Generational Bias: Another Form of Ageism.

Ageism includes discrimination toward both younger and older individuals. Discrimination based on generational cohorts can serve as a proxy for discrimination based on age and, therefore, can be argued as a form of ageism. This study examined the occurrence of generational ageism and its relationship to internalized and relational ageism. This cross-sectional study surveyed 913 individuals recruited through ResearchMatch. Analyses found that those in the Millennial and Gen Z groups reported experiencing the highest levels of discrimination based on generational cohort and reported feeling that their generational groups were viewed as less capable, more opinionated, and more selfish than other generations. Millennial and Gen Z groups also reported experiencing higher internalized and relational ageing anxiety levels than older cohorts. As our collective understanding of the manifestation and perpetuation of ageism grows, it is imperative to explore the impact and consequences of generational bias as a form of ageism.

The Next Critical Turn for Ageism Research: The Intersections of Ageism and Ableism.

BACKGROUND AND OBJECTIVES: Aging includes multidimensional and multidirectional changes in biology, psychology, and social roles. With aging, individuals experience physiological changes that affect ability, stamina, and reserve capacity. Given the natural occurrence of physical decline accompanying aging, it is essential to understand if fear and prejudice toward disability (ableism) intersect and influence fear and anxiety about aging (ageism). RESEARCH DESIGN AND METHODS: A cross-sectional survey study was conducted using ResearchMatch for study recruitment, 913 individuals responded to questions regarding 3 types of ageism, including affinity for older people, internalized ageism, and relational ageism, as well as internalized and relational ableism. RESULTS: Internalized ageism was significantly associated with relational ageism, fear of physical disability, fear of cognitive disability, and affinity for older people. Relational ageism was associated with internalized ageism, relational ableism, fear of physical disability, fear of sensory disability, fear of cognitive disability, and affinity for older people. DISCUSSION AND IMPLICATIONS: Examining the intersection of ageism and ableism represents the next pivotal juncture to developing effective anti-ageism interventions that address the root anxieties influencing negative attitudes about aging and fears of growing older. Public policy initiatives to address community-level interventions and targeted training to inform discourse that addresses the intersection between ageism and ableism are critical to addressing these issues and promoting age and ability inclusivity.

Special Focus Facilities vs Special Focus Facility Candidates: What is the Difference?

OBJECTIVES: This study compares Special Focus Facilities (SFFs) and Special Focus Facility Candidate Facilities (SFFcs) on organizational traits and quality outcomes to evaluate the effectiveness of the SFF program as a quality improvement intervention and inform potential areas for program reform. DESIGN: This is a retrospective analysis. SETTINGS AND PARTICIPANTS: Using data from the Centers for Medicare and Medicaid Services archives for 2020, this retrospective study analyzed 247 nursing facilities (50 SFFs and 197 SFFcs). METHODS: Variables of interest were staffing, profit status, facility size, certification status, number of residents, and complaint citations: t tests, χ2, Fisher's Exact test, and multivariate analysis of variance were used to compare the 2 groups. RESULTS: From an organizational perspective, SFFs and SFFcs are minimally different. Both groups had similar facility size, profit status, hospital affiliation, continuing care retirement community status, and Medicare/Medicaid certification. Large and for-profit facilities were overrepresented in both groups. SFFs and SFFcs exhibited statistical differences in the number of complaint deficiencies. The groups had no significant difference in staffing levels, category, severity of complaints, or incident reports. CONCLUSIONS AND IMPLICATION: The study's findings suggest that the SFF program, while resource-intensive, is minimally impactful. The similarities between SFFs and SFFcs raise questions about the program's effectiveness in improving nursing facility care. Previous adjustments to the program may not have successfully achieved the desired quality improvements. This research highlights the need to further evaluate the SFF program's effectiveness as a quality improvement intervention. It also underscores the importance of addressing biases and subjectivity in state survey agency processes, which affect the enrollment of nursing facilities. The study underscores the flaws within the nursing home monitoring system and the 5-star quality rating system, especially when comparing small samples between states.

An interprofessional geriatrics faculty development program: exploration of the barriers and facilitators of capstone projects.

Faculty development programs (FDPs) are an effective, evidence-based method of promoting knowledge, skills and self-efficacy of faculty. However, implementation and sustainability of curricular capstone projects developed by faculty as part of these programs are rarely reported. Challenges to sustaining programmatic implementation of interprofessional FDP curricular content into academic and clinical settings over time were not found in peer-reviewed literature. To better understand the sustained impact of our geriatrics-focused FDP, we explored barriers and facilitators to implementation and sustainability of capstone projects designed by faculty Scholars in our FDP. Thematic analysis of virtual interviews with 17 Scholars revealed several key factors that impacted the implementation and Dynamic sustainability of curricular projects. Three major themes and sub-themes were identified: Project Implementation (Supportive Factors, Hindering Factors and Filling in Gaps in the Field); Pedagogical Development (Enhancement of Skills and Culture Change); and Sustainability Impact (Project Sustainability, Career Development and Passing the Torch). Results suggest it is important to ensure logistical support, dedicated time, and organizational or institutional support. Implementation of geriatrics-focused FDPs provides an evidence-based approach to sustainability. Further study of the ongoing barriers and facilitators to sustainability is encouraged.

"I like being young, active, alive": first-year medical students' attitudes to their own aging.

BACKGROUND AND OBJECTIVES: Senior Mentoring programs have been developed to expose students to older adults, increase knowledge of geriatrics, and prepare them to provide patient-centered care. However, even while participating in a senior mentoring program, health professions students demonstrate discriminatory language toward older adults and the aging process. In fact, research suggests ageist practices occur, intentionally or not, among all health professionals and within all healthcare settings. Senior mentoring programs have primarily focused on improving attitudes about older people. The current study evaluated a different approach to anti-ageism by examining medical students' perceptions of their own aging. RESEARCH DESIGN AND METHODS: This qualitative, descriptive study explored medical students' beliefs about their own aging at the beginning of their medical education using an open-ended prompt immediately before beginning a Senior Mentoring program. RESULTS: Thematic analysis identified six themes: Biological, Psychological, Social, Spiritual, Neutrality and Ageism. Responses suggest that students enter medical school with a complex view of aging that goes beyond biological considerations. DISCUSSION AND IMPLICATIONS: Understanding that students enter medical school with a multi-faceted view of aging provides an opportunity for future work to explore senior mentoring programs as a way to tap into this complex view of aging by changing the way students think not just about older patients but about aging more broadly, and specifically about themselves as aging individuals.

Measuring Perceived Research Competence of Junior Researchers.

Graduates of doctoral (Ph.D.) programs are expected to be competent at designing and conducting research independently. Given the level of research competence needed to successfully conduct research, it is important that assessors of doctoral programs (e.g., faculty and staff) have a reliable and validated tool for measuring and tracking perceived research competence among their students and graduates. A high level of research competence is expected for all Ph.D. graduates worldwide, in addition to in all disciplines/fields. Moreover, graduates of Ph.D. programs may complete their studies in one country but then obtain a research position in another country, emphasizing the need to ensure that all doctoral programs are fostering similar levels of research competence. Thus, the purpose of this study was to gather additional evidence for validity and reliability of the Research Competence (R-Comp) scale. Specifically, we sought to extend the findings of by adapting the scale, translating it to other languages, and applying the tool with a sample of early stage researchers. Our findings provide initial evidence that the adapted PR-Comp is appropriate for use in three languages and across a variety of disciplines/programs of study.

Creating Interprofessional Readiness to Advance Age-Friendly U.S. Healthcare.

A successful interprofessional faculty development program was transformed into a more clinically focused professional development opportunity for both faculty and clinicians. Discipline-specific geriatric competencies and the Interprofessional Education Collaborative (IPEC) competencies were aligned to the 4Ms framework. The goal of the resulting program, Creating Interprofessional Readiness for Complex and Aging Adults (CIRCAA), was to advance an age-friendly practice using evidence-based strategies to support wellness and improve health outcomes while also addressing the social determinants of health (SDOH). An interprofessional team employed a multidimensional approach to create age-friendly, person-centered practitioners. In this mixed methods study, questionnaires were disseminated and focus groups were conducted with two cohorts of CIRCAA scholars to determine their ability to incorporate learned evidence-based strategies into their own practice environments. Themes and patterns were identified among transcribed interview recordings. Multiple coders were used to identify themes and patterns and inter-coder reliability was assessed. The findings indicate that participants successfully incorporated age-friendly principles and best practices into their own work environments and escaped the silos of their disciplines through the implementation of their capstone projects. Quantitative data supported qualitative themes and revealed gains in knowledge of critical components of age-friendly healthcare and perceptions of interprofessional collaborative care. These results are discussed within a new conceptual framework for studying the multidimensional complexity of what it means to be age-friendly. Our findings suggest that programs such as CIRCAA have the potential to improve older adults' health by addressing SDOH, advancing age-friendly and patient-centered care, and promoting an interprofessional model of evidence-based practice.

Infusing geriatrics expertise in health professions education through interprofessional faculty development.

As the population of older adults continues to grow, the need for health care professionals trained in the delivery of interprofessional care for older adult patients is critical. The purpose of this paper is to detail the outcomes of an interprofessional, geriatrics training program for healthcare professionals with a faculty appointment. Specifically, we gathered outcomes at four levels: reactions/satisfaction, learning, behavioral, and organizational. Our findings suggest that programs structured like the Faculty Development Program (FDP) have the potential to increase the amount of geriatrics content introduced in already existing health professions curricula, as well as to offer faculty needed training in how to provide their students with interprofessional learning experiences.

Evaluation of an interprofessional, evidence-based falls training.

Fall-related injuries and mortality are increasing in older adults. Evidence suggests a need for a multifactorial, interprofessional approach to reducing falls. The Program for All-Inclusive Care for the Elderly (PACE) utilizes an interprofessional approach to care and serves a high-risk population. The purpose of this study was to investigate the effectiveness of an EBP falls prevention training program conducted at a PACE. The program was a revision of an established program and was led by an interprofessional team. The evaluation used a mixed-methods approach to assess program quality, learning and self-efficacy gains, and intended behavioral changes. Quantitative evaluation demonstrated program satisfaction and qualitative responses identified the depth and interprofessional delivery as favorable. Qualitative data identified opportunities to enhance content and learning design. Overall knowledge gains were statistically significant (mean difference 5%), with the greatest gains related to the evidence base (mean difference 2.67%). Self-efficacy ratings increased significantly after each session. Participants noted changes to team function and a willingness to consider practice changes as a result of the training. The findings support the effectiveness of this interprofessional, EBP training program on falls prevention practices in a PACE and highlight the value of a multifaceted assessment and iterative development.