Physician Assistant (Associate) Education in an Aging World

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Physician Assistant (Associate) Education in an Aging World Gerry A. Gairola, Ph.D. and David Fahringer, PA-C,MSPAS, MSPH University of Kentucky College of Health Sciences Department of Clinical Sciences Division of Physician Assistant Studies Presented at IAPAE 9/23/17

Objectives At the conclusion of this session, participants will be able to: 1. Identify strategies for developing geriatric clinical curricula for physician associate students using a combination of clinical experiences and didactic assignments. 2. Identify resources useful in the development of geriatric clinical curricula for physician associate students. 3. Assess the opportunities and challenges in developing geriatric clinical curricula within their own physician associate programs.

Essentials of Primary Care Geriatric Education Includes changes in physiology and anatomy that take place during aging Includes health promotion/disease prevention (e.g. HIV), acute and chronic health problems Includes common geriatric syndromes (e.g., dementia, falls, and polypharmacy) Focuses on individualized care by assessing older peoples goals, medical conditions, and prognosis Identifies resources and effective models for care of older people

Geriatric Education University of Kentucky Physician Assistant Studies Program Didactic Education PAS 640 Survey of Geriatric Medicine Clinical Education PAS 664 Geriatric Clerkship International Education HHS 480 Exploring Health and Care of Older People in Great Britain (Pre-professional students) Graduate Certificate in Gerontology Multi- and interdisciplinary course work

Certificate in Gerontology University of Kentucky The objective of the Graduate Certificate in Gerontology is to prepare both graduate students and practicing professionals to assume key roles in improving the quality of life for older adults and furthering our understanding of the aging process and the status of older adults. Students takes coursed from three areas: Biomedical and Health Sciences Social and Behavioral Sciences Policy, Planning and Ethics

PAS 640 Survey of Geriatric Medicine Topics Lecture 1: Intro to Geriatric, demography, epidemiology Lecture 2: Nursing homes, health services, longterm care Lecture 3: Geriatric assessment, physical examination; evaluating geriatric patients Lecture 4: Medication management; drug therapy; pain management Lecture 5: Chronic disease management; disease prevention; screening, health maintenance Lecture 6: Nutritional disorders, frailty Lecture 7: Falls, immobility, gait/balance disorders Lecture 8: Decreased vitality; failure to thrive; fatigue; anemia; endocrine disease (diabetes, thyroid disorders Lecture 9: Neuropsych; dementia, delirium, depression; cognitive impairment, mood disorders, Parkinson s Disease Lecture 12: Orthopedics; arthritis, osteoporosis, pain management Lecture 11: Urology, Incontinence, urinary tract infections, chronic kidney disease Lecture 12: Cardiovascular; coronary artery disease, valvular, hypertension, heart failure, atrial fibrillation Lecture 13: Pulmonary; COPD, pneumonia, ICU care Lecture 14: Cancer in the geriatric patient; palliative care Lecture 15: GI; upper/lower GI bleed, adnominal pain, diarrhea/constipation; andropause, menopause Lecture 16: HEENT; sensory impairment: vision. hearing

PAS 664 Geriatrics Clerkship 4-week clinical course supervised by a preceptor involving direct patient care in a geriatric, adult or general medicine practice site Online modules and simulations Home site visit for home safety Medication review Nutritional survey Functional assessments (ADLs and IADLs) Mental status examination Managing pressure ulcers and urinary catheters Reading assignments

HHS 480 Exploring Health and Care of Older People in Great Britain Purpose: To help groups of interdisciplinary health science students develop international perspectives and knowledge in relation to care of older people. Two-week travel program to Scotland, England, and Wales Visits to 5 health-related venues: The Dementia Services Development Center (Scotland) Gnosall Medical Centre (England) Royal Othopaedic Hospital (England) Care & Repair Cymru (Wales)

Select Resources for Geriatric Education National Institute on Aging-NIA (USA) Portal of Geriatrics Online Education-Pogoe (USA) American Association of Retire People-AARP (USA) World Health Organization-WHO (WHO) International Association of Gerontology and Geriatrics-IAGG (Multiple countries) Association of Gerontology in Higher Education-AGHG (USA)

Contacts Gerry Gairola, Ph.D. University of Kentucky College of Health Sciences Department of Clinical Science Division of Physician Assistant Studies 900 South Limestone Street Lexington, Kentucky 40536-0200 Email: gagair01@uky.edu David Fahringer, PA-C, MSPAS, MSPH University of Kentucky College of Health Sciences Department of Clinical Science Division of Physician Assistant Studies 900 South Limestone Street Lexington, Kentucky 40536-0200 Email: david.fahringer@uky.edu

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