presentation; Exploring Caregiver Journeys: A Curricular Tool for Family Medicine Residents; D. Sperling; J.T. Thomas
 

Date posted: 
Mon, 12/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 09/23/2020
Contact Person/Corresponding Author:



Suggested Citation:
Building Caregiver Partnerships Through Interprofessional Education. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/292

Goals of Care Conversation Curriculum (GOCCC) Training

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
view reviews
Product Information
Estimated time to complete: 
2
Abstract: 

We developed a 3-part curriculum for teaching the basics of communication about goals of care (GOC) in older persons targeted towards medical students, residents, fellows, and faculty. There are 3 modules: 

1. Communicating Serious News - identifies strategies for effective communication and especially communicating serious news to patients or family members and improving our ability to transmit this news in an empathic and effective manner.

2. Goals of Care Discussion -focuses on the essential components of a GOC discussion; initiation, understanding the patient and family perspective, surrogate decision making, and concluding remarks clarifying and summarizing key discussion points and areas of understanding.

3. Managing conflict with patients and families - focuses on how to address frustrated and perhaps angry patients or family members who sometimes don’t feel that they are being listened to.  As providers, we are often put in this situation with few resources or skills to help guide us on how to deal with the patient’s and family’s emotions as well as our own. 

Each module contains a didactic lecture (45-60 minutes), examples of faculty role play (10-15 minutes), and instructions for participant role play activities. Each module is focused around a clinical case scenario done in dyads (30 minutes), and a sample evaluation form. Each module is best done in 2-hour sessions and in small groups (10-20 participants) but can be modified for 1-hour sessions. The content is applicable to a range of learners although the participant role play will likely be more meaningful for the more advanced learners.

Educational objectives: 

At the end of Module 1: Discussing Serious News, students, residents, and faculty will be able to:        

a.      Use curiosity and good listening skills to understand patient coping styles

b.      Describe empathic and effective approaches to discussing serious news

c.       Identify strategies for discussing prognosis

At the end of Module 2: Basic GOC, students, residents, and faculty will be able to:

a.       Be comfortable and effective in talking with patients and families about goals of care for patients with serious life-threatening, or chronic conditions

b.      Describe goals of care discussions as an essential component of the practice of medicine accepted within the mainstream of legal, moral, and ethical principles

c.       Articulate the complexity and subtleties of surrogate decision-making,  and the concept of substituted judgment

d.      Practice the key components of goals of care discussions in a simulation as a means of gaining competence and confidence in conducting GOC conversations

At the end of Module 3: Managing Conflict, students, residents, and faculty will be able to:

a.       Manage conflict in an effective and empathic manner to de-escalate anger and frustration experienced by patients and families during serious illness

b.      Recognize that in life-threatening situations, anger is a common response

c.       Describe communication techniques for diffusing anger

d.      Apply recommended skills to manage conflict and guide patients, families, and other clinicians through difficult decisions

Date posted: 
Mon, 06/20/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 08/08/2019
Contact Person/Corresponding Author:



Suggested Citation:
Goals of Care Conversation Curriculum (GOCCC) Training. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/292

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