Creating a Learning Community for Academic Clinician-Educators 9 th Annual Reynolds Meeting  Meeting Binder and WiFi Code Meeting Binder can be found here: ents/Binder1.pdf Meeting Binder can be found here: ents/Binder1.pdf ents/Binder1.pdf ents/Binder1.pdf The WiFi code word for the meeting is Reynolds The WiFi code word for the meeting is Reynolds

Reynolds 2011: Creating a Learning Community for Academic Clinician-Educators  See products and learn about projects for teaching and assessing geriatrics  Faculty Development  Start conversations on sustaining and growing the Reynolds’ legacy  Begin to define the Field’s entrustable professional activities (EPAs)

Reynolds Meetings: a Learning Community  Form collaborations that move the field forward Competencies Competencies Certification exam reviews Certification exam reviews Learner Assessment reviews Learner Assessment reviews Web-GEMS Web-GEMS

POGOe

Other Collaborations Born at Reynolds’ Meetings  Re-evaluating Geriatric content on national exams NBME subject exams (shelf exams) NBME subject exams (shelf exams) USMLE Step exams USMLE Step exams ABIM IM exam ABIM IM exam ABFM ITE exam ABFM ITE exam

% Qs with patients > 60 yo Best Estimate* * Assumes 25% of test questions are not scored

% >60 yo Qs that are Geriatric

% All Qs that are Geriatric Best Estimate* * Assumes 25% of test questions are not scored

Geriatric Competencies

Geriatric Syndromes

New Opportunities  Question writers for NBME and USMLE MCQs MCQs Clinical skills scenarios Clinical skills scenarios Computer-based case simulations Computer-based case simulations  Increased geriatrics content on ABIM exam

All Accomplishments of Reynolds Learning Community

But We’re a Closed Club

Reynolds Funded Schools and Departments, 2010

Reynolds Schools Vs. non-Reynolds

Reynolds Schools vs. All Fellowship Programs in Geriatrics

Source: Lou Grosso, ABIM & Gary Jackson ABFM. Compiled by AGS/ADGAP Geriatrics Workforce Policy Studies Center. March 2011

Enlarging and Supporting the Learning Community  Opening meeting to non-Reynolds Clinician- Educators  This meeting– a deep dive Discuss how to retain and support our existing faculty in: Discuss how to retain and support our existing faculty in: Academic PromotionAcademic Promotion Assuming leadership rolesAssuming leadership roles

A Conversation about Clinician- Educators in Academic Geriatrics  Monday AM sessions: Needs Assessment: Supporting and promoting junior and mid-level faculty, regardless of institution Needs Assessment: Supporting and promoting junior and mid-level faculty, regardless of institution Consider how other academic groups are doing this Consider how other academic groups are doing this See Environmental Scan in binder for examplesSee Environmental Scan in binder for examples  Wednesday: Learning community discussion with AGS and ADGAP leadership about findings from the faculty needs assessment Learning community discussion with AGS and ADGAP leadership about findings from the faculty needs assessment

Defining Geriatric Medicine Challenges and Opportunities

2008  IOM report Enhance geriatric competence of entire workforce Enhance geriatric competence of entire workforce Increase recruitment and retention of geriatric specialists and caregivers Increase recruitment and retention of geriatric specialists and caregivers Improve the way care is delivered (both developing methods AND leading system change) Improve the way care is delivered (both developing methods AND leading system change)  Fried and Hall: JAGS editorial What is a Geriatrician? What is a Geriatrician? Social Advocacy Social Advocacy ‘how can the collective geriatrics professional community most effectively mount the social change necessary to make meaningful systems change in the care of older adults?l‘how can the collective geriatrics professional community most effectively mount the social change necessary to make meaningful systems change in the care of older adults?l

Geriatricians, 2011  Identified geriatric competencies for Medical students Medical students IM/FM/EM/Surgical residents IM/FM/EM/Surgical residents  Works in progress Increase recruitment and retention of geriatrician faculty Increase recruitment and retention of geriatrician faculty Improving the way care is delivered Improving the way care is delivered Developing care delivery modelsDeveloping care delivery models Leading system changeLeading system change Research into Geriatric syndromesResearch into Geriatric syndromes  Social and Political Advocacy

What is a Geriatrician? Expertise  Content Knowledge Physiology of aging Physiology of aging Care of patients with multiple diseases Care of patients with multiple diseases Management and prevention of geriatric syndromes (frailty, falls, incontinence, disability, cognitive decline) Management and prevention of geriatric syndromes (frailty, falls, incontinence, disability, cognitive decline) Evaluating risk Evaluating risk Appropriately caring for older adults with different levels of health status Appropriately caring for older adults with different levels of health status Fried L and Hall W. JAGS 2008; 56 (10):

What is a Geriatrician? Expertise  Optimism/realism about aging  Cognitive skills and strategies expertise in complex problem analysis expertise in complex problem analysis patient-centered patient-centered  Practice models interdisciplinary teams interdisciplinary teams  Systems of care targeted to health status, goals targeted to health status, goals Fried L and Hall W. JAGS 2008; 56 (10):

Who do Geriatricians Care for? Priority subsets  Aged>85  Complex biomedical and psychosocial  Geriatric Syndromes  Frailty  Palliative or end-of-life care  Posthospital placement  Nursing home care Fried L and Hall W. JAGS 2008; 56 (10):

Still no clear articulation…  What makes a fellowship trained geriatrician different than a general internist or family practitioner?

Entrustable Professional Activities (EPA)  ACGME competencies  Specialty Milestones (AAIM, AAFP)  Geriatric competencies  EPAs Represent the routine professional-life activities of physicians based on their specialty and subspecialty Represent the routine professional-life activities of physicians based on their specialty and subspecialty 5-7 statements, observable and measureable 5-7 statements, observable and measureable  Together constitute the CORE of the profession

Reynolds 2011: Creating a Learning Community for Academic Clinician-Educators  See products and learn about projects for teaching and assessing geriatrics  Faculty Development  Start conversations on sustaining and growing the Reynolds’ legacy  Begin to define the Field’s entrustable professional activities (EPAs)

EDITORIAL: Leading on Behalf of an Aging Society Journal of the American Geriatrics Society Volume 56, Issue 10, pages , 1 OCT 2008 DOI: /j x Volume 56, Issue 10,

EDITORIAL: Leading on Behalf of an Aging Society Journal of the American Geriatrics Society Volume 56, Issue 10, pages , 1 OCT 2008 DOI: /j x Volume 56, Issue 10,

Step I MCQs * Assumes 25% of test questions are not scored Best Estimate*

Step 2 MCQs * Assumes 25% of test questions are not scored Best Estimate*

Step 3 MCQs * Assumes 25% of test questions are not scored Best Estimate*

Creating a Learning Community for Academic Clinician-Educators 9 th Annual Reynolds Meeting 2011