Improving internal medicine residents' falls assessment and evaluation: an interdisciplinary, multistrategy program

Area of Science:

• Geriatrics
• Medical Education
• Patient Safety

Background:

• Falls are a significant health concern for older adults, often due to inadequate physician training in evaluation.
• Current medical education frequently lacks comprehensive strategies for falls assessment and management.

Purpose of the Study:

• To implement and evaluate a multicomponent educational program for medical residents to improve their knowledge, skills, and clinical actions regarding falls in older adults.
• To assess the impact of electronic medical record (EMR) template modifications on resident-led falls evaluations.

Main Methods:

• A multicomponent intervention including lectures, academic detailing, and case studies was delivered to medical residents.
• EMR templates were modified to include prompts, decision support, and documentation tools for falls assessment.
• Resident knowledge and confidence were measured via pre- and post-intervention questionnaires, while skills were assessed using the Timed Up and Go (TUG) test.

Main Results:

• High participation rates were observed for faculty and staff training.
• Following the intervention, 64% of residents demonstrated the TUG test, and 15% of older adult patients screened positive for falls risk.
• EMR falls templates were completed for 92% of positive screens, and the TUG test was performed in 42% of these patients, with 53% failing the test.

Conclusions:

• The integrated education and EMR system changes significantly improved resident competency in screening, evaluating, and managing falls in the elderly.
• The program demonstrated effectiveness in enhancing knowledge, skills, self-efficacy, and clinical practice related to geriatric falls prevention.