Teaching Geriatric Medicine in Vietnam: Introduction of an interactive learning module for medical students

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Letter to the EditorTeaching Geriatric Medicine in Vietnam: Introduction of aninteractive learning module for medical studentsajag_462 135..136Dear Editor,Demand for health care for older people is increasing inSouth East Asia as the proportion of people aged older than60 years increases [1]. An understanding of geriatric medi-cine is essential for provision of appropriate care, but incountries like Vietnam only 12.5% of medical schools haveindependent units for geriatric medicine [2]. Problem-basedlearning (PBL) and guided clinical experiences are recom-mended teaching styles for geriatric curricula [3,4]. Vietnam-ese medical courses tend to be traditional, didactic andfocused on the biomedical model of patient care, althoughPBL has recently been introduced in some South-East Asianmedical schools [5]. Partnership between Australia andVietnam through the University of Sydneys Hoc Mai Foun-dation previously introduced novel teaching methods forin-country postgraduate training in peri-natology [6].The National Institute of Gerontology (NIG) was establishedin Hanoi, Vietnam in 2005 as a centre for clinical care,research and education. At the request of clinical teaching stafffrom the NIG through the Hoc Mai Foundation, a culturallyappropriate, sustainable teaching module on a geriatric syn-drome (cognitive impairment) was developed, piloted andevaluated by staff and a student of Sydney Medical School.The module addressed dementia and delirium, with a focuson functional and social issues and carer stress, includingVietnamese cultural issues such as filial piety and financialconstraints. It combined lectures, PBL (student-directed tuto-rial based on case with guiding questions) and guided clinicalexperiences (carer interview and observation of patientassessment) to provide examples for future module develop-ment by local staff. The module was trialled on Vietnamesedoctors during fellowships in Australia to detect culturalinconsistencies and on Sydney Medical School students toverify the suitability of the format. It was then translated intoVietnamese. The program was launched and evaluated bythree of the authors (AB, SH, SO) with 12 final year studentsfrom Hanoi Medical University during their week of clinicaltraining at the NIG in December 2008.Positive attitudes towards carers, carer stress and the doctorsrole in education of patients and families increased immedi-ately after the module (assessed using Likert scales). Studentknowledge (assessed using multiple choice questions)improved non-significantly (average score 46% pre-test,62% post-test), with the greatest improvement in knowledgeof treatment. Students reported a perceived improvement intheir understanding of the causes and symptoms of dementia,and increased confidence to assess a patient with dementia.Acceptability of the module (based on comments from afocus group) was good. PBL was a new experience for all andwell received. The guided clinical experiences were con-sidered useful and easy to organise. On assessment usingLikert scales, all of the students reported that they found thecase realistic and the teaching style helpful for learning, and82% preferred group to individual learning.The module appears to be sustainable. The entire module hassubsequently been used for two groups of final year studentsat the NIG, and an abbreviated version (PBL and guidedclinical experiences) has been used by five other groups.Teachers at the NIG plan to extend the program to includeboth fourth and sixth year students in 2010, to create newmodules in the same format on other geriatric syndromes,and to adapt the modules for education of nursing staff.This pilot of an interactive teaching module for Vietnamesemedical students on the geriatric syndrome of cognitiveimpairment was successful. Students showed improvement inattitudes and knowledge immediately after the program; theteaching methods were well received and seemed sustainable.It is hoped that implementation of this type of education willpositively impact health care for older people of Vietnam.AcknowledgementsThis study was funded by Hoc Mai Foundation and Geoffand Elaine Penney Ageing Research Unit.Anthea BroadfootNorthern Clinical School, Sydney Medical School, StLeonards, New South Wales, AustraliaSusan J OgleNorthern Clinical School, Sydney Medical School;Department of Aged Care and Rehabilitation, Royal NorthShore Hospital, St Leonards, New South Wales, AustraliaKirsty FosterNorthern Clinical School, Sydney Medical School, StLeonards, New South Wales, AustraliaHo Kim ThanhNational Institute of Gerontology, Hanoi, VietnamSarah N HilmerNorthern Clinical School, Sydney Medical School;Department of Aged Care and Rehabilitation, Royal NorthShore Hospital, St Leonards, New South Wales, AustraliaDOI: 10.1111/j.1741-6612.2010.00462.x135Australasian Journal on Ageing, Vol 29 No 3 September 2010, 135136 2010 The AuthorsAustralasian Journal on Ageing 2010 ACOTAReferences1 Knodel J, Debavalya N. Social and economic support systems for theelderly in Asia: An introduction. Asia-Pacific Population Journal 1992; 7:512.2 Keller I, Makipaa A, Kalenscher T, Kalache A. Global Survey on Geriatricsin the Medical Curriculum. Geneva: World Health Organisation, 2002.3 Australian Society for Geriatric Medicine. Position Statement No 4 Education and Training in Geriatric Medicine for Medical Students.Australasian Journal on Ageing 2006; 25: 218222.4 Duque G, Bonnycastle M, Nazerali N et al. Building a learning experience:The implementation of a clerkship in geriatric medicine. EducationalGerontology 2003; 29: 671683.5 Amin Z, Eng KH, Gwee M, Rhoon KD, Hoon TC. Medical education inSoutheast Asia: emerging issues, challenges and opportunities. MedicalEducation 2005; 39: 829832.6 Hirst JE, Jeffery HE, Morris J et al. Application of evidence-based teach-ing in maternal and child health in remote Vietnam. International Journalof Gynaecology and Obstetrics 2009; 104: 152155.L e t t e r t o t h e E d i t o r136 Australasian Journal on Ageing, Vol 29 No 3 September 2010, 135136 2010 The AuthorsAustralasian Journal on Ageing 2010 ACOTA

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