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78. 老年精神病学住院医师培训：解决差距和加强准备（aagp学者计划项目）

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry Pub Date : 2025-07-14 DOI:10.1016/j.jagp.2025.04.080

Erica Stagliano , Helen Kyomen

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引用次数: 0

摘要

老年精神病学领域越来越被认为是必不可少的，因为老年人口不断增长，这一人口面临着独特的心理健康挑战。来自研究生医学教育认证委员会的数据显示，2002-2003学年，老年精神病学研究员的数量达到了106人的峰值，而在2020-2021学年，这一数字下降到了48人，相当于研究员人数下降了55%。因此，居民的准备和信心管理老年精神病条件完成住院比以往任何时候都更加关键。研究表明，进入老年精神病学师资队伍是影响对该专业兴趣的关键因素。随着专家加入该领域的人数急剧下降，如何优化住院医师培训以满足日益增长的老龄化人口的需求，这些人口无疑将受到普通成人精神科医生的照顾？该项目作为AAGP学者计划的一部分，旨在评估住院医生对他们在管理老年精神病学治疗方面的信心和准备的培训观点，特别是在一个没有老年精神病学奖学金培训的服务教师的项目中。根据获得的反馈，实施了有针对性的教育干预措施，包括开发老年精神病学系列讲座，综合课程，以及为住院医生和医学院学生在老年精神病学轮转期间设计的动手纵向丰富活动-寻宝游戏。方法采用一项匿名调查的方法，评估精神科住院医师对老年精神病学领域的认知和准备情况。这项匿名在线调查包括多项选择题和李克特量表问题，旨在评估以下领域：-对老年精神病学范围的理解。-认识到老年精神病学培训的重要性。-对启动痴呆症诊断检查和讨论治疗方案的信心。-准备处理老年病人的急性精神需要。-促进准备的因素。-需要/期望额外培训或教育的领域。针对住院医师在老年精神病学培训方面存在的差距，我们开发了一个有针对性的讲座系列，分为四个部分：1。痴呆和谵妄患者认知、情绪和行为问题的药理学管理。基于MOCA的精神病学神经认知筛查综述与实践。影像学诊断神经认知障碍的综述此外，还开发了一套老年精神病学课程，将循证实践和互动学习机会结合起来。课程旨在提高住院医师的能力、信心和准备，以整体的方式为老年患者提供高质量的护理。最后，为老年精神病学轮转的医学生设计了一个寻宝游戏，在老年精神病学轮转住院医师的指导下完成。这项活动为住院医师提供了教学机会和额外的丰富经验，并在医学院培训期间提高了认知筛查、诊断和访谈技巧。该课程和寻宝游戏目前被纳入本学年的精神病学住院医师计划。调查后的审查计划在未来进行。结果初步调查显示，居民认为需要在药理学管理、神经认知筛查和神经认知障碍诊断等方面接受额外的教育。在一系列讲座的试点之后，调查后的数据表明，由于老年精神病学讲座系列，人们对老年精神病学的理解、信心和准备都有了实质性的提高。除了在整个学年周期结束时对结构化课程和寻宝活动进行调查审查外，调查和系列讲座将于2025年1月再次进行。结论随着老年人口的增长，对有效老年精神病学护理的需求不断增加，优化精神病学住院医师专业培训的必要性日益突出。奖学金注册人数的显著下降提出了一个必须解决的重大挑战，以使未来的精神科医生为与老年患者相关的复杂性做好准备。通过评估住院医生对他们的培训和实施有针对性的教育干预，如专门的系列讲座，综合课程开发和实践活动，AAGP学者项目旨在增强住院医生管理老年精神疾病的信心和能力。初步结果表明，这些举措解决了该计划中现有的培训缺口，迄今为止得到了住院医生的好评。此外，该项目还为其他项目提供了结构化的方法，以促进更广泛地实施有效的培训策略。未来的努力应集中在持续评估和改进这些教育策略，以配合老年精神病学不断变化的需求，确保住院医生为他们的专业角色做好充分的准备。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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78. GERIATRIC PSYCHIATRY TRAINING IN RESIDENCY: ADDRESSING GAPS AND ENHANCING PREPAREDNESS (AAGP SCHOLAR PROGRAM PROJECT)

Introduction

The field of geriatric psychiatry is increasingly recognized as essential due to the growing elderly population and the unique mental health challenges faced by this demographic. Data from the Accreditation Council for Graduate Medical Education reported a peak of 106 geriatric psychiatry fellows during the 2002–2003 academic year that decreased to just 48 during 2020–2021, equating to a 55% drop in fellowship enrollment. Thus, residents' preparedness and confidence in managing geriatric psychiatric conditions by completion of residency are more critical than ever. Research indicates that access to geriatric psychiatry faculty is a key factor influencing interest in the specialty. With such a drastic decline in specialists joining the field, how can training during residency be optimized to meet the growing demand of the aging population, who will undoubtedly come under the care of the general adult psychiatrist?

This project, conducted as part of the AAGP Scholars Program, aimed to evaluate residents' perspectives on their training regarding their confidence and preparedness in managing geriatric psychiatric treatment, particularly within a program without geriatric psychiatry fellowship-trained faculty on services. Based on the feedback obtained, targeted educational interventions were implemented, including the development of a geriatric psychiatry lecture series, a comprehensive curriculum, and a hands-on, longitudinal enrichment activity—a scavenger hunt—designed for residents and medical students during their geriatric psychiatry rotation.

Methods

An anonymous survey was designed to assess psychiatry residents' perceptions and preparedness in the field of geriatric psychiatry in a psychiatry residency program without geriatric psychiatry fellowship-trained faculty on services.

The anonymous, online survey consisted of multiple-choice and Likert-scale questions designed to evaluate the following domains:

-Understanding of the scope of geriatric psychiatry.

-Perceived importance of geriatric psychiatry training.

-Confidence in initiating the diagnostic workup of dementia and discussing treatment options.

-Preparedness to manage acute psychiatric needs of geriatric patients.

-Contributing factors to preparedness.

-Areas where additional training or education is needed/desired.

In response to the identified gaps in geriatric psychiatry training among residents, a targeted lecture series was developed in four parts:

1. Pharmacological Management of Cognitive, Emotional, and Behavioral Issues in Dementia and Delirium

2. Neurocognitive Screening in Psychiatry with MOCA Review and Practice

3. Diagnosing Neurocognitive Disorders with a Review of Imaging

4. Developmental Psychology and End of Life Ethics

Additionally, a geriatric psychiatry curriculum was developed incorporating evidence-based practices and interactive learning opportunities. The curriculum aims to enhance residents' competence, confidence, and readiness to deliver high-quality care to geriatric patients in a holistic approach.

Lastly, a scavenger hunt was designed for medical students on a geriatric psychiatry rotation to be completed with guidance from residents on geriatric psychiatry rotation. This activity provides teaching opportunities and additional enrichment experience for residents as well as enhancing skills in cognitive screening, diagnosis, and interview techniques during medical school training.

The curriculum and scavenger hunt are currently being incorporated this academic year by the psychiatry residency program. Post-survey reviews are planned for the future.

Results

The initial survey indicated that residents felt the need for additional education in areas such as pharmacological management, neurocognitive screening, and diagnosing neurocognitive disorders. After a pilot of the lecture series, the post-survey data indicated substantial improvements in understanding, confidence, and preparedness related to geriatric psychiatry, attributed to the geriatric psychiatry lecture series. The surveys and lecture series will be run again in January 2025 in addition to survey reviews of the structured curriculum and scavenger hunt activity at the conclusion of a full academic year cycle.

Conclusions

The increasing demand for effective geriatric psychiatric care amidst a growing elderly population underscores the necessity of optimizing specialized training for psychiatry residents. The notable decline in fellowship enrollment presents a significant challenge that must be addressed to prepare future psychiatrists for the complexities associated with aging patients. By assessing residents' perspectives on their training and implementing targeted educational interventions—such as a dedicated lecture series, comprehensive curriculum development, and hands-on activities—this AAGP Scholars project aimed to enhance residents' confidence and competence in managing geriatric psychiatric conditions. Preliminary results suggest that these initiatives addressed existing training gaps in the program and have so far been well-received by residents. Additionally, this project proposes structured methods for other programs to utilize, facilitating broader implementation of effective training strategies. Future efforts should focus on the ongoing evaluation and refinement of these educational strategies to align with the evolving needs of geriatric psychiatry, ensuring that residents are adequately prepared for their professional roles.

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来源期刊

American Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

13.00

自引率

4.20%

发文量

381

审稿时长

26 days

期刊介绍： The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.