86 Chapter 4 are conducted on EM trainees (16, 17, 25) or trainees of other specialties (26) and not on EPs, cannot be extrapolated to specialist ED care. Third, we combined a survey of EPs and ED managers. Our study is the first to investigate ED managers’ view on GEM provided by EPs. Only one study investigated the care for frail older people in the ED and surveyed geriatricians as well as ED managers (27). In that study, the results of ED managers were not incorporated in the final results of the study, because of low response rate: only 12% of ED managers returned (incomplete) questionnaires. Other strengths of our study are our sample size and our extensive questionnaire. Our study also has some limitations. First, it is a survey study and therefore includes non-responder bias. This is inherent to the nature of this type of study. However, our non-responder analysis showed that the group of responding EPs was comparable to non-responding EPs, except for the sex. Female EPs were overrepresented in the group of non-responders. Though they mostly show higher response rates (24). Second, as this is a survey study, the results represent a subjective evaluation of medical practice. Actual clinical practice may differ. A third limitation of the study is, that our analysis is mainly based upon Likert scores. Although it is a convenient and natural seeming scale to use, it is known that Likert scores are subject to a central tendency bias: respondents usually avoid the most extreme options to obtain variation in their answers (28). These phenomena might explain high percentage of respondents choosing for midline answers in our surveys. The combined results of our study illustrates the shortcomings of current GEM curricula and EM residency training, and provides input to future education programs in core curricula and emergency medicine residency training. Strategies may include e-learning modules, rotations at geriatric wards, or additional rotations in related fields such as palliative medicine and community-based geriatrics. Such educational strategies are currently not often employed in EM residency training in the Netherlands. Formalizing and implementing a geriatric curriculum in residency training, could empower future EPs in the Netherlands with key geriatric skills. Conclusions The current study showed that a minority of EPs in the Netherlands find themselves sufficiently skilled in competences of geriatric emergency care. Although Dutch EPs appear to get sufficient time for GEM education, and seem to be allowed to manage their GEM education, the majority of EPs did not follow enough GEM education to fulfill their educational needs. Future studies should explore how current EPs most effectively can achieve their geriatric emergency skills.
RkJQdWJsaXNoZXIy MjY0ODMw