Evaluation of a nursing home medical director's curriculum for geriatric medicine fellows

To describe the evaluation of a nursing home medical directorship curriculum for geriatric medicine fellows.

Six first-year geriatric medicine fellows from the University of Hawaii program participated in this educational intervention.

A medical directorship curriculum based on the American Medical Directors Association's description of the roles and responsibilities of the medical director. Seven 1-hour sessions covering core topics were delivered in case-based format, with the opportunity to practice application.

The curriculum's impact on learner's knowledge, attitudes, skills, and abilities was evaluated using pretests and posttests. The curriculum was evaluated using a structured individual feedback interview after the completion of this curriculum. Pre-post mean scores for attitudes and skills/ability items were compared using paired t tests. A summary of comments from fellows' interviews was tabulated.

Fellows showed a significant improvement in knowledge scores after the intervention (63.33% correct before the intervention and 76.67% correct after the intervention, mean change = 13.33%, P = .03). The mean overall scores for attitudes and skills/ability items increased from 4.72 to 5.33 (change = 0.61, P = .11), and 2.67 to 3.83 (change = 1.17, P = .009), respectively. Comments from the interviews were positive and fell into 3 categories. First, fellows felt that they achieved a good knowledge base. Second, they gained a better understanding of the roles and responsibilities. Last, all participants felt the curriculum was very practical and helped them feel more prepared to become medical directors.

An innovative curriculum for nursing home medical direction provided for first-year geriatric medicine fellows had a significantly positive impact on their knowledge, ability, and skills. The curriculum was effective in helping fellows better understand and apply what they learned regarding the roles and responsibilities in medical direction.