PREVIOUS SFDC PROGRAM: GERIATRICS IN PRIMARY CARE

Each year six medical faculty are selected to attend the Stanford Faculty Development Center for training as Geriatrics in Primary Care (GiPC) seminar facilitators. The 1-month facilitator training course provides participants with the background knowledge and seminar leadership skills they need to deliver a series of eight 2-hour seminars to faculty and residents.

Curriculum:

The Geriatrics in Primary Care curriculum covers the following areas:

Diversity of Health & Function in the Third Age
Assessment & Management of Selected Geriatric Syndromes
Health Promotion: Screening
Health Promotion: Behavior Change
Depression, Dementia & Delirium
Longitudinal Care Options
Addressing Difficult Decisions

The seminars are designed to assist primary care faculty to enhance their own ability to care for older patients as well as their ability to teach medical trainees to care for older patients. Participants are encouraged to explore attitudes, knowledge, and skills related to geriatrics through a variety of instructional methods including: case studies, didactic presentations, role play exercises, brainstorming sessions, and personal and institutional goals setting. During an eighth session, participants develop a set of recommendations for improving their institution's educational environment for geriatrics.

Facilitator Training:

Training activities at Stanford include:

Instruction in curriculum by project faculty
Review of selected background literature
Training in teaching skills
Review and practice of the seminars
Delivery of practice seminars to local faculty and postdoctoral fellows
Presentations by guest speakers
Field trips to older adult care programs
Sessions on homesite implementation and data collection for program evaluation.

Program faculty: Peter Pompei, MD; Oma Morey, PhD; Catherine Bree Johnston, MD, MPH; and program alumni.

List of Trained GiPC facilitators:

36 Institutions	44 Facilitators	Program
Boston University, Boston, MA	Laura Goldman	GiPC 2004
Case Western Reserve, Cleveland, OH	Amir Guirguis	GiPC 1999
Christiana Care Health System, Wilmington, DE	Diane Coniglio	GiPC 2000
Cornell University	Veronica LoFaso	GiPC 2001
Emory University, Atlanta, GA	Stephanie Brown-Johnson Monica Parker	GiPC 1998 GiPC 2004
Georgetown University Medical Center, Washington, DC	Shyrl Sistrunk	GiPC 1997
Henry Ford Health System, Detroit, MI	Elena Perry-Thornton	GiPC 1999
Highland General Hospital, Oakland, CA	Sonia Levingston	GiPC 1998
McKeesport Hospital, McKeesport, PA	Daphne Bicket	GiPC 1998
Meharry Medical College	Adejoke Aina-Babalola Leonard Webster	GiPC 2001 GiPC 2002
Monterrey Institute of Technology, Monterrey, Mexico	Abel Barragan-Berlanga	GiPC 2003
Morehouse School of Medicine, Atlanta, GA	Folashade Omole	GiPC 2000
Mount Sinai Medical School, City University of New York, NY	Rainier Soriano	GiPC 2000
New York Medical College, New York, NY	Caroline Vitale	GiPC 2004
Oregon Health Sciences University, Portland, OR	Elizabeth Eckstrom	GiPC 1997
Ponce School of Medicine, Ponce, Puerto Rico	Hector Gil de Rubio Muneca Rivera	GiPC 2003 GiPC 2003
Santa Clara Valley Medical Center, San Jose, CA	Gary Pasternak	GiPC 1997
Singapore General Hospital, Singapore	Ng Yuen Yen	GiPC 2003
St. Joseph's Mercy Hospital, Ann Arbor, MI	Evan Morrison	GiPC 1997
Uniformed Services Univ. of the Health Sciences, Bethesda, MD	Ellen Pinholt	GiPC 2002
University of Buenos Aires, ARGENTINA	Judith Estremero	GiPC 1999
University of California, Davis, CA	Lisa Gibbs	GiPC 2001
University of California, Irvine, CA	Anne Musser	GiPC 2002
University of California, San Diego, CA	Arnold Gass	GiPC 2003
University of California, San Francisco, CA	Helen Chen Gregory Bugaj Diana Jao	GiPC 1998 GiPC 1998 GiPC 2001
University of California, Los Angeles, CA	Huan Guu Theresa Nevarez	GiPC 2000 GiPC 2004
University of Illinois, Chicago, IL	James Wendt	GiPC 2001
University of Miami, Miami, FL	Lisa Granville	GiPC 1997
University of Michigan, Ann Arbor, MI	Brent Williams	GiPC 2002
University of Nevada, Reno, NV	Diane Chao	GiPC 2003
University of Oklahoma , Tulsa , OK	Robert Salinas	GiPC 1999
University of Pennsylvania, Philadelphia, PA	Hollis Day Jennifer Kapo	GiPC 1998 GiPC 2004
University of Ryukyu, Okinawa, JAPAN	Yuko Takeda-Yamashita	GiPC 2000
University of South Carolina, Columbia, SC	Natalie Johnson Donna Ray	GiPC 2001 GiPC 2002
University of Texas, Southwestern, Dallas, TX	Larry Irvin	GiPC 2002
Wayne State University, Detroit, MI	Vidya Chalasani	GiPC 1997

Homesite Seminars:

Following their training at Stanford, the facilitators return to their home institutions to conduct the seminars for a group of their fellow faculty and for a group of residents. As part of the evaluation of this train-the-trainer diffusion process, the facilitators are asked to play a critical role in gathering data during the post-training year. Evaluation activities include questionnaire administration, videotape recording of seminars, and personal record keeping during the implementation of training.

The teaching of seminars in subsequent years is based on an institution's size and needs. Trained facilitators also serve as regional and national faculty development resources for geriatrics in primary care.

Results of Program Evaluation:

Seminars rated as highly useful
Significant increases in participants' knowledge of geriatric content
Significant increases in self-reported skills related to geriatrics

Comments from SFDP-trained Geriatrics in-Primary Care Facilitators:

"This has been an outstanding opportunity for personal and professional growth. This has been the most intense and productive learning experience that I can recall."

"An opportunity to be re-inspired about practicing medicine and teaching."

"It has been a rigorous month both in terms of content and process... it has allowed me to "think again" which I think we don't get to do much of with clinical pressures. It is a faculty development program and I feel rejuvenated and ready to pursue clinical teaching and continued self improvement with a new found energy."

"My knowledge has expanded exponentially. The content was well chosen and I now feel dramatically more comfortable with it than when I first arrived. The "extra" talks and field trips helped keep us focused on the real people we are learning to care for, and this curriculum includes a very heartfelt humanism that could have easily been lost."

"My content knowledge increased
considerably. My interest in self-directed learning via reading, computer, etc. sky rocketed. My desire to really learn and understand what I can do to improve the quality of life for my older patients has increased. My consciousness of the special problems and barriers to caring for the elderly is much higher."

"There is clearly a stimulating and concise method to teach geriatrics in primary care which I was beginning to doubt but am happy to realize exists."

"Taking care of [a] primarily geriatric population, I thought I knew geriatrics. This course allowed me to have new insights about the field. Not only did I learn [the] clinical knowledge base to care for the patient, [but] I also learned the basic principle behind it that I will now be able to teach. I enjoyed the past 30 days and will enjoy geriatrics in primary care for life."

Comments from Faculty Participants in Home-site Seminars:

"Attending this seminar changed my attitude and knowledge about geriatric care."

"Thorough review of information for both clinical use and teaching use - very practical."

"Overall excellent - will recommend the seminars to others."

"Enjoyed exposure to concentrated geriatric teaching, which I did not receive in my medical training."

"Our facilitator is a great resource for us on geriatric issues."

Comments from Resident Participants in Home-site Seminars:

"I was enlightened by the difference between knowing a subject well enough to practice, and teaching it. I enjoyed learning the tools for teaching."

"Excellent course on geriatrics in terms of learning theories and practical applications of common geriatric problems. I feel more confident in managing my geriatric population: it does not seem overwhelming now."

"I have incorporated many of the tools for assessment into my practice."

"I had hardly any knowledge base as a foundation; now I have a practical guide to utilize."

"Concise seminars: lots of group involvement and participation."

"I expected not to enjoy this seminar - to be bored. I was pleasantly surprised. I think it was definitely interesting and very relevant and useful. The instructor did a great job. I will speak highly of it to colleagues."

"The small group lesson format was particularly effective; the instructor obviously put in a tremendous amount of effort; the time I spent here was extremely useful."

Download the Geriatrics in Primary Care Literature Database (Final Update 1/2005)