Introduction: Emergency care of older adults requires specialized knowledge of their unique physiology, atypical presentations, and care transitions. Older adults often require distinctive assessment, treatment and disposition. Emergency medicine (EM) residents should develop expertise and efficiency in geriatric care. Older adults represent over 25% of most emergency department (ED) volumes. Yet many EM residencies lack curricula or assessment tools for competent geriatric care. Fully educating residents in emergency geriatric care can demand large amounts of limited conference time. The Geriatric Emergency Medicine Competencies (GEMC) are high-impact geriatric topics developed to help residencies efficiently and effectively meet this training demand. This study examines if a 2-hour didactic intervention can significantly improve resident knowledge in 7 key domains as identified by the GEMC across multiple programs. Methods: A validated 29-question didactic test was administered at six EM residencies before and after a GEMC-focused lecture delivered in summer and fall of 2009. We analyzed scores as individual questions and in defined topic domains using a paired student t test. Results: A total of 301 exams were administered; 86 to PGY1, 88 to PGY2, 86 to PGY3, and 41 to PGY4 residents. The testing of didactic knowledge before and after the GEMC educational intervention had high internal reliability (87.9%). The intervention significantly improved scores in all 7 GEMC domains (improvement 13.5% to 34.6%; p<0.001). For all questions, the improvement was 23% (37.8% pre, 60.8% post; P<0.001) Graded increase in geriatric knowledge occurred by PGY year with the greatest improvement post intervention seen at the PGY 3 level (PGY1 19.1% versus PGY3 27.1%). Conclusion: A brief GEMC intervention had a significant impact on EM resident knowledge of critical geriatric topics. Lectures based on the GEMC can be a high-yield tool to enhance resident knowledge of geriatric emergency care. Formal GEMC curriculum should be considered in training EM residents for the demands of an aging population. [West J Emerg Med. 2014;15(4):409-413.].
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机译：简介：老年人的急诊需要他们独特的生理学，非典型表现和护理过渡的专业知识。老年人通常需要进行特殊的评估，治疗和处置。急诊医学（EM）居民应在老年人护理方面发展专业知识和效率。老年人占大多数急诊科（ED）的25％以上。然而，许多新兴市场居民缺乏能胜任老年医学护理的课程或评估工具。对居民进行紧急老人护理的充分教育可能需要大量有限的会议时间。老年急诊医学能力（GEMC）是具有高影响力的老年医学主题，旨在帮助住院医师有效地满足这一培训需求。这项研究检查了2个小时的教学干预是否可以显着提高GEMC在多个计划中确定的7个关键领域的居民知识。方法：在2009年夏季和秋季举行的针对GEMC的讲座前后，在六个EM住院医生中进行了经过验证的29个问题的教学测试。我们使用配对的t检验分析了得分作为单个问题和在定义的主题领域中的得分。结果：总共进行了301项考试; PGY1的居民为86，PGY2的居民为88，PGY3的居民为86，PGY4的居民为41。 GEMC教育干预前后的教学知识测试具有较高的内部可靠性（87.9％）。干预措施显着提高了所有7个GEMC域的得分（提高13.5％至34.6％; p <0.001）。对于所有问题，改善程度均为23％（之前37.8％，之后60.8％; P <0.001）PGY年发生了老年知识的分级增长，干预后PGY 3级别的改善最大（PGY1 19.1％比PGY3 27.1） ％）。结论：简短的GEMC干预对EM居民对老年性重要主题的知识产生了重大影响。基于GEMC的讲座可以成为提高居民对老年急诊知识的高收益工具。在培训新兴市场居民以应对人口老龄化的需求时，应考虑使用正式的GEMC课程。 [西急救医学杂志。 2014; 15（4）：409-413。]。
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