Reynolds Grantee Program Supports Development of Innovative Projects, Materials and Approaches to Enhancing Geriatrics Training

In "I've Lost My Get Up and Go," a video send-up of a 50's style detective movie, a woman visits a gumshoe's office, tells him that her elderly neighbor has "lost her get up and go" and pleads for help. He suggests she bring the neighbor by. When she does, he asks the older woman to take a simple test -- and proceeds to take her through the Timed Get Up and Go Test, a key test for evaluating older adults' risks of falls. Written, acted, and filmed by a geriatrics fellow and medical students at the University of Arizona College of Medicine, the educational video short -- which neatly demonstrates how to use the Get Up and Go Test -- is part of an innovative Podcast the college has developed to introduce students, residents and others to key elements of geriatric medicine.

Arizona developed the Podcast and two others, and has four more in the works, thanks to a grant from the Donald W. Reynolds Foundation's Aging and Quality of Life Program. The program supports comprehensive projects that improve geriatrics training. Since 2001, it has awarded 30 academic centers 4-year grants of roughly $2 million each. Grant recipients develop projects, materials and strategies for improving training for medical students, residents, and practicing clinicians in all specialties. Grantees also gather once a year to share their projects.

"With funds from the Reynolds Foundation we've been able to develop these 5- to 3-minute Podcasts that provide a quick format that learners can access while on the go with their iPods," notes Anne Morrison, MPA, director of the college's Center on Aging. "Our hope is that by providing the information quickly and in an interesting way we'll be able to capture the interest of learners who might not otherwise have accessed this information."

Arizona's Podcasts (accessible online via http://www.geriatrics.medicine.arizona.edu/azreynolds/EduProducts/podcasts.cfm) won "Product Of The Year" at the 2007 Reynolds grantee meeting in Las Vegas this past October - amid stiff competition. The University of California at San Francisco (UCSF) Geriatrics Division, for example, weighed in with a popular Jeopardy-like game called Geri-pardy, designed to enhance the teaching of geriatrics topics to residents in ophthalmology. UCSF Geriatrics faculty are also working with their colleagues in several other surgical specialties to develop Geri-pardy games focused on urology, anesthesiology and orthopedics.

The idea for Geri-pardy came from the University of California at Los Angeles' (UCLA) geriatrics program, which shared its own Jeopardy-like, geriatrics-focused game with UCSF and other California medical schools at a meeting of the state's Academic Geriatric Resources Program consortium. UCLA, also a Reynolds grantee, developed its version of the game with funding from the "Aging and Quality of Life" program, as well.

"We hear through the grapevine that geriatrics is a little bit dry and boring , so we felt that we should try extra hard to make our material fun, interesting and engaging, and we thought playing a game would be a great way of doing it," says Bree Johnston, MD, MPH, Associate Professor of Medicine and Associate Chief for Education in UCSF's Division of Geriatrics. To add to the fun, participating teams use noisemakers to signal when they're ready to answer, and winners take home small prizes. "The game also helps build on residents' competitive nature," Dr. Johnston adds. "When they don't know the answers to common geriatrics questions, it gives them pause and motivates them to learn."

Another bonus: It's easy to customize the game and update it in light of new research and developments, adds Joan Abrams, MA, MPA, UCSF's Reynolds Project Coordinator.

In Geri-pardy, the entertainment factor helps engage students and residents. In "Freda Sandrich: Center Stage," another of UCLA's Reynolds grantee projects, it's the human element that's so compelling.

A"Freddie" National Health and Medical Media Award finalist, the DVD features Mrs. Sandrich, a patient of UCLA medical school geriatrics division chief David Reuben, MD, from 1998 until her death, at age 103, in 2003. Each year, Dr. Reuben and his staff videotaped her annual visit, ultimately editing the tape into the 25-minute DVD. Footage of her first visit shows Dr. Reuben giving Mrs. Sandrich a mental status exam; testing her leg strength, balance and gait; and interviewing her about her daily activities. In the second visit, after Mrs. Sandrich has suffered a fall and begun needing 'round-the-clock, live-in help, her gait and balance are shakier. She's also beginning to have more noticeable memory and cognitive problems. Though she was prescribed medication to slow her cognitive decline, Mrs. Sandrich clearly loses ground over the next few years both physically and cognitively -- but not her dignity.

In just 20 minutes, the video manages to highlight both key elements of a comprehensive geriatrics exam and common age-related health problems, and pay tribute to Mrs. Sandrich's enduring spirit.

"The idea was to develop an educational tool that would stimulate discussion about dignity in the face of failing physical and cognitive health," says Dr. Reuben, who shows the video to UCLA undergrads in the university's Frontiers of Aging Honors Cluster course, to students in UCLA's AGS Student Chapter, and at the Donald W. Reynolds Mini - Fellowship Program at UCLA. During those sessions, he gives visiting faculty lists of discussion questions they can raise with their students and residents after sharing the DVD with them.

"Most of our students have loved it," Dr. Reuben says of "Freda Sandrich: Center Stage." "Some have cried when they've learned that she died. But, in general, they have been very upbeat - just like Mrs. Sandrich."

Reynolds grantee materials ready for dissemination are posted to the Portal of Online Geriatrics Education, at www.POGOe.org, a free, online clearinghouse that offers access to high-quality training and related materials.