16 Chapter 1 Geriatric education of emergency physicians Better geriatric education of health care professionals is key for providing a high standard of care for older adults in the ED. Emergency physicians are expected to acquire the ability to care for older adults during undergraduate and postgraduate medical education. However, evidence shows that current education does not adequately prepare ED professionals to provide high-quality care for older adults (34-36). Medical students, residents working at the ED, and staff report feeling unprepared and uncomfortable caring for older adults (35, 36, 37). Shortcomings in training and education in geriatric emergency medicine could be an underlying cause of inadequate geriatric knowledge and skills. To overcome the problem of inadequate training, geriatric curriculum domains have been published (38), and specific geriatric curricula for emergency care residency training in Europe have been developed (39, 40). Nevertheless, in the Netherlands, no emergency medicine residency program has incorporated formalized geriatric education. The organization and implementation of nonformalized education in the care of older adults during emergency care residency training is also lacking, perhaps because many emergency staff members have had insufficient geriatric training themselves. Inadequacies in core curricula and residency training and a lack of continued medical education in geriatrics for emergency physicians are probably the main reasons why practising emergency physicians feel uncomfortable with the treatment of older adults in the ED. Despite the recognition of the need for geriatric education and training for emergency physicians, insight is lacking regarding the currently available geriatric education programs in the Netherlands and whether these programs meet the perceived educational needs of emergency physicians. Improvement of acute geriatric care in the emergency department Multiple studies have shown that older adults admitted to the ED are at high risk for adverse health outcomes (functional decline, hospitalization, ED return visits, death) after the ED visit (10, 41, 42). These outcomes show the urgent need to improve the care of older adults visiting the ED. A number of interventions have been performed to improve the quality of care for older adults in the ED (43). Many of these interventions focused on the use of screening tools, the use of specialized beds for older adults, follow-up care, and the education of ED professionals.
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