Download Slide 1

Innovations in Surgical Education: A Geriatric Surgical Fellowship
Hugh Willcox, MD; Richard Bell, MD, FACS; James Nottingham, MD, FACS; G. Paul Eleazer, MD
University of South Carolina Department of Surgery
Defining the Problem:
The Solution: The Academic Geriatric Surgeon
The United States is Aging
Educational Modules to Develop an Academician
They will need operative interventions
An improvement is needed
Educational Modules to Develop a Geriatric Surgeon
1. Statistics Primer
1. Preoperative Evaluation of the Elderly
- Basic Statistics
- Functional status
- Application of appropriate methods
- Comorbidity Evaluation
- Critical Analysis of published data
- Specific organ assessment
2. Epidemiology Basics
2. Acute Pain Control for the Elderly
- Factors influencing the health of the elderly
- Pathophysiology of pain
- Descriptive and analytic techniques applied
- Options for pain control
to the study of the geriatric population
- Evaluation of side effects
requiring surgical services
3. Polypharmacy
3. Clinical Trial Designs
- Assessment of medications
- Fundamentals of designing trials
- Methods to minimize medications
- Navigating the IRB
- Understanding the Beers Criteria
- Human research subjects training
4. Nutrition in the Elderly
4. Grant writing
- Risks for malnutrition in the elderly
- NIH
- Physiologic changes in body composition
- How to find grants
- Assessment of nutritional status
- Writing and budgeting grants
- Potential interventions
5. Evidence Based Medicine
5. Basic Science of Aging
- Techniques
- Theories of Aging
- Methodology
- Assessments of true age – chronology vs
- Applications
physiology
6. Economics, Accounting and Budgeting
- Specific organ changes with aging
- Economics of health care in the aged
6. Delirium in the Elderly Surgical Patient
- Maximizing beneficial spending
- Risk factors
- Principles of accounting for
- Evaluation of cognitive awareness
department/division leaders
- Interventions
7. Legislation and Ethics
7. Beyond the Hospital
- Understanding relevant South Carolina
- Advanced discharge planning
legislation and how it applies to the
- Home visitation
elderly
8. Trauma in the Elderly
- Evaluating ethical issues of the elderly
- Demographics
8. Palliative Care Training
- Prevention
- Hospice options
- Interventions
- Operative palliative techniques
9. Anesthesia in the Elderly
- End of life issues – communication,
- Normothermia
symptom management
- Fluid and blood management
9. Evaluation and Education Techniques
- Anesthetic options
- Theories of adult education
10. Surgical considerations in the elderly
- Strategies to evaluate students, residents
- Common surgical diseases of the aged
References:
- Application of these principles
- Exploring intraoperative techniques
1. Polanczyck CA; Marcantonio E; Goldman Let al; Impact of Age on Perioperative Complications and Length of Stay in
10. Curriculum Development
Patients Undergoing Noncardiac Surgery; Annals of Internal Medicine; 2001; 134: 637-643
- Defining the problem
2. Data from CDC Advance Data No. 329, June 19, 2002
- Developing a solution
3. Cox SS, Pofahl WE, Pories WJ; Surgical Residency Curriculum, 4th edition, 2003
- Evaluation of success
4. Rosenthal RA; Zenilman ME; Katlic MR; Principles and Practice of Geriatric Surgery (1st edition); Springer Verlag:
New York, 2001