title: Geriatric education for surgical residents: identifying a major need.
abstract: This study evaluated a program designed to test and enhance residents' knowledge of geriatrics. A 2-year prospective interventional trial was conducted. Surgical residents underwent pretesting (pre) in three areas: polypharmacy, delirium, and end of life. They then received educational  materials and completed a posttest within 1 month and a patient simulation examination graded by a physician observer and the patient on his or her satisfaction. Forty-nine residents (51% interns, 55% general surgery residents) participated. Seventy per cent had no prior geriatrics education.  Test scores significantly improved from pretest to posttest (12.9 ± 3.1 vs 13.78 ± 3.12, P = 0.01). The scores were consistently better on poly topics and consistently worse on end-of-life topics: pretest per cent correct: polypharmacy 60, end of life 46, P  = 0.007; posttest percent correct: polypharmacy 63, end of life 49, P = 0.0014. By Pearson correlation, the pretest and posttest scores did not correlate with either the observer (R = -0.16, P = 0.27 pre, R = -0.08, P = 0.59 post) or subscores  (R = -0.27, P = 0.11 pre, R = -0.13, P = 0.45 post), although the observer and subscore correlated with each other (R = 0.35, P = 0.036). Performance was poor and did not correlate with better patient care by simulation. Other options for  geriatric education need to be considered and evaluated.
authors.affiliation: Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA. tmduane@vcu.edu
authors.forename: Therèse M
authors.initials: TM
authors.lastname: Duane
authors.forename: Lingbo
authors.initials: L
authors.lastname: Fan
authors.forename: Arline
authors.initials: A
authors.lastname: Bohannon
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Han
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfe
authors.forename: Julie
authors.initials: J
authors.lastname: Mayglothling
authors.forename: James
authors.initials: J
authors.lastname: Whelan
authors.forename: Michael
authors.initials: M
authors.lastname: Aboutanos
authors.forename: Ajai
authors.initials: A
authors.lastname: Malhotra
authors.forename: Rao R
authors.initials: RR
authors.lastname: Ivatury
mesh_terms: D002983:Clinical Competence; D013502:General Surgery / Q000193:education*; D005853:Geriatrics / Q000193:education*; D007396:Internship and Residency; D011446:Prospective Studies