Clinical Decision-Making for Older Patients With Multiple Chronic Conditions: A Case-Based Exercise for Medical...

Area of Science:

• Geriatrics
• Medical Education
• Clinical Decision-Making

Background:

• Over 50% of US adults over 65 have multimorbidity (3+ chronic diseases).
• Current research often focuses on single chronic diseases, not complex multimorbidity.
• A framework for clinical decision-making in multimorbidity has been established.

Purpose of the Study:

• To describe a preclinical medical student session focused on multimorbidity management.
• To train students in applying a decision-making framework for patients with multiple chronic conditions.

Main Methods:

• A 90-minute small-group session using a hypothetical multimorbidity case.
• Students worked with faculty mentors to apply the framework.
• Key elements included patient preferences, evidence review, prognosis estimation, feasibility, and treatment planning.

Main Results:

• Approximately 180 students completed the session.
• Outcome data indicate improved mastery of multimorbidity management concepts.

Conclusions:

• Preclinical curricula need to include skills like prognosis estimation and goal elicitation for older patients.
• This session is a valuable tool for educators to enhance geriatric training.
• It equips future physicians with core competencies for geriatric care.