Event Title

Not Wanted on the Voyage: Has Case-based Undergraduate Medical Education Abandoned Geriatric Content?

Start Date

5-10-2011 10:45 AM

End Date

5-10-2011 11:45 AM

Abstract

Case‐based learning (CBL) is a prevalent teaching method in North American undergraduate medical schools. However, given the imminent rise in patients over the age of 65, case‐based scenarios may not reflect typical patient presentations that medical students can expect to encounter in the clinical setting.

The authors conducted a systematic curriculum audit at a large research‐based Canadian university that sought to determine undergraduate students’ pre‐clinical exposure to geriatric content. A database was created following a detailed inventory of all existing clinical scenarios used in testable coursework and learning materials during the 2008‐09 academic year. From each clinical scenario information was extracted regarding patient age, gender, and presenting illness, as well as existing medical, social, cognitive, and functional issues, to determine typical patient profiles presented to students prior to clerkship.

920 clinical scenarios were identified. Mean patient age was 37.7 (SD 21.9). The most commonly presented age group was 26‐45 (277 cases or 30.1% of total). Only 130 cases (14.1%) featured patients 65 or older. Patients ≥75 featured in 54 cases (5.87%) and of those only 11 (1.2%) were ≥85 years. Medical, cognitive, and functional issues were consistently underreported across all age groups; common geriatric syndromes such as delirium, dementia, and depression were reported in 20 cases (1.74%).

Older patients are critically underrepresented in case‐based pre‐clinical curriculum at this site. Immediate research is needed to assess whether underrepresentation of older patients is common in undergraduate medical pedagogy and, if so, what steps should be taken to increase geriatric content.

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Oct 5th, 10:45 AM Oct 5th, 11:45 AM

Not Wanted on the Voyage: Has Case-based Undergraduate Medical Education Abandoned Geriatric Content?

Case‐based learning (CBL) is a prevalent teaching method in North American undergraduate medical schools. However, given the imminent rise in patients over the age of 65, case‐based scenarios may not reflect typical patient presentations that medical students can expect to encounter in the clinical setting.

The authors conducted a systematic curriculum audit at a large research‐based Canadian university that sought to determine undergraduate students’ pre‐clinical exposure to geriatric content. A database was created following a detailed inventory of all existing clinical scenarios used in testable coursework and learning materials during the 2008‐09 academic year. From each clinical scenario information was extracted regarding patient age, gender, and presenting illness, as well as existing medical, social, cognitive, and functional issues, to determine typical patient profiles presented to students prior to clerkship.

920 clinical scenarios were identified. Mean patient age was 37.7 (SD 21.9). The most commonly presented age group was 26‐45 (277 cases or 30.1% of total). Only 130 cases (14.1%) featured patients 65 or older. Patients ≥75 featured in 54 cases (5.87%) and of those only 11 (1.2%) were ≥85 years. Medical, cognitive, and functional issues were consistently underreported across all age groups; common geriatric syndromes such as delirium, dementia, and depression were reported in 20 cases (1.74%).

Older patients are critically underrepresented in case‐based pre‐clinical curriculum at this site. Immediate research is needed to assess whether underrepresentation of older patients is common in undergraduate medical pedagogy and, if so, what steps should be taken to increase geriatric content.