tions in palliative care, end-of-life care, or hospice, and only 2.7 percent felt unprepared to care for dying patients (Pan et al., 2005).

In October 2006 the American Board of Medical Specialties (ABMS) announced Hospice and Palliative Medicine as a new subspecialty for ten different specialty boards (ABMS, 2006). The first certifying exams will be administered in October 2008.

Interdisciplinary Team Training

One element common to many models described in Chapter 3 is the use of interdisciplinary teams. The value of interdisciplinary teams for the care of older adults with complex care needs has been increasingly acknowledged in recent years (Dyer et al., 2003; Howe and Sherman, 2006; Inouye et al., 2000; Maurer et al., 2006; Wheeler et al., 2007; Williams et al., 2006). The term “interdisciplinary team” implies an interaction and an interdependence among practitioners with different areas of expertise who are working together to treat a single patient. Still, health care professionals are typically trained separately by discipline, which fosters ideas of hierarchy and responsibility for individual decision making (Hall and Weaver, 2001). As a result, providers may gain little understanding of or appreciation for the expertise of other providers or the skills needed to effectively participate in an interdisciplinary team. However, most health care professions identify interdisciplinary team practice as a necessary competency in the care of older adults.

The field of geriatrics led the movement toward team training in health services. In the 1970s the VA developed the Interdisciplinary Team Training in Geriatrics (ITTG) Program, and in the 1980s HRSA began awarding grants for GECs to teach collaboration and teamwork to health care professionals working in geriatrics (Heinemann and Zeiss, 2002).

In 1997 the John A. Hartford Foundation funded eight national programs to develop geriatric interdisciplinary team training (GITT) programs for students in nursing, social work, and medicine in order to foster the skills needed for effective team care. These programs often included other professionals, such as pharmacists, dentists, and rehabilitation therapists. GITT seeks to train health professionals to work more effectively on geriatric care teams. The announced goals included the creation of a national model to forge partnerships between geriatric care providers and institutions of education, the development of educational curricula for interdisciplinary team training, training health care professionals in team skills, and the testing of new models of training for practicing professionals (Flaherty et al., 2003).

To evaluate this training, several measures have been developed to assess trainees’ knowledge of interdisciplinary geriatric-care planning, their

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