Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
Krain, L.P., J.T. Fitzgerald, Jeffrey Halter, and B.C. Williams. 2007. "Geriatrics attitudes and knowledge among surgical and medical subspecialty house officers." Journal of the American Geriatrics Society, 55:2056-2060.
OBJECTIVES: To examine geriatrics knowledge and attitudes of non-primary care house officers (HOs) before and after a multidisciplinary faculty development program. DESIGN: Serial cross-sectional surveys. PARTICIPANTS: HOs. SETTING: A large midwestern academic medical center. INTERVENTION: Faculty from seven surgical and six medical subspecialties participated in weekly seminars for 9 months and implemented geriatrics curricula in their HO programs. MEASUREMENTS: HO geriatrics attitudes and knowledge were measured using the University of California at Los Angeles Geriatrics Attitudes Scale (GAS; 14 items), two scales of the Maxwell Sullivan test (Therapeutic Potential and Time/Energy; six items each; lower scores denote more-favorable attitudes), and the Geriatrics Clinical Knowledge Assessment (20 multiple choice items; range 0-100%). Repeat surveys were administered in seven disciplines after geriatrics curriculum implementation. RESULTS: Baseline (n = 175) geriatrics attitudes were favorable (e. g., 3.7 for GAS; 2.1 for Time/Energy), with more-favorable attitudes among medical subspecialty than surgical HOs (e. g., mean GAS 3.8 and 3.6, respectively; P = .001), and with advanced training. Mean baseline knowledge scores were 65.1% among all HOs. No differences in attitudes or knowledge were observed between the first (n = 100) and second (n = 90) cohorts in the seven disciplines that administered subsequent tests. CONCLUSION: Geriatrics attitudes of non-primary care HOs are positive, and knowledge is moderate, suggesting need for and potential effect of geriatrics curricula. Demonstrating effects on learner outcomes of faculty development programs may require more than one faculty member per discipline and measures that are curriculum-specific and detailed rather than general and brief.