Overview
The area of education and research selected for this study is the veterans’ health department, located in a level 1 health facility within the city. This department is engaged in continuous medical education (CME) targeting members of the healthcare profession in response to the rapidly aging veteran population. Specifically, the department has made substantial contributions not only in the advancement of aging research, geriatric education and training, and clinical care within and outside the confines of the health facility, but also in translational research aimed at enhancing the clinical care of future aging populations, and in providing leadership in educating family-based and general practitioners about the unique needs of older persons (Supiano et al., 2012). It is the objective of this paper to interview one member of the leadership team responsible for this department, with the view to benefiting from the perspective of a leader in education and research.
Interview
This interview was conducted with the program coordinator of the veterans’ health department, which oversees the day-to-day running of the department. The coordinator was in charge of all the educational and research activities undertaken by the department, hence had immeasurable knowledge and expertise in issues relating to education and research in healthcare settings. The interviewee was a medical doctor by profession (Ph.D.), but also with postdoctoral qualifications in geriatric medicine and clinical research methods. Additionally, he also provided consultancy services and taught at one of the medical schools affiliated with the health facility.
Main Findings of the Interview
Trends
The interviewee identified three trends that are currently impacting education and research activities in the veterans’ health department. The first trend entailed the surging numbers of elderly people in the American society. Available literature demonstrates that the population of the elderly is growing at an unprecedented level in developed economies such as the United States due to recent medical advancements as well as major improvements in hygiene and food supply (Arai et al., 2012).
The second trend entailed the loss of substantial sums of money to continuing medical education (CME) and research activities. Research activities undertaken by the department toward developing evidence-based practices in the treatment of the elderly, in particular, were using a lot of money that was not sufficiently reimbursed by relevant agencies. This trend has been reinforced in the literature through a report that demonstrates that 14 of the 20 most research-intensive institutions in the United States are experiencing financial stress, and that half of these institutions are losing money while the other half are recording eroded margins as profits continue to be redirected to education and research activities (Academic Medical Centers, 2000).
The third trend reported by the interviewee concerned low enrollment levels of healthcare practitioners interested in taking the available geriatric courses offered by the department, with the aim of improving the health of the elderly. Indeed, the interviewee underscored the fact that most healthcare professionals were unwilling to advance their education and skills in gerontology and geriatrics owing to the fact that their investments in such education were less likely to be reimbursed by relevant authorities. In the literature, it is evident that the desire by practitioners to engage in continuous medical education (CME) is curtailed substantially by the current procedure-weighted reimbursement structure, which in reality penalizes them financially for incorporating gerontology and geriatrics activities into their educational or research-based practices (Thomas et al., 2006).
Challenges
The challenge that arises from the high number of the elderly in need of healthcare services is reflected in terms of the department becoming financially overwhelmed by the high number of elderly people in need of healthcare services, resulting in a situation whereby a substantial amount of the department’s budget is used to take care of these needs rather than engaging in continuous medical education (CME) and research activities. This trend is reinforced in the literature by the finding that most institutions oriented toward the provision of facility-sponsored education and research activities are increasingly unable to meet their requirements due to budgetary deficits (Bragg et al., 2012). According to the interviewee, the department is actively addressing this challenge by looking for donor agencies and sponsors to sponsor its education and research-based activities.
According to the interviewee, the most serious challenges arising from the trend of losing substantial sums of money involve continued loss of sponsorship as well as the danger of imminent closure of the department. It has been reported in the literature that medical schools experiencing loss of money in education and research-related activities in the United States today are increasingly selling their hospitals to either for- or non-profit organizations, with a case in point being the sale of Georgetown University Medical Center and Tulane (Academic Medical Centers, 2000). The department is addressing this challenge by bringing more sponsors and donors on board, as well as streamlining its education and research activities to ensure minimal wastage.
Finally, according to the interviewee, the trend involving low enrollment levels of healthcare professionals brings a challenge in that most of the healthcare professionals available are not competent enough to deal with the medical and psychological needs of the elderly. This challenge, therefore, means that older people are not getting the needed type of care due to lack of skills and experience among care providers, especially in light of the fact that geriatrics education and research remains a low priority for graduate students and other healthcare professionals in spite of the fact that older people are faced with unique health needs (Litvin et al., 2012). To deal with this challenge, the department is using innovative and less-costly strategies to dispatch education, such as active-mode learning, conferences, seminars, as well as print and electronic media.
Similarities & Differences in Trends
The results contained in the above table demonstrate disturbing trends in the context of education and research in healthcare settings. While available literature shows that the most important goal of hospital education is to enhance practice through learning (Hotvedt & Laskowski, 2002) and that a commitment to lifelong learning and research is not only a physician’s duty but also a moral obligation and an integral constituent of professionalism (Fletcher, 2001), it is clear from the emerging trends that it may impossible for healthcare departments and institutions to continue engaging in education and research if adequate corrective measures are not put in place. Medical schools and research-intensive institutions need not be sold as is the case in the United States today (Academic Medical Centers, 2000); on the contrary, these institutions serve as centers of excellence and innovation in healthcare delivery (Thomas et al., 2006). But as a matter of fact, the trends highlighted in this paper need to be sufficiently addressed if these institutions are to continue serving their rightful mandate in education and research.
References
Academic Medical Centers. (2000). Web.
Arai, H., Ouchi, Y., Yokode, M., Ito, H., Vematsu, H., Eto, F…Kita, T. (2012). Toward the realization of a better aged society: Message from gerontology and geriatrics. Geriatrics & Gerontology International, 12(1), 16-22
Bragg, E.J., Warshaw, G.A., Meganathan, K., & Brewer, D.E. (2012). The development of academic geriatric medicine in the United States 2005 to 2010: An essential resource for improving the medical care of older adults. Journal of the American Geriatrics Society, 60(8), 1540-1545.
Fletcher, P. (2001). Continuing medical education in a district hospital: A snapshot. Medical Information, 35(10), 967-972.
Hotvedt, M., & Laskowski, R.J. (2002). Establishing priorities for hospital education. Journal of Continuing Education in the Health Professions, 22(3), 181- 186.
Litvin, C.B., Davis, K.S., Moran, W.P., Iverson, P.J., Zhao, Y & Zopka, J. (2012). The use of clinical decision-support tools to facilitate geriatric education. Journal of the American Geriatrics Society, 60(6), 1145-1149.
Supiano, M.A., Alessi, C., Chernoff, R., Goldberg A., Morley, N.E., Schmader, K.E., & Shay, K. (2012). Department of veterans’ affairs geriatric research, education and clinical centers: Translating aging research into clinical geriatrics. Journal of the American Geriatrics Society, 60(7), 1347-1356.
Thomas, D.C., Johnston, B., Dunn, K., Sullivan, G.M., Brett, B., Matzko, M., & Levine, S.A. (2006). Continuing medical education, continuing professional development, and knowledge translation: Improving care of older patients by practicing physicians. Journal of the American Geriatrics Society, 54(10), 1610-1618.