Virtual Reality Computer Simulated Home Visit: Teaching Home Safety

Poster Abstracts / JAMDA 14 (2013) B3eB26B12

United States, and <1% of nurses, pharmacists, and physician assistantsspecialize in geriatrics. Retention and recruitment of health careworkers, especially within long term care settings, remains a significantdilemma. Many long term care facilities in rural communitiesthroughout the United States have virtually no access to geriatricmedicine. There is a substantial need to harness the expertise ofcurrent geriatricians and geriatrics health professionals to efficientlytrain the remaining workforce to provide competent and compas-sionate care to older adults. Additionally, improved access to geriatricexpertise through the use of innovative efficient teaching models willbe critical to the dissemination and education of other health careprofessionals. Furthermore, the vast majority of older adults havemultiple complex chronic illnesses in addition to significant cognitiveand functional impairments that require the coordination of care frommultiple providers. The effective and efficient management of thesegeriatric syndromes depends on better team-based care. Objectives: 1)Evaluate interprofessional team training impact on attitudes towardteams and self-perceived teamwork skills. 2) Assess interprofessionalteam training impact on knowledge of geriatric multidisciplinarycompetencies: Dementia and Delirium. 3) Compare the impact andacceptability of videoconference versus in-person geriatric interpro-fessional team training.Design/Methodology: 1) Interprofessional Team Training Program: Wehave drawn upon resources such as the Hartford Geriatric Interdisci-plinary Team Training (GITT) program and Interprofessional Educa-tional Collaborative (IPEC) to design interactive educational sessionsthat focus on the health care team as a well-functioning unit. 2)Multidisciplinary Competency Education Program: Highlighting severalkey Partnerships for Health and Aging (PHA)/American GeriatricsSociety (AGS) Multidisciplinary Competencies (Dementia andDelirium). Methodology: Quasi-experimental with crossover so thateach group will experience both in-person and videoconferenceinterventions. This will allow for between-group as well as in-groupanalysis. Two levels of evaluation will be employed for both compo-nents of the program using pretest-posttest evaluations. 1) LearnerLevel Evaluation: Attitudes Toward Health Care Teams Scale (ATHCT):Consisting of two subscales: a) Attitudes Towards Team Value and b)Attitudes Towards Team Efficiency. Team Skill Scale (TSS): Self-assessment of skills related to the ability to represents one’s owndiscipline within the team and apply geriatric principles to care forolder adults. Multidisciplinary Competency Questionnaire: Assessmentof knowledge related to dementia and delirium. 2) Program LevelEvaluation: Course Evaluation: Designed in order to provide feedbackpertaining to both the didactic and practicum components. Thisevaluation will ask learners to: 1) rate the usefulness/relevance of thetopic areas and exercises presented in the curriculum, 2) rate thevalue of and comment on the practicum experience, and 3) compareeffectiveness/preference regarding videoconference versus in-persontraining.Results: Telegeriatric Interprofessional Team Training demonstratedimprovement in team members’ attitudes toward teams, self-perceivedteamwork skills and knowledge of multidisciplinary competencies.Additionally, when compared to in-person, the video teleconferenceinterprofessional team training curriculum was as effective in improvingteam members’ attitudes towards teams, self-perceived team skills andknowledge of geriatric multidisciplinary competencies. It was furtherdemonstrated that the telegeriatric interprofessional team trainingcurriculum was well received by team members as an alternate mode ofinterprofessional team education. **Of note, detailed data analysis is stillongoing and thus specific data results are not currently available at timeof this submission**Conclusion/Discussion: Telegeriatrics Interprofessional Team TrainingCurriculum, a novel educational program, demonstrated effective andacceptable means of education within Long Term Care. However, largermultisite studies are needed to fully assess its feasibility and generaliz-ability. Efforts are currently underway to take Telegeriatrics to this nextlevel.Author Disclosures: All authors have stated there are no financialdisclosures to be made that are pertinent to this abstract.

Virtual Reality Computer Simulated Home Visit: Teaching Home Safety

Presenting Author: Irene Hamrick, MD, University of Wisconsin FamilyMedicineAuthor(s): Irene Hamrick, MD

Introduction/Objective: To improve home safety instruction for healthprofessionals, students and patients leaving long term care facilities toreturn home. Most health professional students are required to do homevisits but may be limited in their experience by driving distance thatdecreases available time, or by differences in home visit environments.Design/Methodology: Health professional students, resident physicians(combined as learners) and patients (n¼300) will be recruited to takea survey in a computer lab with research assistants on site to answerquestions. Participants will enter demographic information and takea home safety pretest. After completing the Virtual Reality ComputerSimulated Home Visit (VRCSHV), participants will take a home safety post-test to evaluate learning using identical questions in different orders, fol-lowed by an assessment of the software. The VRCSHV is a 3D computerinteractive home environment that allows the user to “walk” with a first-person viewpoint, similar to a video game. Participants look for safetyhazards and click on objects to “fix” them. The total number of clicks andcorrect fixes are recorded. Throughout, the simulation informational boxesexplain the hazards and a summary at the end provides feedback. Thecontrol group in this pilot study will be family medicine residents sched-uled for a home visit. They will complete the pretest, go on a home visitwith Dr. Hamrick where she will read the list of hazards, and then take thepost-test. After three months, a follow up post-test will be e mailed by theinstructors to the learners and patients. Statistical analysis will be recordedby Chi-square and t-test.Results: We hypothesize: Health professionals, learners and patients willimprove their knowledge about home safety using VRCSHV; Teachinghome safety is more comprehensive with the VRCSHV; Evaluation of homevisits will be more uniform and objective than with live home visits and;The VRCSHV is accepted and well received by learners and patients.Conclusion/Discussion: The VRCSHV will teach health professionals,learners and patients to identify and correct safety hazards to make thetransition to home safer, more comprehensive and fun, and evaluationsmore uniform.Author Disclosures: Irene Hamrick, MD has stated there are no financialdisclosures to be made that are pertinent to this abstract.

What do Family Medicine Residents Know About American MedicalDirectors Association and Clinical Practice Guidelines?

Presenting Author: Murthy R. Gokula, MD, CMD, University of ToledoDepartment of Family MedicineAuthor(s): Murthy R. Gokula, MD, CMD, Zahra Aftab, MD,Ehab Wanas, MD, Handel Desa, MD, Anu Garg, MD; and Cletus Iwuagwu

Introduction/Objective: The American Medical Directors Association(AMDA) is an organization dedicated to providing education, advocacy,and information for professionals who work in the long term care field.The Clinical Practice Guidelines (CPGs) are published by AMDA and offerevidence-based, peer-reviewed publications on important topicsregarding treatment of common diseases in long term care. These guide-lines, recognized by CMS are helpful as evidence based/expert endorsedresources for MDS 3.0 and also serve as a valuable tool for the clinicalpractitioner. The purpose of this project was to determine the awareness ofthe AMDA organization and its Guidelines among a select group of FamilyMedicine Residents (FMR).Design/Methodology: Family Medicine Residents in three communityhospital residency programs in a Midwest City were asked to participate ina 10-question survey. The questionnaire evaluated the residents’ famil-iarity of the AMDA; it’s publication of the Clinical Practice Guidelines(CPGs), and other associated principals. Surveys were administered elec-tronically and on paper.Results: Less than half of the residents surveyed were aware of AMDA asan organization. A large percentage of the residents who were aware of