TABLE 3.
Geriatric model: from medical school and residency competencies to training applications1
| Steps (date) | Group | Method | Milestone |
| Landmark events (2000–2001) | |||
| Hartford Foundation/AAMC US medical school awards (n = 40): to enhance geriatric curriculum | — | — | Publications |
| DW Reynolds Foundation: to create a national database of geriatric medicine training and practice | — | — | |
| DW Reynolds Foundation US medical school awards (n = 10): for comprehensive medical education | — | — | |
| Medical school competency (2007) | |||
| Potential domains | Steering committee (n = 13) | Curricular documents | 52 domains |
| Narrow domains | Steering committee, foundation grant recipients, and educators (n = 48) | Survey and online review | 23 domains |
| Domain consensus | Steering committee, foundation grant recipients, and societies’ interest groups (n = 117) | Online survey for top 8 domains | 8 domains |
| 3–5 Competencies/domain | Each individual in the steering committee review 1 domain (n = 13) | Check with other competencies | 35 competencies |
| Content validity | Residency and clerkship directors | Online survey | |
| Draft and evaluate implementation | AAMC/JAHF advisory committee (n = 98) | 2 domains/group for 4 groups | 26 competencies |
| Review and changes | Conference AC and participants, steering committee (n = 93) | E-mails, online survey, endorse | 26 competencies |
| Landmark IOM report (2008) | |||
| “Retooling for an Aging America: Building the Health Care Workforce” critical need to expand geriatrics competence among all physicians | — | — | Publication |
| Residency competency (2007–2008) | |||
| Potential domains | Working group IM and FM academic educators and geriatricians (n = 8) | Review clinically relevant medical student competencies | 52 competencies |
| Narrow domains | Geriatric educators from 36 academic institutions (n = 100) | Meeting 3–6 competencies/domain and survey to rate importance | 46 competencies |
| Domain consensus | Nongeriatric residency educators (n = 26) | Rate importance | 7 competencies |
| Review and changes | Residency program directors and faculty (n = 12) | Review, endorse | 7 competencies |
| Training applications (2008–2009) | |||
| Training medical students (2008) | Fourth-year FM medical students (n = 158) | Multisite interdisciplinary, team-based, 1-mo rotation, AAMC GQ evaluation | 3/4 agree learned 7 competencies |
| Training medical residents (2009) | Chief residents from 13 medical and surgical disciplines (n = 47) | 2-d offsite chief resident training, Train-the-trainer, interdisciplinary, self-assess | Improved knowledge and teaching confidence |
Sources: references 63–67. This effort included support and participants from the AAMC, the Association of Program Directors of Internal Medicine, the Association of Family Medicine Residency Directors, the American Geriatrics Society, the Society of General Internal Medicine, and the Society of Teachers of Family Medicine for recommending expert reviewers; the Donald W Reynolds Foundation; the John A Hartford Foundation; the American Medical Association; the American Board of Family Medicine; various academic centers and affiliated hospitals; and the Mount Sinai School of Medicine, Portal of Online Geriatrics Education. AAMC, Association of American Medical Colleges; AC, advisory committee; FM, family medicine; GQ, Medical School Graduate Questionnaire from the AAMC; IM, internal medicine; IOM, Institute of Medicine; JAHF, John A. Hartford Foundation.