| Title |
Incorporating prognosis in the care of older adults with multimorbidity: description and evaluation of a novel curriculum
|
|---|---|
| Published in |
BMC Medical Education, December 2015
|
| DOI | 10.1186/s12909-015-0488-x |
| Pubmed ID | |
| Authors |
Nancy L. Schoenborn, Cynthia Boyd, Danelle Cayea, Kelly Nakamura, Qian-Li Xue, Anushree Ray, Matthew McNabney |
| Abstract |
Prognosis is a critical consideration in caring for older adults with multiple chronic conditions, or "multimorbidity". Clinicians are not adequately trained in this area. We describe an innovative curriculum that teaches internal medicine residents how to incorporate prognosis in the care of older adults with multimorbidity. The curriculum includes three small-group sessions and a clinical exercise; it focuses on the assessment, communication, and application of prognosis to inform clinical decisions. The curriculum was implemented with 20 first-year residents at one university-based residency (intervention group). Fifty-two first-year residents from a separate residency affiliated with the same university served as controls. Evaluation included three components. A survey assessed acceptability. A pre/post survey assessed attitude, knowledge, and self-reported skills (Impact survey). Comparison of baseline and follow-up results used paired t-test and McNemar test; comparison of inter-group differences used t-test and Fisher's exact test. A retrospective, blinded pre/post chart review assessed documentation behavior; abstracted outcomes were analyzed using Fisher's exact test. The curriculum was highly rated (4.5 on 5-point scale). Eighteen intervention group residents (90 %) and 29 control group residents (56 %) responded to the Impact survey. At baseline, there were no significant inter-group differences in any of the responses. The intervention group improved significantly in prognosis communication skills (5.2 to 6.6 on 9-point scale, p < 0.001), usage of evidence-based prognostic tools (1/18 to 14/18 responses, p < 0.001), and prognostic accuracy (1/18 to 9/18 responses, p = 0.005). These responses were significantly different from the control group at follow-up. Of 71 charts reviewed in each group, prognosis documentation in the intervention group increased from 1/25 charts (4 %) at baseline to 8/46 charts (17 %) at follow-up (p = 0.15). No prognosis documentation was identified in the control group at either time point. Inter-group difference was significant at follow-up (p = 0.006). We developed and implemented a novel prognosis curriculum that had significant short-term impact on the residents' knowledge and communication skills as compared to a control group. This innovative curriculum addresses an important educational gap in incorporating prognosis in the care of older adults with multimorbidity. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 50% |
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 59 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 59 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 8 | 14% |
| Student > Postgraduate | 5 | 8% |
| Student > Master | 5 | 8% |
| Student > Doctoral Student | 5 | 8% |
| Professor | 5 | 8% |
| Other | 16 | 27% |
| Unknown | 15 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 22 | 37% |
| Social Sciences | 6 | 10% |
| Psychology | 5 | 8% |
| Nursing and Health Professions | 2 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Other | 4 | 7% |
| Unknown | 18 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 January 2016.
All research outputs
#13,960,063
of 22,835,198 outputs
Outputs from BMC Medical Education
#1,880
of 3,323 outputs
Outputs of similar age
#196,431
of 387,566 outputs
Outputs of similar age from BMC Medical Education
#38
of 63 outputs
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We're also able to compare this research output to 63 others from the same source and published within six weeks on either side of this one. This one is in the 38th percentile – i.e., 38% of its contemporaries scored the same or lower than it.