Title: Innovating undergraduate geriatric medicine training: A training fellowship to develop, test and refine a novel undergraduate medical curriculum using mixed methods, evaluated within the wider framework of national and international medical training.
Funder: Dunhill Medical Trust

Abstract: In the face of a global ageing population, health-care systems must adapt yet undergraduate curricula are inadequate in content13 and duration (see Appendix 1 for current UK provision) and ageist behaviour is sadly evident in medical practice2–4. Medical school provides a unique opportunity to shape the attitudes and knowledge of ‘tomorrow’s doctors’14. Quality undergraduate education in geriatrics leads to medical students having more positive attitudes towards older people15, with increased pursuit of careers in geriatrics as well as positive outcomes on the quality of care delivered to older people. This fellowship will: 1. Demonstrate that investment in geriatrics curricula teaching and learning has measurable, positive impact on the attitudes and skills of ‘tomorrow’s doctors’ to provide compassionate and quality care for older adults 2. Provide outstanding mentorship and training for a fellow in a world class research and education institute supported by supervisors with established expertise and experience. They will be equipped and inspired to develop an independent career as a researcher to improve the care of older people. 3. We will establish innovative teaching and learning methods that have demonstrable positive outcomes on care for older people and findings and practice will be rapidly disseminated through different modalities and organisations (e.g. BGS Education committee, World Health Organisation, Dunhill Medical Trust, EUMed students and the Medical Schools Council.) Bristol Medical School is uniquely positioned transitioning between the previous (MB16) programme to the new (MB21) curriculum (Appendix 2). In MB16, typical of many UK medical schools, geriatrics teaching was delivered in a 4-week module. MB21 has an expanded and highly innovative 18-week programme; ‘Complex Medicine for Older People’.

Lay abstract: A medical degree in the UK typically lasts 5-6 years however currently only about 2% of that time is spent explicitly learning the care of older people. Geriatrics is the branch of medicine that deals with the health and care of older adults, a diverse group of people with complex health needs. Their health needs are frequently affected by psychosocial issues such as loneliness, anxiety, fear, grief, depression, neglect, abuse, self-care issues, loss of confidence, and lack of social and support networks. The ‘art’ therefore of this branch of medicine is to holistically incorporate assessment of these different factors to deliver comprehensive, timely and compassionate care. As the global population are ageing there is a widely recognised and yet, unmet need, to ensure that doctors of the future can safely and effectively treat older patients regardless of which speciality of medicine they choose. The World Health Organisation (WHO) advocates teaching on geriatric medicine at medical school based on evidence which showed that this encourages positive attitudes towards older people and also make doctors more likely to become a specialist in this area of medicine. There is also evidence that investment in undergraduate education in geriatrics improves the quality of care and quality of life for older adults. Currently the University of Bristol medical school teaches geriatrics as a 4-week unit in the (MB16) curriculum). Bristol Medical School has recently developed a new undergraduate medicine curriculum (MB21). This now includes 18-week (half the academic year, in year 4) module in ‘Complex Medicine in Older People’ (CMOP). We are therefore in a unique position to compare students graduating from the current MB16 curriculum with those that will graduate from the MB21 programme. We will use this opportunity to assess how 2 different approaches to geriatrics education affect outcomes in examinations, students’ attitudes towards older people and later-on their choice of speciality. We will systematically look at research that has been performed already that innovates teaching and assessment in geriatrics. We will ascertain how geriatric medicine is taught in all other medical schools. We will build links with the World Health Organisation to incorporate their development in ageism prevention, teaching and global improvement in older people’s care into our curriculum. We will reinforce and promote the specialist skills and expertise in caring for older people as an essential cornerstone of medical education. This will pave the way for other institutions to change the way geriatrics is taught to ensure that all future doctors are equipped with the knowledge and compassion required to deliver high-quality care to their older patients.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;7.3 MANAGEMENT AND DECISION MAKING
Health categories: GENERIC HEALTH RELEVANCE