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Retooling for an Aging America: Building the Health Care Workforce
who care for older adults should be educated and trained in the full spectrum of health care needs, from health promotion to palliative care. Finally, as discussed in Chapter 3, interdisciplinary care of older adults shows promise, so students in all professions should be trained on how to be an effective member of an interdisciplinary team.
A well-recognized barrier to geriatric education and training of all health care providers is the inadequate number of available and qualified academic faculty (Berkman et al., 2000; Berman et al., 2005; Cavalieri et al., 1999; Graber et al., 1999; Hazzard, 2003; Kovner et al., 2002; Rhee et al., 2004; Rubin et al., 2003; Simon et al., 2003; Warshaw et al., 2006). Any effort to increase geriatric education will find itself limited by the availability of trained faculty. Furthermore, beyond the need for a greater number of geriatric faculty, all geriatric fields need strong expert leaders to develop new knowledge and recruit new students.
It is a controversial question whether advanced geriatric training programs should be designed to train geriatric specialists for clinical practice or to train them for academic research and leadership. Some argue that, for the sake of the efficient use of scarce resources, geriatric specialists should concentrate on their roles of performing research and training the future health care workforce and should act as clinical consultants in only the most complex cases.
Beyond academics and clinical care, geriatric leaders need to learn the skills to manage staff, promote quality, and create a healthy work environment. For example, the relationship between nursing supervisors and nurse aides plays a significant role in the development of a hospitable work environment that leads to increased job satisfaction (see Chapter 5 for more on job satisfaction and turnover among direct-care workers) (Tellis-Nayak, 2007). In addition, certain management principles, such as providing rewards to nurse aide staff, have been associated with improved patient outcomes (Barry et al., 2005). This relationship will also have increased importance as direct-care workers assume more patient responsibility in the cascading mechanism of job delegation (discussed more later in this chapter).
To increase the number of geriatric leaders, a number of public and private entities have developed programs to promote research and teaching capacities in geriatrics. Examples include the following:
The Hartford Geriatric Social Work Faculty Scholars Program, funded by the John A. Hartford Foundation, aims to develop leaders in geriatric social work through research support, mentoring,