Lynn McCleary, Associate Professor, Department of Nursing, Brock University; Peter Donahue, Associate Professor, School of Social Work, Renison University College, University of Waterloo; Tricia Woo, Associate Professor, Faculty of Health Sciences, McMaster University; Veronique Boscart, Post-doctoral Fellow, Toronto Rehabilitation Institute; Katherine McGilton, Senior Scientist, Toronto Rehabilitation Institute & Associate Professor, University of Toronto

Despite evidence that care of older persons is the core business of health care, in Canada, as elsewhere, there is limited capacity for gerontology education in nursing, medicine, and social work, with limited clinical learning opportunities, a dearth of gerontology courses, and a lack of interest in gerontology by students nearing graduation (Baumbusch & Andrusyszyn, 2002; Diachun, Hillier, & Stolee, 2006; Mellor & Solomon, 1995). Contributing to this problem is a lack of faculty with advanced gerontology or geriatrics training and education, meaning that gerontology content is taught by non-experts who need support to include the best evidence in their teaching.

We addressed this problem at the Canadian Knowledge Exchange Institute for Geriatric Nursing, Medical & Social Work Education, held May 4-6 2011 at Brock University in St. Catharines, Ontario, Canada. The Knowledge Exchange Institute was an initiative of the National Initiative for Care of the Elderly (NICE). NICE is an international network of researchers, practitioners, students and older adults dedicated to improving the care of older adults, both in Canada and abroad through knowledge translation. One of NICE’s goals is to improve gerontological education curricula for health professionals and social workers.

The goal of the Knowledge Exchange Institute was to equip Canadian faculty and senior trainees to incorporate evidence based gerontology knowledge into education of nursing, medical, and social work students. The Knowledge Exchange Institute was based on a successful Institute we held for nursing faculty and trainees in 2009 (McCleary, McGilton, Boscart, & Oudshoorn, 2009) and the U.S. Geriatric Nursing Education Consortium project (American Association of Colleges of Nursing, 2009). There was a dual focus on equipping participants to both enhance their courses and influence their colleagues to enhance curriculum.

We used the Knowledge in Action Process Model (Graham et al., 2006), the knowledge translation model used by the Canadian Institutes of Health Research (CIHR www.cihr-irsc.gc.ca/e/39033.html). According to this model, the knowledge creation process results in synthesized research findings such as systematic reviews and practice guidelines and other knowledge products, such as pocket guides produced by NICE (for examples, see www.nicenet.ca ). We told participants we would provide them with “so many resources and knowledge products you won’t believe it”, and we did. We gave them USB keys filled with research summaries, lecture notes, PowerPoint slides, case studies, and more. We also provided paper copies of examples of key knowledge products, demonstrated use of some of the knowledge products, and showed them websites and portals to teaching tools. A publicly accessible wiki created for the first Institute has links to most of these resources (https://kumu.brocku.ca/geriatricnursingeducation). We think many of them would be relevant for our U.K. colleagues and encourage readers to view it.

In the Knowledge in Action Process Model, knowledge is applied to practice in an action cycle. We took participants through the steps of the action cycle.

1. Select Knowledge and Match to Problem. Participants identified opportunities to enhance courses and curriculum. They completed a course mapping and curriculum mapping exercise before they attended, comparing one course they taught and their program curriculum to core gerontological competencies. This prepared participants to select personally relevant knowledge products.
2. Adapt Knowledge to Local Context. Participants worked on a plan to select and adapt relevant knowledge products for their course. They also identified knowledge products that could be used to enhance gerontological content of courses taught by other members of their departments and schools.
3. Assess Barriers and Facilitators to Knowledge Use. Interactive sessions focussed on assessing and planning strategies for five key stakeholders for curriculum enhancement (clinical and practice faculty; clinical and practice settings; students; faculty; and Deans or Directors).
4. Select, Tailor, and Implement Interventions to Incorporate the Knowledge in Practice. Participants left with preliminary plans for enhancing their courses and influencing their colleagues. They set three specific goals for next steps towards enhancing gerontological content in their programs.
5. The last steps in the action cycle are: monitoring knowledge use; evaluating outcomes; and sustaining knowledge use. Participants will be contacted in six months with encouragement to continue with their plans. They will be contacted in one year for an evaluation of the extent to which they used the knowledge products.

There were 39 participants, 11 participants from social work, 25 from nursing, 1 from medicine, and 2 who were in interprofessional programs. Twenty-seven of the participants were faculty members; 3 were also PhD students. An additional 12 participants were graduate students (n=10 PhD students and 2 master’s students). Participants came from 25 universities across Canada. With funding from the NICE and CIHR, we were able to offer the Institute at no cost to the participants, providing travel expenses, accommodation at Brock University, meals, and all materials.

Feedback from participants was positive with most indicating that their personal goals had been met and that they planned to use the resources they received. Examples of their comments include:

Thank you for providing a stress free conference with so many useful tools and resources. You are enabling all of us to be key leaders in our education facilities and our communities. You have supported and encouraged us to be change agents.

This information will be passed on to other colleagues in the academy and in practice. I believe it will have a great influence on gerontology in my province.

This has been an inspirational experience that will lead to concrete positive outcomes. I am certain that what has been shown and learned will be used immediately to improve gerontological education. I can’t thank you enough for this opportunity to connect with faculty from across the country.

Many of the participants indicated that one of their goals was to network and connect with other faculty with an interest in gerontological education. There was plenty of opportunity for networking, including an evening excursion to Niagara Falls. Most participants indicated that they planned to stay in contact with other participants.

Between this Institute and our 2009 Institute for nursing educators, we have trained 70 educators and senior trainees to enhance gerontological content in the education of health and social work professionals. We hope to be able to extend the reach of the training as our participants connect with their colleagues and through additional Knowledge Exchange Institutes. The Institute was an efficient, low cost way to disseminate knowledge products to educators who need them, provide the educators with the tools they need to incorporate the knowledge products in their teaching, and provide them with tools to influence their colleagues. The energy and enthusiasm of the Institute participants was awesome. We are hopeful that they will achieve their goals and the coming years will see more improvements in our students’ preparation to meet the needs of older Canadians.

References:

American Association of Colleges of Nursing (2009) Geriatric Nursing Education Consortium GNEC. http://www.aacn.nche.edu/gnec.htm.

Baumbusch, J. L., & Andrusyszyn, M. A. (2002) Gerontological Content in Canadian Baccalaureate Nursing Programs: Cause for Concern?” Canadian Journal of Nursing Research 34(1), 119–129.

Diachun, L. L., Hillier, L. M., & Stollee, P. (2006) Interest in geriatric medicine in Canada: How can we secure the next generation of geriatricians? Journal of the American Geriatrics Society, 54, 512-519.

Graham, I. D., Logan, J., Harrison, M. B., Strauss, S. E., Tetroe, J., Caswell, W., & Robinson, N. (2006) Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26, 13-24.

McCleary, L., McGilton, K., Boscart, V., Oudshoorn, A. (2009) Improving gerontology content in baccalaureate nursing education through knowledge transfer to nurse educators. Nursing Leadership, 22(3), 33-46.

Mellor, M. J., & Solomon, R. (1995) Geriatric Social Work Education. Binghamton, NY: The Haworth Press.