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Retooling for an Aging America: Building the Health Care Workforce
The Boston University Medical Center developed the Chief Resident Immersion Training (CRIT) Program in the Care of Older Adults to improve understanding and teaching of geriatric principles among residents in non-geriatric fields (ADGAP, 2007a). The program is being disseminated nationally.
In 2003-2004 the Society of General Internal Medicine and the John A. Hartford Foundation worked in Collaborative Centers for Research and Education in the Care of Older Adults to enhance the ability of general internists to teach geriatrics (Williams et al., 2007).
HRSA administers the National Advisory Council on Nurse Education and Practice, which, in response to the Nursing Reinvestment Act, provided grants for the geriatric education and training of registered nurses so that they can act as leaders and trainers for CNAs and LPNs (HRSA, 2003).
Geriatric experts have tried to infuse geriatrics into training programs for personnel who might not normally gain exposure to geriatric principles. Faculty at Northern Michigan University developed a training program for correctional workers that focused on the needs of the aging prison population (Cianciolo and Zupan, 2004).
Ethnogeriatrics As discussed in Chapter 2, the elderly population of the future will be more diverse than today’s older adults. Thus increased knowledge of different cultural belief systems will be important to the development of comprehensive and effective plans of action. For example, older Asian adults may not disclose their non-Western health beliefs, including the use of herbal medications or alternative health procedures, unless directly asked (McBride et al., 1996). These concerns are especially important considering the potential mismatch between the diversity of the health care workforce and the diversity of the older adult population. For example, the high proportion of IMGs among fellows in geriatric medicine and geriatric psychiatry was demonstrated earlier in this chapter. However, concerns exist for issues of communication and cultural competency in particular when IMGs care for older adults (Howard et al., 2006; Kales et al., 2006).
Several efforts have been started to improve upon the ethnogeriatric education and training of the health care workforce in settings where providers are responsible for taking care of diverse populations. For example, the Collaborative for Ethnogeriatric Education produced a five-module Core Curriculum in Ethnogeriatrics and 11 Ethnic Specific Modules which can be