Center of Excellence in Geriatric Medicine
In 1998, the Section of Geriatrics at Boston University School of Medicine became a Center of Excellence in Geriatrics (COE) funded by the John A. Hartford Foundation. The purpose of this faculty development program is to attract outstanding physicians to careers as geriatrically oriented faculty. It is designed to produce future leaders in geriatric education, research, and administration, produce clinicians skilled in geriatric care, and assist in the education and training of generalists with competency in geriatric care in order to meet the health needs of increasing numbers of elderly. This program also aims to support primary care and geriatrics clinician-educators in the acquisition of credentials needed for faculty promotion and retention. Our COE focus is considered to be very innovative by the Hartford Foundation.
Geriatric Medicine and Geriatric Oncology Fellows, along with interdisciplinary BMC Faculty Scholars and House Staff, are trained for one year in the clinical, scientific and educational skills necessary to become effective teachers of geriatric medicine. Our Geriatric Medicine fellows join our faculty scholars in the Geriatric Clinical Content Module, the Evidence-Based Medicine Module, the Stanford Faculty Development Program Clinical Teaching Module, and the Health Care Systems Module. Together these modules extend over an nine-month period of time, taking place on one morning each week.
Inclusive of our current faculty scholars, we have trained faculty members from disciplines that range from dentistry, urology, otolaryngology, emergency medicine, rehabilitation medicine, family and general internal medicine, as well as nursing, pharmacy and physical therapy clinical staff.
The Center has attracted outstanding physicians to careers as geriatrically-oriented faculty and has produced future leaders in geriatric education, research, and administration. The Center has assisted in the education and training of providers with competency in geriatric care. We provide faculty clinician-educators with the clinical, scientific and educational skills necessary to become effective teachers of geriatric medicine and support the acquisition of credentials needed for faculty promotion and retention.
Scholars participate in the program for one half-day per week for one year. For the first nine months, one-half day per week is spent in structured educational experiences. During the last three months, one-half day per week is spent in supervised scholarly activities and the remainder in clinical settings. Individual Faculty Scholars are assigned an advisor from the Center of Excellence in Geriatrics and participate in the design of a curriculum appropriate to his or her needs:
- Geriatrics Content Module. Small-group, interactive seminars address topics in geriatric medicine, using a case-based, evidence-based approach to the extent possible. Topics include: geriatric assessment and multidisciplinary teams, health promotion and disease prevention, cognitive impairment, mobility disorders and falls, substance abuse, urinary incontinence, polypharmacy, the biology of aging and additional topics to be determined by the Scholars themselves.
- Clinical Teaching Module. This module is based on the clinical educator curriculum developed by the Stanford Faculty Development Center. It consists of seven interactive seminars over approximately two months, covering the following topics: 1) Learning Climate; 2) Control of Session; 3) Communication of Goals; 4) Understanding and Retention; 5) Evaluation; 6) Feedback; and 7) Self-directed Learning.
- Evidence-Based Medicine Module. This module consists of training in the techniques of evidence-based medicine and provides guidance in developing skills for the finding, filtering, and judging of relevant clinical medical information. Four sessions are conducted in which Scholars learn: 1) to derive focused questions from patient care problems; 2) to use MEDLINE in a productive and time-efficient manner to retrieve information related to the question; 3) to review articles critically, emphasizing the concepts of internal and external validity; and 4) to apply information thus obtained to answer the specific clinical questions.
- Health Care Systems Module. In order to develop and successfully administer academic clinical programs, faculty need better understanding of administrative and management issues. This module addresses: 1) health care systems and the impact of environmental factors on clinical programs and practice; 2) clinical, financial and ethical aspects of managed care in geriatric practice; 3) fundamentals of health care finance and reimbursement systems; and 4) operational management and quality improvement.
- Clinical Experience. Geriatrics training at Boston Medical Center takes place in a rich clinical milieu that includes a continuum of care, from the ambulatory clinic to the home, to the inpatient service, to rehabilitation programs, and to long-term care facilities. Faculty Scholars are mentored by geriatrician-clinical nurse specialist teams and become familiar with resources for older patients in the community and in local institutions.