Pressure ulcer education: a pilot study of the knowledge and clinical confidence of geriatric fellows

To assess the educational experiences of geriatric fellows on the subject of pressure ulcers and to begin validation of a survey that assesses pressure ulcer content knowledge of physicians in training.

Pilot study using a prospective survey.

42 geriatric fellows in New York State.

Likert scale ranking for self-reported feeling of preparation to manage geriatric patients with pressure ulcers and to teach other clinicians about the subject; knowledge test scores using a multiple choice, single-best-answer format.

Geriatric fellows in New York State who participated in the survey felt "adequately" prepared to lead a team and teach about pressure ulcers. Sixty-nine percent reported having teaching responsibilities. Sources of information included bedside rounds (79%), nurses (71%) lectures (67%), textbooks (67%), and geriatric attendings (60%). Educational settings were nursing homes (86%) and hospital units (64%). Forty-eight percent of geriatric fellows surveyed correctly identified the Braden Scale as a screening tool. Sixty-seven percent identified a description of a Stage I pressure ulcer and 52% identified a description of a Stage IV pressure ulcer. The mean score on the knowledge test for the cohort was 58 +/- 18% (SD) correct (range, 20% to 80%); the range for the fellowship programs was 36% to 62% correct.

Geriatric fellows need to improve their knowledge and confidence with regard to pressure ulcer care to become competent as clinicians and educators for this condition. Specific curricular guidelines and a validated knowledge assessment instrument on pressure ulcers are needed to improve the educational effectiveness of a geriatrics fellowship.