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A national survey of Canadian emergency medicine residents’ comfort with geriatric emergency medicine

  • Tristan Snider (a1), Don Melady (a2) (a3) and Andrew P. Costa (a4)

Abstract

Background

Geriatric patients represent a large and complex subgroup seen in emergency departments (EDs). Competencies in geriatric emergency medicine (EM) training have been established. Our objectives were to examine Canadian postgraduate year (PGY)-5 EM residents’ comfort with the geriatric EM competency domains, assess whether Canadian EM residents become more comfortable through residency, and determine whether geriatric educational exposures are correlated with resident comfort with geriatric EM.

Methods

A national, cross-sectional study of PGY-1 and PGY-5 Royal College EM residents was conducted to determine their comfort in geriatric EM clinical competency domains. Residents reported their level of comfort in satisfying each competency domain using a seven-point Likert scale. Residents were also asked about the location of their medical education as well as the type and number of different geriatric exposures that they had received to date.

Results

Of the 141 eligible residents from across Canada, 77% (109) consented to participate. None of the PGY-1 EM residents and 34% (14) of PGY-5 EM residents reported that they were comfortable with all eight geriatric EM competency domains. PGY-5 EM residents were significantly more comfortable than PGY-1 EM residents. Residents reported a highly variable range of geriatric educational exposures obtained during training. No relationship was found between resident-reported comfort and the nature or number of geriatric exposures that they had received.

Conclusion

Current Royal College EM residency training in Canada may not be adequately preparing graduates to be comfortable with defined competencies for the care of older ED patients.

Introduction

Les personnes âgées forment un sous-groupe important et très diversifié de patients au service des urgences (SU). Les compétences à acquérir durant la formation en médecine d’urgence (MU) gériatrique sont déjà établies. L’étude visait à examiner l’aisance des résidents en formation postdoctorale de niveau V (« PGY-5 ») en MU au Canada dans les domaines de compétences en MU gériatrique; à évaluer si l’aisance des résidents en MU au Canada s’améliorait au fil de la formation; et à déterminer s’il y avait une corrélation entre l’aisance des résidents en MU gériatrique et l’exposition à différents cas de gériatrie durant la formation.

Méthode

Une étude transversale a été menée à l’échelle nationale parmi les résidents en formation postdoctorale des niveaux I et V en MU du Collège royal des médecins et chirurgiens du Canada afin de déterminer leur aisance dans les domaines de compétences cliniques en MU gériatrique. Les résidents ont exprimé leur degré d’aisance dans chacun des domaines de compétences à l’aide d’une échelle de Likert en 7 points. Les résidents devaient également indiquer le lieu de leur formation médicale ainsi que le type et le nombre de cas en gériatrie auxquels ils avaient été exposés jusqu’au moment de l’enquête.

Résultats

Sur 141 résidents admissibles à l’étude partout au Canada, 77% (109) ont accepté d’y participer. Aucun des résidents de niveau I ne s’est déclaré à l’aise dans les huit domaines de compétences en MU gériatrique, tandis que 34% (14) des résidents de niveau V ont indiqué l’être. Les résidents de niveau V en MU se sentaient beaucoup plus à l’aise que les résidents de niveau I. Les résidents ont fait état d’une exposition à une grande diversité de cas en gériatrie durant leur formation en spécialité. Aucune relation n’a été établie entre l’aisance déclarée des résidents et la nature ou le nombre de cas qu’ils avaient vus en gériatrie.

Conclusion

La formation actuelle en MU du Collège royal au Canada peut ne pas rendre les résidents suffisamment à l’aise dans les domaines de compétences à acquérir en matière de soins aux personnes âgées au SU.

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Copyright

Corresponding author

Correspondence to: Dr. Tristan Snider, Division of Emergency Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, C7-53, Toronto, ON M4N 3M5; Email: Tristan.snider@mail.utoronto.ca

References

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