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Don't Fall for That: A Residency Curricular Innovation about Fall Prevention
David R Lee1, Joan C Lo2,3, H Nicole Tran1,2
1Department of Internal Medicine, Oakland Medical Center, CA.
Introduction:
Amid a growing geriatric population and rise in frailty-related morbidity, fall prevention represents an opportunity to improve patient outcomes and reduce health care costs. Traditional lectures on geriatric content have had limited impact on physician behaviors; however, use of multimodal teaching can be more effective in building knowledge and skills.
Objective:
To develop a novel, engaging fall prevention program to empower internal medicine residents to identify and manage patients at risk of falls and fall-related injuries.
Methods:
Two 20-minute multimodal workshops were created: 1) a classroom session with a video depicting a fall scenario, a team exercise ("Where's the Fall Risk?") and review of the American Geriatrics Society Beers Criteria; and 2) a small-group session reviewing a screening algorithm, case study, physical examination maneuvers, and patient resources.
Innovation:
The first workshop included a 5-minute Kaiser Permanente video depicting an older couple whose travel plans are upended by a fall and how they modify their home and lifestyle, a competitive game in which trainees identify fall hazards, an overview of Beers Criteria, and Medical Knowledge Self-Assessment Program questions to apply knowledge to practice. The second workshop, held in small groups before clinic, included a discussion of the Centers for Disease Control and Prevention's fall prevention screening algorithm, review of a case, and education on how to properly perform the Timed Up and Go test.
Conclusion:
Fall prevention remains an important yet undertaught topic for trainees and practicing physicians. These brief multicomponent workshops can be easily implemented and adapted for all clinical learners.
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