A half-day geriatrics assessment workshop is held during the conclusion of the second year physical examination course.
Goals and Objectives
Goal:
Teach that assessment of older adults includes physical and cognitive function.
Objectives:
- Describe physical function using
- Utilize methods to assess physical function such as the Get-up-and-go test
- Describe neuropsychiatric function
- Utilize standardized tools to assess cognition such as the MiniCog
Program Structure
- Didactic Lecture on geriatric assessment (full class, 180 students) – 1 hour
- Small group workshops: 12 groups of 15 students with 2 preceptors each – 2 hours
- Geriatric Assessment Instrument Completion for Simulated Patient and Actual patient
- Distribution of Geriatric Assessment Pocket Cards
Program Content
- Simulated Patient Session for Cognitive Assessment
Goal: Teach approach to the geriatric patient, interviewing skills, the use of cognitive and neuropsychiatric assessment tools, and to describe findings
- Activities with simulated patient: Students complete the following tasks demonstrating for the group:
- Chief complaint & History of Present Illness
- Geriatric Review of Systems
- Social History
- Neuropsychological assessment
- Mini Cog – 3 – item recall & clock drawing
- Digit repetition
- Timed Naming
- Optional activities: Discussion of delirium, depression and dementia. Introduction to the following tools:
- Confusion Assessment Method
- Geriatric Depression Scale
- Discussion
- Students describe the mental status of the simulated patient
- Students describe the impairments that they observed
- Discuss scoring and interpretation of the Minicog
- Discuss potential neurological/medical causes of the impairments and their treatment
- Real Patient with Gait Disorder for Functional Assessment
Goal: Teach the fundamentals of a gait assessment and the Get up and Go test
- The student evaluates an actual patient with a gait disorder. Students complete the following activities:
- History of Present Illness related to the gait problem
- Geriatric Review of Systems (Activities of Daily Living, Instrumental Activities of Daily Living)
- Standing balance
- Static balance – semi-tandem; full tandem stance
- Gait
- 360 Degree Turn
- Full Get Up and Go Test
- Optional additional tests – Tinetti Performance-Oriented Assessment of Balance and Performance-Oriented Assessment of Gait
- Discussion
- Students describe the ADL status
- Students describe the impairments that they observed
- Discuss simple neurological/medical causes of such impairments and their treatment
- Student Evaluation of Workshop
- Faculty Review of Workshops