114 Chapter 5 According to interviewees, the lecturer had an important role in the EPs’ learning process by providing constructive feedback to participants, moderating group discussions, anticipating on participant needs, and by letting EPs first explore geriatric problems and possible care approaches themselves before giving feedback. Although interviewees described mainly positive experiences with the program, many felt that the program requires further improvement to ensure that the most essential geriatric information and skills are memorized by EPs and ultimately become part of their routine practice. According to them, the use of a ‘take home messages’ and summary recaps of previous education sessions, and easy access for EPs to education material (e.g., presentation slides, minutes, recordings, references and the description and geriatric analysis of cases) could contribute to the further improvement of the program. EP 1: It is a pity that no minutes were made during the program. That way you could say: “Alright, I missed a few things, but I can just check the minutes to find out what it was about.” Now I feel that there is a lot that I should know about, but I cannot find out what it was. (...) [The lecturer] gave us a great deal of useful advice. So it would have been nice if we could have looked that up again somewhere. Discussion Our quantitative findings show that the geriatric training programmay increase the EPs’ knowledge in geriatric medicine. These findings are supported by the interviews with participants; the program improved their ability to recognize frailty and geriatric syndromes, and their attentiveness for recognizing vulnerable older patients at the ED. There were several limitations to our study. First, because there was no coexisting control group (as each EP served as his or her own control), we cannot ascertain whether the educational program was the cause of the improved knowledge. The observed (lack of) effects could be explained by societal attention for the growing number of older adults attending the ED, EPs’ experiences with older adults or preexisting educational materials [22]. Second, outcome effects and experiences with the program were based on a relatively small sample of EPs and medical charts. Only the effects on (self)perceived geriatric knowledge and attitudes towards older adults were based on a larger sample, including EPs from a second hospital. Moreover, the program was fully implemented and evaluated at only one hospital with an existing geriatric consultation service. This limits the generalizability of our findings to other hospitals. However, this
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