IMPROVING GERIATRIC HEALTH CARE: THE ROLE OF EDUCATION

A look to the past shows how education shaped the contemporary system of health care. The consequences of the structure of this system on health care of the elderly are discussed. We also describe an image of health care in the future based on the needs of the elderly. There are two courses of action that can be followed as the United States moves toward the first half of the 21st century. One course accepts the structure and direction of the contemporary system. The other suggests a reorganization of the health care system based on current and future needs of the population and the nature of resources available. Both of these courses of action are discussed and examples of existing programs cited. We believe medical educators must make the necessary changes toward one or both of these courses of action now to ensure improved geriatric health care in the future.     

GERIATRIC FOOT CARE: A MODEL EDUCATIONAL PROGRAM FOR MID-LEVEL PRACTITIONERS

Studies have indicated that at least 80% of those over age 50 have at least one foot problem. Feet often reflect systemic disease conditions, especially since this population has a higher prevalence of chronic diseases such as atherosclerosis and diabetes. As a result of a needs assessment completed by nurse practitioners, the Appalachian Geriatric Education Center developed a model educational program in the area of geriatric foot care for mid-level practitioners. The program is designed to prepare the mid-level practitioner with the education and skills necessary to provide foot care to adults and elderly clients in the community. The program includes both didactic and clinical learning experiences with topics such as anatomy, physical assessment, management of minor conditions, and referral for specialty care. The total number of students who have completed the course is 72: 59 nurse practitioners; 12 physician assistants; and 1 physician. There was a significant difference in the pre- and post-test scores, with the post-test scores being significantly higher: t = -13.446, p < .000. In the follow-up evaluation, the majority of the participants said they incorporated what they learned into their clinical practices and have increased their referral base to podiatrists and orthopedic surgeons.     

INTERDISCIPLINARY CONTINUING EDUCATION IN A RURAL AND REMOTE AREA: THE APPROACH OF THE NORTHERN EDUCATIONAL CENTRE FOR AGING AND HEALTH

This article describes an interdisciplinary continuing education approach for health professionals in a rural remote area implemented by the Northern Educational Centre for Aging and Health (NECAH) at Lakehead University in Thunder Bay, Ontario, Canada. The article discusses issues of rural health care practice and the implications for practitioners’ educational needs. The key components involved in delivering interdisciplinary education and teamwork training are reviewed, followed by a discussion of the relevance of an interdisciplinary participatory approach for rural practitioners given their practice context and work style. Using NECAH's experience in planning and delivering a 5‐day interdisciplinary education program in palliative care as a case example, it is argued that simultanous attention to these issues in the design and delivery of continuing professional education for rural professionals contributes to a relevant educational experience in the short‐term and an increased interdisciplinary collaboration in the long‐term. The article suggests that NECAH's interdisciplinary participatory approach is a significant model for the continuing education of health professionals in rural remote areas.     

GERONTOLOGICAL INTEREST AND OPINIONS OF HEALTH CARE PROVIDERS

The purpose of this study was (1) to examine and analyze the opinions and interests in geriatrics, gerontology, and older people of physicians, registered nurses, and dentists; and (2) to make comparisons of the expressed interests and opinions between the three groups of practitioners. The instrument consisted of two parts, demographic information and 22 questions regarding the interest and training in geriatrics/gerontology and opinions of the health needs of the elderly. From the results obtained in this study implications for the future training of health care providers are discussed.     

MENTAL HEALTH EDUCATION IN GERIATRIC FELLOWSHIPS

Geriatric fellowship curricula in primary care specialties of medicine include a minimum of mental health education, resulting in inadequate psychiatric assessment of the elderly. An educational program was developed to teach the psychology of aging, communication skills, and psychotherapy principles with older adults to geropsychiatry fellows during a 2‐year fellowship. The program's impact on fellows' performance was measured using 10 rated skill areas from the Periodic Review of Psychotherapy Skills. Improvement or maintenance of skills at the highest level was achieved by all fellows. The program's success is indicated by improved conceptualization of older adults' problems, increased accuracy of diagnoses, development of more appropriate treatment plans and goals, and refined communication and psychotherapy skills. Applicability to other medical and nonmedical disciplines and impediments to fellowship integration are discussed.     

CONTINUING EDUCATION: A FACTOR IN PREPARING FOR RETIREMENT

This study focuses on the role of formal continuing education in helping persons prepare for retirement. The subjects were 206 classified, university employees between the ages of 50 and 65. The Retirement Preparation Indexes were used to measure behavior, information, and attitude toward retirement. Using the analysis of variance (a = .05), participants in formal continuing education (N = 46) scored significantly higher on the indexes community activity behavior, health care issues, psychological adjustment information, preretirement zest attitude, total behavior, total information, and the complete retirement preparation index. Preretirees involved in lifelong learning were found to be more concerned about their own development regardless of age and more aware of the options available to them upon retirement.     

SERVICE-LEARNING EDUCATION IN COMMUNITY-ACADEMIC PARTNERSHIPS: IMPLICATIONS FOR INTERDISCIPLINARY GERIATRIC TRAINING IN THE HEALTH PROFESSIONS

Major changes are taking place within the health care system that have important implications for health professions education in geriatrics. The forces driving these changes are also affecting academic settings, where trends supporting the development of community-academic partnerships, service-learning models, and interdisciplinary education are all evident. These trends have major implications for health professions educators working to develop academic programs to prepare students for future practice with older adults. This article explores the impacts of these changes, in particular, on the design of interdisciplinary or collaborative education programming, including the following dimensions: assessment and definition of the problem, emphasis on functioning and quality of life, professional identity, changing roles of faculty and students, and institutional-organizational implications. General recommendations on how to respond to the challenges represented in these trends are also explored.     

CONTINUING EDUCATION: OPEN FOR ALL?

The paper (developed from one presented at the 1980 Conference of the Association) concerns itself with experience gained by the academic side of the Open University/BBC partnership. It concentrates upon the different roles in which broadcasting can be used and upon some of the ways in which broadcasting has been tackled in the past within an overall multi‐media package.

The different styles and approaches which could be made within the Open University Continuing Education division are considered.

Within this framework two important threads emerge. One is the need to provide further learning opportunities by the provision of additional educational materials. The second relates to the necessity of subjecting the knowledge claims of television to more rigorous assessment.     

WHEN PATIENTS TEACH THEIR DOCTORS: A CURRICULUM FOR GERIATRIC EDUCATION

In response to aging patient demographics and a call for increased formal geriatric training in medical schools, a community volunteer geriatric mentor program, Bridging Generations, was developed to shape attitudes of medical students caring for the elderly. The geriatric mentor experience provided students with unique insight into the challenges and joys that accompany aging and encouraged the medical students to become empathetic and knowledgeable providers of care for geriatric patients.     

INTRODUCTION TO THE SPECIAL ISSUE OF EDUCATIONAL GERONTOLOGY: INTERDISCIPLINARY GERIATRIC EDUCATION IN THE HEALTH CARE PROFESSIONS: THE DEVELOPMENT,IMPLEMENTATION, AND EVALUATION OF PROGRAMS IN THE RHODE ISLAND GERIATRIC EDUCATION CENTER

The interest around intergenerational programs and the fostering of intergenerational relationships is growing internationally. However, studies on the profile and functions of intergenerational program managers are still scarce. Furthermore, available approaches to the traits and functions of intergenerational program managers have not highlighted which features are distinctive of these professionals. Through a Delphi study undertaken in Spain, with participation of 18 intergenerational program managers and 12 intergenerational specialists, consensus was reached around characteristics of both the general profile of intergenerational program managers and the specificities of this occupational role. On the one hand, being able to work on a team, having skills for observation and contextual analysis, and being skilled at managing resources were identified as the most important general characteristics. On the other hand, being good at promoting contacts, social relationships, interactions, and bonds was deemed to be the most distinctive feature of this profile. After contrasting our results with international guidelines and standards for intergenerational work, the need to develop and reinforce further the relational nature of this professional figure is argued.     

社会分层和弱势群体的继续教育

中国的经济改革和社会性人口流动使职业重新区分和组合,导致了社会阶层的重构。大量农村劳动力涌入新兴工商业实体,由于缺乏充足的职前教育培训准备,缺乏可利用的社会、文化和经济资源,居住的社区缺乏社会服务设施,他们长期陷入不利境地,成为弱势群体。教育有两重性,既可以促进一个人向上流动,也有社会分层和阻碍向上流动的作用。继续教育作为第二次机会,政府的投资和转移支付应该着重放在公共空间的建设,改善弱势群体社会活动的基础设施和环境,便于不同的教育服务机构和志愿者进入,为弱势群体提供切身需要的教育培训和服务。     

PROGRAM DEVELOPMENT STRATEGIES IN GERIATRIC EDUCATION: IMPLICATIONS FOR FACULTY

The demographic imperative for geriatric training and care is well documented and comes as no surprise to health care professionals working in the field (see National Institutes of Health, 1987). The dramatic increase in the numbers of elderly, particularly those age 75 and older, suggests that geriatric health care will grow in importance throughout the next decade. This article briefly examines strategies for geriatric education that may have relevance for attempts to formalize and institutionalize geriatric content in academic institutions, and suggests strategies for implementation.

The domains of geriatrics and gerontology have continued to overlap as models of training and health care delivery have evolved. Distinctions between these two perspectives remain important, particularly as they pertain to the emphasis on training related to normal versus pathological aging. For purposes of simplicity, the term geriatric is used in a broad context that includes gerontological education as well. The reality of our educational experiences suggests that a balance between normal and pathological aging content in our curriculum is one of the first crucial variables that needs to be addressed.     

师范体育教育面向农村问题的探讨

师范院校是培养农村中小学师资的基地．因此,师范体育教育必须面向农村,为农村体育发展服务     

A JEWISH SCHOOL MODEL FOR MORAL EDUCATION

Since Gaonic times a great deal of Jewish history had been made, and vast areas of Jewish living had been vitally affected by an intellectual device known as “Shaalot Utshuvot” (“Responsa”), an exchange of correspondence between two leaders of Jewish thought and learning. Something in the nature of such a responsum took place between our colleagues Drs. Judah Pilch and David Kuselewitz, on the occasion of the former's publishing an experimental edition of a proposed High School curriculum, in his former capacity as director of the Curriculum Research Institute.

We publish herewith David Kusele‐witz's reply to Judah Pilch's request for his evaluation of the curriculum proposal. Written in 1965, it is still very relevant to our troubles and our challenges, and offers much food for bold and innovative thought on several vital Jewish educational issues.