Goals, Objectives & Evaluations

By the end of their 1st year in Geriatrics, the subspecialty resident will:

• • Have developed expertise in comprehensive geriatric assessment and a sound knowledge of the major geriatric syndromes

  • Be able to appreciate factors affecting discharge of patients from hospital

  • Be able to determine who would benefit from further rehabilitation after an acute illness or functional decline

During their inpatient rotations, residents will:

• • Learn to diagnose and treat acute illness in the elderly 

  • Recognize atypical presentations of disease in this vulnerable population

  • Be able to prioritize their time in dealing with the sickest patients first  

Residents will spend time learning about the major psychiatric conditions affecting seniors and be comfortable conducting cognitive and competency assessments. A visit with the Public Guardian’s office will help them gain an appreciation of their role. 

In addition, residents will gain the ability to communicate effectively with other health care professionals, patients and families, and will begin to lead team & family meetings. Their written communication skills must be equivalent to those of a staff physician.

Throughout the year, residents will regularly attend a longitudinal ambulatory clinic with a supervising Geriatrician.  As the year progresses, a level of independence in running the clinic should develop.

During their training, further ambulatory experiences will occur in a variety of settings, including: assisted living, rural communities, day programs, and in patients’ homes.  There will be exposure to telehealth consultation to more remote communities. Involvement in specialized clinics such as the Movement Disorder Clinic, Incontinence and Cognitive Clinics will also occur. 

Residents will spend time with the Elder Abuse Intervention Team and accompany them on patient visits to gain an appreciation of the resources available for this vulnerable population.

During their palliative care experience, residents will become comfortable managing chronic pain and end-of-life issues. 

By participating in the research methodology course in their 1st year, residents will develop skills that will help them in the implementation of a research or quality assurance project that they initiate in their 1st year. However, the bulk of the work related to this will be done in their 2nd year of training. 

For those trainees who have not previously participated in the ethics course open to Internal Medicine residents at the University of Alberta, they will be given the opportunity to do so during their Geriatric Medicine training.

The Geriatric Medicine resident is required to participate in journal club presentations, teaching sessions to rotating residents, faculty and other trainees in Geriatrics, complete reflective learning exercises, and present at Geriatric Grand Rounds. 

During their 2nd year of training, residents will build on the skills gained in their 1st year, developing a greater degree of independence in running their outpatient clinics and when attending on the inpatient units. They should be working towards completion of their research project by the end of their 2nd year. 

The resident will be able to choose from a wide variety of elective choices in their final year of training, determined by their interests and future career plans. Some possibilities include urogynecology, movement disorder clinics, ophthalmology, rheumatology, dermatology, brain injury, stroke rehabilitation and amputee programs, and Geriatric Medicine rotations in more rural locations or other Canadian cities.

Discussion around the CanMEDS competencies, evidence-based medicine, and administrative and ethical issues relevant to Geriatrics will occur throughout their 2 years of residency in Geriatric Medicine. By the end of their training, the resident should feel comfortable in looking after seniors in both community and hospital settings and be well equipped to function as an independent consultant. 

EVALUATIONS occur throughout the rotation using EPAs as well as ITERs at the end of every rotation and will be based upon the rotation-specific goals and objectives. In some cases, preceptors will also be encouraged to complete a midpoint evaluation outlining areas of strength and/or weakness requiring improvement.

Evaluative methods include EPAs, ITERs, STACERS (standardized assessments of clinical evaluation report), oral exams and direct clinical observation.

STACERS involve direct observation of the resident conducting a family meeting, an interdisciplinary team meeting and a clinical examination. An assessment grid exists to evaluate the resident's performance (see links below).

• • • STACER - Procedure for the conduct of the Clinical Examination

    • STACER - Procedure for the conduct of the Family Meeting

    • STACER - Procedure for the conduct of the Interdisciplinary Team Meeting

During the course of their training, the resident's teaching, presentation abilities, and critical appraisal skills will also be assessed by staff on clinical rotations & formally when they present journal clubs and lecture/guide case-based learning sessions to rotating residents & trainees during the academic half-day teaching sessions.

 The University currently uses three evaluation systems.

• • 1. One45/Webeval: used for ITERs, STACERs, AHD evaluations as well as your academic calendar, vacations, flex days.  Webeval is also used for resident feedback on preceptors as well as rotations.  Information is compiled yearly for preceptors along with all medicine evals so there is no identifying information.  Rotation evals are compiled over four to five years.  No evaluator demographics are collected for preceptor or rotation evals; they are tracked for completion only.

    2. CBME.med: initiate EPA, view EPA summary of submitted/verified EPA's, progress forms, as well as pending forms.

    3. DASH.med: detailed EPS observation and progress reports in all stages of training, repository of uploaded files etc.

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