Teaching empathy: comparison of a virtual reality experience using head-mounted display versus group streaming.

Empathy, an integral component of bedside manners, correlates with good healthcare provision. Training physician assistant (PA) students using Head-Mounted Display (HMD) virtual reality (VR) contributed to significant empathy increases. This pilot study, which relied on a retrospective analysis, compared a VR experience using HMD to a streamed modality (due to COVID safety) with PA students to measure empathy. We hypothesized that fully immersive and interactive HMD VR would lead to a statistically significant increase in empathy versus the streaming modality. The "Alfred Lab" VR allows viewers to "embody" a 74-year-old African American man with vision and hearing loss. The University of New England PA class of 2021 (n = 47) completed the HMD lab while the class of 2022 (n = 50) viewed the streaming modality as a group. Identical pre/post surveys were completed by each cohort. The analysis utilized paired sample t-tests, ANOVA, frequency analysis (quantitative), and content analysis with thematic coding (qualitative). The results for each cohort revealed a statistically significant increase in empathy (p < 0.05) after completing the VR lab (pre- to post-test results). The comparison of both cohorts (HMD versus group streaming) revealed no noteworthy difference. Streaming VR could improve access to PA programs unable to acquire expensive VR equipment yet still allow for the development of empathy.

The #PalliativeCare Conversation on Twitter: An Analysis of Trends, Content, and Caregiver Perspectives.

CONTEXT: Palliative care is known to improve patients' quality of life, but oftentimes these conversations occur outside of the health-care setting. OBJECTIVES: To characterize the #PalliativeCare Twitter network and evaluate the caregiver experience within palliative care. METHODS: In this cross-sectional study, a total of 182,661 #PalliativeCare tweets by 26,837 users from June 1, 2015 to June 1, 2019 were analyzed using Symplur Signals. Analysis included activity metrics, content analysis, user characteristics, engagement, and network analysis. Similar metrics were performed on tweets by self-identified caregivers (482), who wrote a total of 3952 tweets. Qualitative analysis was completed on a systematic sample of caregiver tweets. RESULTS: The number of #PalliativeCare tweets, users, and impressions has increased by an annual average of 18.7%, 16.4%, and 32.5%, respectively. Support, access, and patients were among the Trending Terms. About 39.4% of Trending Articles were scientifically valid, and information about palliative care and comorbidities had the greatest number of articles. The majority of users wrote five or less #PalliativeCare tweets. Network analysis revealed central hubs to be palliative care advocacy organizations and physicians. The five main themes from qualitative analysis of caregiver tweets were 1) advocacy and events, 2) care strategies, 3) resources, 4) public health issues, and 5) myths related to palliative care. CONCLUSION: The use of Twitter as a platform for palliative care conversations is growing rapidly. Twitter serves as a platform to facilitate #PalliativeCare conversation among patients, caregivers, physicians, and other healthcare providers.

48-Hour Hospice Home Immersion Encourages Osteopathic Medical Students to Broaden Their Views on Dying and Death.

To augment learning about interprofessional palliative and end-of-life care, the University of New England College of Osteopathic Medicine immersed 2 second-year osteopathic medical students in an 18-bed acute care hospice home in Scarborough, Maine, for 48 hours. The students worked with an interprofessional staff and independently to provide patient care, family support, and postmortem care. For data collection, students wrote in journals before the immersion experience (prefieldwork), while living in the hospice home (fieldwork), and for 10 days following the immersion experience (postfieldwork). The students recorded their subjective and objective reporting of observations, experiences, feelings, and patient/family encounters. Data analyses included a review of the journals, identifying thematic categorizations, and coding through content analysis. Three themes identified in the students' journals reflected shared experiences: (1) shifting perspectives, (2) path to family acceptance, and (3) emotional journey. The students learned how to converse with patients and families about end-of-life care while ensuring attainment of patients' goals. They also learned about the importance of helping patients enjoy life's simple pleasures like taking them outside to enjoy the sunshine, and they learned to trust themselves when handling emotional and difficult situations. Each student gained confidence in her ability to help guide patients through this stage of life.

Health professions education: Advancing geriatrics and gerontology competencies through Age-Friendly University (AFU) Principles.

This article elucidates opportunities for health professions education programs to make a mark in the Age Friendly University (AFU) initiative. Specifically, key approaches are introduced for health professions education programs based on the Age Friendly University Global Network initiative and the Academy for Gerontology/Geriatrics in Higher Education (AGHE) Program of Merit for Health Professions Programs. Higher Education Institutions (HEIs) that offer health professions education, have various options to establish and enhance student gerontology/geriatrics competence and confidence. However, two options are germane to new initiatives that are making their mark in HEIs. First, Age Friendly University Guiding Principles applicable to health professions education allow health gerontology faculty to be catalysts to promote and integrate these principles within their program's curriculum contributing to their institution's readiness to apply for the Age Friendly University designation. Second, the Academy for Gerontology in Higher Education (AGHE) Program of Merit (POM) provides specific geriatrics/gerontology competencies for health professions programs to integrate into the program's curriculum along with an option to attain recognition as an AGHE Program of Merit. Attaining both designations contributes to preparing future health professions providers with improved older adult health care skills that also benefits older adults.

Using virtual reality in medical education to teach empathy.

OBJECTIVE: The project adopted technology that teaches medical and other health professions students to be empathetic with older adults, through virtual reality (VR) software that allows them to simulate being a patient with age-related diseases, and to familiarize medical students with information resources related to the health of older adults. METHODS: The project uses an application that creates immersive VR experiences for training of the workforce for aging services. Users experience age-related conditions such as macular degeneration and high-frequency hearing loss from the patient's perspective. Librarians and faculty partner to integrate the experience into the curriculum, and students go to the library at their convenience to do the VR assignment. RESULTS: The project successfully introduced an innovative new teaching modality to the medical, physician assistant, physical therapy, and nursing curricula. Results show that VR enhanced students' understanding of age-related health problems and increased their empathy for older adults with vision and hearing loss or Alzheimer's disease. CONCLUSION: VR immersion training is an effective teaching method to help medical and health professions students develop empathy and is a budding area for library partnerships. As the technology becomes more affordable and accessible, it is important to develop best practices for using VR in the library.

Delirium and the Family Caregiver: The Need for Evidence-based Education Interventions.

Delirium, an acute confusional state, is experienced by many older adults. Although there is substantial research on risk factors and etiology, we hypothesized that there is a dearth of information on educating the family caregivers of delirious older patients. A date-specific (2000-2013) literature review of articles, written in English, was conducted in several major databases using keyword searches. This systematic review focused on 2 objectives: (1) investigate published studies on the impact of delirium on the family regarding caring for a loved one; and (2) determine if there are interventions that have provided family caregivers with education and/or coping skills to recognize and/or manage delirium. A systematic elimination provided outcomes that met both objectives. Thirty articles addressed impact on family caregivers (objective 1); only 7 addressed caregiver education regarding the delirious state of a loved one (objective 2). Few studies consider the impact of delirium on family caregivers and even fewer studies focus on how to manage delirium in loved ones. With increased risks to older adult patients, high cost of care, and the preventable nature of delirium, family caregiver education may be an important tactic to improve outcomes for both patient and caregiver.

Learning by living: life-altering medical education through nursing home-based experiential learning.

The University of New England College of Osteopathic Medicine Learning by Living Project (referred to as Learning by Living) was piloted in 2006 as an experiential medical education learning model. Since its inception, medical and other health professions students have been "admitted" into nursing homes to live the life of an older adult nursing home resident for approximately 2 weeks-24 hours a day/7 days a week-complete with a medical diagnosis and "standard" procedures of care. The Learning by Living Project applies qualitative ethnographic/autobiographic research methods to collect students' perspectives and experiences about life lived as an older adult with functional challenges in a residential setting. To date, all students have completed their extended stay successfully and felt that this experiential learning project provided life-altering medical education. Longitudinal data reveals that students' maintain patient-centered attitudes and skills such as the use of eye contact, touch, body position, and voice cadence. Barriers to working with older adults are decreased; understanding is gained by "wheeling a mile in an older person's wheelchair."

Osteopathic medicine and the silver tsunami: preparing tomorrow's first responders for the elder boom.

In response to the shifting demographics observed in the United States, a variety of organizations have begun issuing consensus statements and patient care guidelines to help health professionals meet the anticipated medical needs of the older population. The authors describe a collaborative effort within the osteopathic medical profession focused on translating geriatric core competencies into curricula guidelines for osteopathic medical education. Osteopathic physicians will likely be the "first responders" for elder care needs in the United States as a result of their disproportionately high rates of primary care practice.

End-of-life care curricula in undergraduate medical education: a comparison of allopathic and osteopathic medical schools.

End-of-life care curricula in osteopathic medical schools were compared with allopathic school offerings. An 8-question online survey of undergraduate medical education administrators at all United States osteopathic medical schools (n = 26) and 26 allopathic schools geographically closest to them was conducted in 2007. Responses from 80% (n = 21) of osteopathic schools and 77% (n = 20) of allopathic schools revealed that both osteopathic and allopathic medical schools offered end-of-life care education. Of note is that 71% of the osteopathic medical school respondents had a course that concentrates on end-of-life care compared with 37% of allopathic school respondents (P = .03). This disparity in percentages may be due to a number of reasons, 2 of which may include course identification methods and the primary care orientation and philosophy inherent in osteopathic medical schools.

Functional fitness: maintaining or improving function for elders with chronic diseases.

OBJECTIVE: This study's objective was to prove or disprove four hypotheses, three addressing physical function and a subjective measure of self-perceived well-being from participating in an elder functional fitness program. METHODS: Participants included 17 chronically ill residents from an assisted-living center in Maine. Measures on mobility, metabolic equivalent estimation (MET) levels, resting heart rate, blood pressure, oxygen saturation, muscular strength, flexibility, and body weight were conducted at three intervals-baseline, 6 months, and 1 year. SAS software was used for analysis of means and paired t test. RESULTS: Increases in or maintenance of function proved significant. The subjective hypothesis also proved significant. DISCUSSION: Research on elder exercise focuses on one or two components, rather than the benefits of a thorough fitness program. This study illustrated improvements in physical function and well-being from participating in a comprehensive elder fitness program.