The effect of a 12-month longitudinal long-term care rotation on knowledge and attitudes of internal medicine residents about geriatrics

Objective: To determine if participation in a 12-month longitudinal long-term care (LTC) rotation resulted in improved knowledge and attitudes about geriatrics. Design: Longitudinal study with paired measurements. Setting: A community LTC facility and a University-affiliated, community-based internal medicine residency program. Participants: Sixty-seven internal medicine residents who participated in the rotation from 1997 through 2004. ntervention: The internal medicine residents attended nursing home (NH) rounds one half day per month for 1 year, during which time they participated in a case-based interactive lecture on a core geriatric topic and rounded on their assigned patients. Measurements: Knowledge was assessed using a 70-item test. Attitudes were evaluated with a 28-item, 5-point Likert scale (1 = least positive, 5 = most positive). Results: The percent correct responses on geriatric knowledge pretest was 47% (95% CI = 45.2% to 48.8%) and on the posttest it was 57.5% (95% Cl = 55.3% to 59.6%) (t = 8.180, df = 67, P <.001). The pretest total attitude score was 3.6 (95% Cl = 3.6 to 3.7), with a posttest score of 3.7 (95% Cl = 3.7 to 3.8) (P <.001). The difference in this total was accounted for mainly by the significant changes in the attitude subscales in educational preparation (pretest 3.6 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P < .001]), general attitudes (pretest 4.0 [95% Cl = 3.9 to 4.1]; posttest 4.2 [95 % CI = 4.0 to 4.3] [P = .006]), and therapeutic potential (pretest 3.7 [95% Cl = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P = .048]). Conclusion: A longitudinal LTC rotation is an efficient and effective way to systematically provide internal medicine residents their core knowledge and experience in geriatrics.