The effect of a 12-month longitudinal long-term care rotation on knowledge and attitudes of internal medicine residents about geriatrics.
OBJECTIVE
To determine if participation in a 12-month longitudinal long-term care (LTC) rotation resulted in improved knowledge and attitudes about geriatrics.


METHODS
Longitudinal study with paired measurements.


METHODS
A community LTC facility and a university-affiliated, community-based internal medicine residency program.


METHODS
Sixty-seven internal medicine residents who participated in the rotation from 1997 through 2004.


METHODS
The internal medicine residents attended nursing home (NH) rounds one half day per month for 1 year, during which time they participated in a case-based interactive lecture on a core geriatric topic and rounded on their assigned patients.


METHODS
Knowledge was assessed using a 70-item test. Attitudes were evaluated with a 28-item, 5-point Likert scale (1 = least positive, 5 = most positive).


RESULTS
The percent correct responses on geriatric knowledge pretest was 47% (95% CI = 45.2% to 48.8%) and on the posttest it was 57.5% (95% CI = 55.3% to 59.6%) (t = 8.180, df = 67, P < .001). The pretest total attitude score was 3.6 (95% CI = 3.6 to 3.7), with a posttest score of 3.7 (95% CI = 3.7 to 3.8) (P < .001). The difference in this total was accounted for mainly by the significant changes in the attitude subscales in educational preparation (pretest 3.6 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P < .001]), general attitudes (pretest 4.0 [95% CI = 3.9 to 4.1]; posttest 4.2 [95% CI = 4.0 to 4.3] [P = .006]), and therapeutic potential (pretest 3.7 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P = .048]).


CONCLUSIONS
A longitudinal LTC rotation is an efficient and effective way to systematically provide internal medicine residents their core knowledge and experience in geriatrics.
Baum
Elizabeth E
EE
Northeastern Ohio Universities College of Medicine (NEOUCOM), Affiliated Hospitals at Canton, Canton, OH 44708, USA. elizabeth.baum@csauh.com
Nelson
Karl M
KM
D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003362:Cost-Benefit Analysis; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000458:organization & administration; D004521:Educational Measurement; D017598:Efficiency, Organizational; D015577:Geriatric Assessment; D005853:Geriatrics / Q000193:education*; D017408:Guidelines as Topic; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration*; D008134:Long-Term Care / Q000458:organization & administration*; D008137:Longitudinal Studies; D009735:Nursing Homes; D009820:Ohio; D015397:Program Evaluation; D020377:Self Efficacy; D011795:Surveys and Questionnaires