title: Multidimensional attitudes of emergency medicine residents toward older adults.
abstract: BACKGROUND
  The demands of our rapidly expanding older population strain many emergency departments (EDs), and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM) resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis.
  
  
  METHODS
  Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA.
  
  
  RESULTS
  173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score). Attitudes trended to more negative in successive post-graduate year (PGY) levels.
  
  
  CONCLUSIONS
  EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels.
authors.affiliation: University of Chicago, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Teresita M
authors.initials: TM
authors.lastname: Hogan
authors.affiliation: Presence Resurrection Medical Center, Chicago, Illinois.
authors.forename: Shu B
authors.initials: SB
authors.lastname: Chan
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Bhakti
authors.initials: B
authors.lastname: Hansoti
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D004503:Education, Medical, Graduate; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital; D005260:Female; D005853:Geriatrics / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D011795:Surveys and Questionnaires