Many community-based primary care physicians will soon spend the majority of their time caring for older adults.   Yet, most physicians currently in practice received little or no formal geriatrics training.  Evaluation of physician performance in the management of common geriatric conditions reveals the need to improve physician practice in these areas.  Traditional continuing medical education (CME) lectures delivered to passive audiences in a “dark room with slides” have not been shown to be effective in changing physician practice. 

Using a train-the-trainer approach to delivering community-based CME to primary care providers, the Practicing Physician Education (PPE) in Geriatrics Project has been shown to change physician practice in the care of older adults.
 
Physicians are trained as peer educators.  They learn small group, interactive instructional methods based on current adult learning theory.  They are also trained to teach an organized, office-based approach to managing common geriatric conditions, using the specially designed toolkits found on this site.

The evidence-based, case-based tool kits contain easy-to-use screening and evaluation tools, chart forms, and patient education handouts that support a collaborative physician/patient approach to chronic disease management and health care decision-making.

Project Outcomes

Facilitator training sessions held in collaboration with the American Acacemy of Family Physicians, American College of Physicians, American Geriatrics Society, Veterans Administration, and various medical schools and healthcare institutions have created a pool of 180 facilitators.  These facilitators have, in turn, taught an approach to geriatrics assessment and management to over 4,000 practitioners in their communities.

A formal evaluation of the train-the-trainer model was conducted from 1999 to 2001.  Evidence of the model’s effectiveness includes:

• High satisfaction with facilitators’ teaching skills (≥ 4.21, Likert scale 1-5, on 7 items measuring teaching performance).
• Clinically and statistically significant improvement in workshop participants’ self-reported knowledge, attitudes and office-based practice at the time of training and at 6-month follow-up.
• A high percentage of providers developing practical plans for evaluation and education of patients with the syndromes for which tool kits were developed.
• Self-reported practice change through the use of specific patient evaluation and education tools 6 months post-intervention.
• High ratings for the added value of interactive sessions compared with off-the-shelf reviews.