CHIEF RESIDENT IMMERSION TRAINING (CRIT)

Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs

Supported by the Hearst Foundations and Donald W. Reynolds Foundation

Donald W. ReynoldsFoundation

Increasing Need for Geriatrics Expertise

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

Source: census.gov

Proportion of Work Within Surgical Specialty by Age Group,%

Specialty < 65 yrs > 65 yrsOrthopedics 49 51General Surgery 40 60Urology 35 65Cardiothoracic 30 70Ophthalmology 12 88

Source: National Hospital Discharge Survey, National Survey of Ambulatory Surgery, 1996

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

What is CRIT?

• Weekend session to enhance chief residents’ knowledge in the care of older patients.

• “Training the trainer”• Case-based discussions• Interactive approach with many small group

“breakout” sessions• Informal and relaxed atmosphere of learning.

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

Chief Resident Skills

• Very high proportion of their patients are older adults

• Approach to special problems of older patients• Each chief resident will choose an area of geriatric

focus for his/her chief residency year.• Chief resident mentored by geriatrics faculty

members throughout the year.• Focus on enhancing skills of chief resident as leader

and mentor to junior residents.

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

CRIT Background

• Focus on inter-specialty coordination of care for older patients.

• Since its inception at BUMC in 2003, the CRIT program has been disseminated over 30 times at 16 institutions nationwide.

• Funded by the Hearst Foundations and Donald W. Reynolds Foundation; no participant expenses for chief residents, program directors, and families.

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

CRIT History

2003: BUMC develops CRIT with support from the Reynolds Foundation

2005: First BUMC CRIT Program held

2007: BUMC/ADGAP receives Hartford grant for CRIT national demonstration

2008: BUMC partners with two Reynolds-funded institutions to replicate CRIT

2010: Univ. of Arizona Center on Aging puts on institutionally funded version of CRIT

2011: Four institutions continue CRIT in the most recent round of Reynolds geriatrics training grants

2011: BUMC/ADGAP receives Hearst and Reynolds funding for continued national dissemination

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

National CRIT DisseminationSince 2005, 16 institutions have implemented CRIT programs a total of 30 times

Baystate Medical Center

Cooper University Hospital

Marshall University/Joan C. Edwards School of

Medicine

Medical College of Wisconsin

Northeast Ohio Medical University

Stony Brook School of Medicine

University of Arizona

University of Cincinnati

University of Colorado

University of Kansas

University of Nebraska

University of Rochester University of South Carolina/Palmetto

Health

Wake Forest University School of

Medicine

Warren Alpert School of Medicine of Brown University

Yale University

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

CRIT Schedule

Insert Your Program Schedule HERE

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

CRIT Schedule (cont’d)

Insert Your Program Schedule HERE

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

Sample Chief Resident Action Projects

• Algorithm for Management of Epistaxis in the Older Patient and Implementation of Geriatric Topics in Otolaryngology Grand Rounds

• Implementing Focused Geriatrics Teaching for Family Medicine Residents

• Physical Activity Plan for Older Adults (PM&R)• Functional Assessment of the Older Adult in the ED:

Alerting the PCP

Sample Chief Resident Action Projects (Cont’d)

• Incorporating Geriatric Principles into Gynecologic Care: Teaching Modules & Tools and Addressing Goals of Care and Code Status on Gyn Oncology

• Eye Medication Application and Resources• Restoring Your Smile at Any Age: Geriatric Dentistry

Outcomes

Six-month follow-up surveys with chief residents who have participated in CRIT showed that they:• Were more confident in their application of clinical skills related to

the care of older adults• Were more likely to teach geriatrics principles to residents and

medical students• Had an increased recognition of the importance of interdisciplinary

approaches to the care of older adults• Had more confidence to coordinate care across disciplines and

specialties, facilitate small groups, give feedback, connect with reluctant learners, and resolve conflicts in their roles as chief residents.

CHIEF RESIDENT IMMERSION TRAINING (CRIT)Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

Testimonials

Great materials provided that I have already gone back to for reference.

It was a great experience learning from peers and passing on the information to the house-staff. It feels like I achieved something.

The CRIT experience helped me develop a more robust set of leadership skills that I was able to utilize throughout the year. Having the geriatrics training at the CRIT was a fantastic review of geriatric clinical pearls. This was highly valuable.

This was a great experience to have a focused education session on a topic that we deal with frequently in surgery but do not have much formal training in. There was a good mix of leadership education topics as well.CHIEF RESIDENT IMMERSION TRAINING (CRIT)

Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic ProgramsSupported by the Hearst Foundations and Donald W. Reynolds Foundation

Save the Date!Insert your program

date HERE

Donald W. ReynoldsFoundation