title: Simulation training for geriatric medicine.
abstract: BACKGROUND
  Geriatric medicine encompasses a diverse nature of medical, social and ethical challenges, and requires a multidimensional, interdisciplinary approach. Recent reports have highlighted failings in the care of the elderly, and it is therefore vital that specialist trainees in geriatric medicine are afforded opportunities to develop their skills in managing this complex patient population. Simulation has been widely adopted as a teaching tool in medicine; however, its use in geriatric medicine to date has involved primarily role-play or discrete clinical skills training. This article outlines the development of a bespoke, multimodal, simulation course for specialist trainees in geriatric medicine.
  
  
  METHODS
  A 1-day multimodal and interprofessional simulation course was created specifically for specialist trainees in geriatric medicine, using six curriculum-mapped scenarios in which the patient perspective was central to the teaching objectives. Various simulation techniques were used, including high-fidelity human patient manikins, patient actors, with integrated clinical skills using part-task trainers, and role-play exercises. Debriefs by trained faculty members were completed after each scenario.
  
  
  RESULTS
  Twenty-six candidates attended four similar courses in 2012. Quantitative analysis of pre- and post-course questionnaires revealed an improvement of self-reported confidence in managing geriatric scenarios (Z = 4.1; p < 0.001), and thematic analysis of candidate feedback was supportive of simulation as a useful teaching tool, with reported benefits for both technical and non-technical skills.
  
  
  CONCLUSIONS
  Simulation is an exciting and novel method of delivering teaching for specialist trainees in geriatric medicine. This teaching modality could be integrated into the training curriculum for geriatric medicine, to allow a wider application.
authors.affiliation: Department of Ageing & Health, St Thomas' Hospital, London, UK.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Mehdi
authors.forename: Alastair
authors.initials: A
authors.lastname: Ross
authors.forename: Gabriel
authors.initials: G
authors.lastname: Reedy
authors.forename: Angela
authors.initials: A
authors.lastname: Roots
authors.forename: Thomas
authors.initials: T
authors.lastname: Ernst
authors.forename: Peter
authors.initials: P
authors.lastname: Jaye
authors.forename: Jonathan
authors.initials: J
authors.lastname: Birns
mesh_terms: D000368:Aged; D002983:Clinical Competence; D003479:Curriculum; D005853:Geriatrics / Q000193:education*; D006801:Humans; D016544:Patient Simulation; D013663:Teaching / Q000379:methods