Elderly surgical patients: are there gaps in residency education?
BACKGROUND
Geriatric education is essential to ensure the competency of residents caring for the aging population. This study assesses and correlates resident and faculty perceptions of resident geriatric-related competencies to clinical care.


METHODS
A survey was sent to 40 general surgery residents and 57 faculty members. Five clinical care markers were identified for chart audit. A retrospective chart audit was performed of 22 injured elderly patients.


RESULTS
Among the respondents, 30 of 40 (75%) residents and 22 of 57 (39%) faculty completed the survey. Residents rated their competency higher than faculty on all competency-related questions (p = 0.0002). The following 4 questions had a mean faculty rating below acceptable: screening guidelines, delirium management, contraindicated medications, and medication adjustments. On chart review: code status was documented in 7 of 22 (32%) patients and goals of care in 1 of 22 (5%) patients. Pain control included rib block or epidural in 14 of 22 (64%) patients. Contraindicated medications were prescribed in 13 of 22 (59%) patients.


CONCLUSIONS
A competency-based needs assessment of geriatric training in a general surgery residency has identified educational "gaps." This needs assessment supports implementation of geriatric education initiatives in our general surgery program.
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
John
J
Petronovich
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Thomas J
TJ
Wade
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Kathryn
K
Denson
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: trwebb@mcw.edu.
Travis P
TP
Webb
D000368:Aged; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate; D013502:General Surgery / Q000193:education*; D005853:Geriatrics / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D020380:Needs Assessment; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States
Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; curriculum; geriatrics; needs assessment; residency