RESUMO
Introduction: The field of geriatric psychiatry has in recent decades developed into an independent discipline, incorporating elements of psychiatry, neurology and internal medicine. In view of demographic changes, this field is becoming increasingly relevant for primary care and undergraduate medical training. So far, however, there is little educational guidance for instructional design of geriatric psychiatry in undergraduate medical education. Project description: A narrative literature review of medical education studies in the field of geriatric psychiatry was conducted. Student evaluations of a geriatric psychiatry clerkship seminar were analyzed, followed by a target group analysis. Results informed the iterative development of new clerkship seminar content and structure. This was implemented and evaluated over several academic cycles. Learning material was made available via the open-source learning management system "ILIAS". Results: A total of 29 medical education articles were identified and evaluated. The previous seminar in geriatric psychiatry at our university hospital was rated below average (Likert item overall rating of 4.3/6 compared to other seminars with an average overall rating of 5.2, p<0.001). An evidence-oriented revision of the content and instructional design was implemented. Activation of learners, self-reference effect, and audience questioning were used during the lecture. Additionally, two geriatric psychiatry case scenarios were adapted for discussion. We saw continuous improvement of student evaluations of the revised course, reaching a rating improvement of 5.3 out of 6 (p<0.01, U=135.5 Cohen's d=1.28). Conclusion: A systematic approach was used to develop a geriatric psychiatry clerkship seminar, based on medical education evidence, for undergraduate medical students, resulting in better student evaluations. The teaching materials can be adapted for local implementation at other teaching hospitals. Future studies should also explore effects regarding higher learning outcomes.
Assuntos
Estágio Clínico , Educação de Graduação em Medicina , Estudantes de Medicina , Idoso , Estágio Clínico/métodos , Currículo , Educação de Graduação em Medicina/métodos , Psiquiatria Geriátrica/educação , Humanos , Projetos PilotoAssuntos
Acatisia Induzida por Medicamentos/diagnóstico , Demência/tratamento farmacológico , Dronabinol/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Acatisia Induzida por Medicamentos/psicologia , Estudos Cross-Over , Demência/psicologia , Humanos , Masculino , Agitação Psicomotora/diagnóstico , Agitação Psicomotora/psicologiaRESUMO
BACKGROUND: Vocally disruptive behavior (VDB) in the elderly is a common condition, especially in people with dementia, but difficult to treat. It may occur in as many as 40% of nursing home residents. This study is a review of the existing literature on this condition. METHOD: The literature review was conducted using PubMed (particularly Medline and the Cochrane database) and reference lists from relevant publications in English, French, and German. RESULTS: Most studies are small and no conclusive prevalence data are available. Many biological and psychosocial treatments have been advocated, but most studies are little more than anecdotal case reports. It is evident that VDB can have deleterious consequences on others and the patients themselves, although no studies specifically examine the range or the pervasiveness of VDB. Etiopathogenic research on VDB is still in its infancy. CONCLUSIONS: Most aspects surrounding VDB are insufficiently understood. The heterogeneity and multiple contributive factors regarding VDB suggest quite convincingly that a panoply of different interventions tailored to the individual's needs will be required to overcome VDB and the suffering related to it.
