Canadian University Faculties of Pharmacy: Undergraduate curriculum survey of geriatric content

American Journal of Pharmaceutical Education, Fall 2001 by Misiaszek, Brian C, Borrie, Michael J, Grymonpre, Ruby E, Brymer, Chris D, Et al

* "Health promotion.. incidence and prevalence of disease ...patterns of drug use... polypharmacy."

* "Topics is not the issue - we are adding a course dealing with the general issues surrounding different patient populations."

* "Not necessarily more topics, but more exposure to geriatric patients earlier in the program."

Four schools did not provide a written comment

Clinical and Placement Experiences

Specific clinical rotations for undergraduate pharmacy students in geriatrics, in geriatric rehabilitation units, geriatric assessment units and long-term care settings are outlined in Table IV Three schools had their undergraduate pharmacy students assigned to a geriatric preceptor, to whom they were responsible for reporting issues regarding specific geriatric patients under their care. At four schools, preceptors were available for counseling and to act as resource people. Respondents for two of the schools were unable to determine if their students had either a mandatory or elective preceptor. Opportunities for communication skills practice with clients, with caregivers, and strategies to improve medication adherence were commonly available but not mandatory. The one school that did not offer any of these, indicated that such opportunities would become available in their new curriculum. Only three schools indicated that there were special geriatric related electives available in that school's home city, with only a single school indicating that out-of-town experiences were available.

Critical Appraisal/Innovative Teaching

Just over half of the schools taught their students the critical appraisal skills needed to review published clinical guidelines. Just over half reviewed previously published specific geriatric guidelines for inappropriate prescribing of medications in older persons. Two schools mentioned that they were in the process changing their curriculum to incorporate the teaching of critical appraisal in the near future. Table V outlines innovative programs on geriatric topics and issues provided by the various faculties.

Feedback

Open-ended comments by several respondents (written often as marginalia in their faxed replies) emphasized that at several schools of pharmacy, issues dealing with the elderly are integrated into the pharmacokinetics and pharmacodynamics courses, rather than being dealt with in a separate course. One school has plans for an updated curriculum with more geriatric content beginning in the 1999-2000 school year. Their revised curriculum was used in the final analysis. Some respondents commented that the survey instrument was relatively inflexible to adequately capture the geriatric content of courses where geriatric issues are integrated into, but are not the primary focus of the course. One respondent, in commenting on this topic, wrote:

"We found it very difficult to estimate contact time with students given that geriatrics is not directly targeted in any course (with the exception of the geriatric pharmacy elective)."

Another respondent wrote: