ABSTRACT
Background: The COVID-19 pandemic profoundly impacts post - graduate medical education. Training programs redeploy their residents in various ways, emphasizing on - line curriculum for subsets of trainees held in reserve for medical service coverage should a shortage of providers occur. Block rotations are subject to disruptions due to trainee quarantines and mid - rotation re-assignments. All these factors potentially impact Geriatrics education, arguably one of the most important rotations for trainees confronting a myriad of Geriatric problems during the pandemic such as atypical manifestation of disease, social isolation, deferred chronic disease management and important What Matters issues relevant to serious COVID-19 illness. Methods: A required block rotation for 3rd year Internal Medicine and Family Medicine residents was evaluated for pandemic - related changes in trainee attendance, didactic engagement, and knowledge acquisition represented by pre and post rotation written examinations. Results: Resident attendance at the Geriatric clinics was reduced by 50% or more during the pandemic. Internal medicine residents averaged 12 days per month of Geriatric clinics pre - pandemic whereas this attendance decreased to 4 days per month during the pandemic. Similarly, family medicine residents averaged 10 days of attendance per month pre - pandemic and this number declined to 5 days per month during the pandemic. None of the days missed in Geriatric clinic were due to quarantines. The absences were attributed to redeployment to the hospital, increased administrative tasks such as on - line interviewing of resident applicants, interviews for fellowship programs, and un-excused absences. Trainee test performances after the rotation showed no improvement in Geriatrics knowledge and surprisingly rivaled Geriatrics knowledge levels of 3rd year medical students who take the same test. Conclusions: The pandemic has profoundly disrupted Geriatric Block rotations for post graduate medical trainees resulting in inadequate clinical experiences and failure to achieve incremental improvements in Geriatrics knowledge representative of an independently practicing internist or family medicine provider.
ABSTRACT
Background: The ongoing COVID-19 pandemic has adversely affected face-to-face time for teaching and learning of geriatric concepts in undergraduate medical education. To augment learning experiences in older adult healthcare the Geriatrics Department at the North Dakota School of Medicine and Health Sciences developed a case-based curriculum for a 2-week geriatrics elective designed for third year medical students. Method: Older adult patient cases were developed from multiple sources. Learning objectives were tailored toward undergraduate medical education and mapped to ACGME Core Competencies. Case reports were supplemented with evidence-based medicine from PubMed® citations and made available as reading material. Pre- and post-clerkship assessment multiple-choice questions were developed to cover fundamental core concepts. Result: Curriculum was implemented using Blackboard® and Zoom® technology. Feedback on the curriculum from both learners and teachers was generally positive. Pre test results showed 70% knowledge of Geriatrics that improved by 8-10% after the mini- clerkship. We did not track trainee engagement of the cited medical literature, thus offering a new round of project analysis regarding how many students are stimulated by case reviews to delve deeper into the Geriatrics clinical research. Conclusion: An online, case-driven geriatrics elective can be implemented successfully to strengthen 3rd year student's Geriatrics knowledge sans face to face clinical encounters. It remains to be seen if this type of learning augments face to face experiential learning.