ArticleBMC medical education2015
Incorporating prognosis in the care of older adults with multimorbidity: description and evaluation of a novel curriculum.
Article in BMC medical education, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Strategies for discussing long-term prognosis when deciding on cancer screening for adults over age 75.Journal of the American Geriatrics Society · 2022Article
- Geriatric Educational Interventions for Physicians Training in Non-Geriatric Specialties: A Scoping Review.Journal of graduate medical education · 2021Article
- Teaching and assessing communication skills in the postgraduate medical setting: a systematic scoping review.BMC medical education · 2021Article
- A Novel Curriculum on Using Life Expectancy to Inform Cancer Screening in Older Adults.Journal of the American Geriatrics Society · 2021Article
- Predicting Mortality and Adverse Outcomes: Comparing the Frailty Index to General Prognostic Indices.Journal of general internal medicine · 2020Article
- Impact of interprofessional education about psychological and medical comorbidities on practitioners' knowledge and collaborative practice: mixed method evaluation of a national program.BMC health services research · 2016Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundPrognosis 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.
methodsThe 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.
resultsThe 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).
conclusionWe 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.
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