85 Geriatric education of Dutch emergency physicians CHAPTER 4 Regression analyses additionally showed that, factors at the personal level and organizational factors in the ED are associated with the EPs’ need for GEM education. EPs with the possibility to consult a geriatrician in the ED, had lower educational needs, which may be explained by having an option to consult a geriatrician. Another explanation could be that this group of EPs may have obtained more geriatric knowledge through their prior collaboration with geriatricians. A surprising finding of our analysis is, that EPs aware of geriatric education, apparently had less need for GEM education. One explanation for this finding could be, that EPs aware of actual GEM education programs, were physicians with high interest in geriatrics and may have already gained geriatric knowledge/skills throughout their career. Althoughmost of EDmanagers prioritized care for older adults, surprisingly less than half found improving geriatric skills of EPs important. Reported key obstacles for ED managers to organize local geriatric education for EPs were financial limitations and lack of time. Previous studies have addressed these factors as important barriers for hospitals that aim to organize advanced educational programs for their medical staff (19-21). Managers may choose for alternative and creative ways to improve care for older adults, such as implementation of frailty screening instruments, an ED-embedded geriatrician with individual feedback on geriatric practice, and close cooperation between emergency- and geriatric medicine faculties to organize short and low-cost geriatric courses. To the best of our knowledge, only one study has examined the self-perceived needs of EPs regarding GEM education before (22). In that survey 45% of EPs stated to have more difficulty in the management of certain presenting complaints in older adults compared to younger adults. We confirmed what was found in that study: the majority of EPs believed that time spent for GEM education during residency training-, and continuing geriatricmedical education post-residency, was insufficient for their needs. Their main finding, that EPs were uncomfortable with the management of older adults, is in line with results of our study. Our study has several strengths. First, the response rate of EPs is comparable to response rates of published physician survey-based studies (23). The response rate of ED managers in our survey was markedly higher than physicians’ response rate. This is in line with literature, as physicians are often a group with relatively low survey response rates (24). Studies on our topic with higher response rates (>65%) of physicians comprise studies with EM trainees (17, 25). We speculate that trainees receive less survey requests and do indeed have more time to participate in survey-based studies. Second, a strength of this study is that it is conducted on EPs. Most studies exploring the need for GEM education
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