Expanding Workforce Capacity to Care for Older Veterans: The VA GRECC Interprofessional Training Experience

Abstract The Veterans Health Administration (VHA) contributes more to training healthcare professionals in geriatrics/gerontology than any other entity nationally, with the Geriatric Research Education and Clinical Center (GRECC) network serving as a leader in geriatric-/gerontology-specific interprofessional education. The Associated Health Training (AHT) Program is supported by all GRECCs, training ~427 trainees annually (FY17). Each AHT program brings together a diverse array of trainees – the specific constellation of disciplines unique to each GRECC based on local capacity/expertise. Common to all programs is intentional interprofessional training, aligned with Interprofessional Education Collaborative (IPEC) competencies. In 2016, the VA Office of Academic Affiliations (OAA) administered a 22-item survey to characterize the depth and breadth of geriatric-/gerontologic-specific interprofessional education across GRECCs. Questions explored how AHT programs addressed each of the four IPEC competency domains. Responses were de-identified; at least 2 coders independently applied directed coding to responses. Across GRECCs (n=18), 323 interprofessional training activities were coded, of which 9% were didactic; 27%, clinical; and, 63%, combination. Interprofessional education activities were integrated with profession-specific curricula (65.3%) or featured as part of GRECC-specific core curricula (5.4%). GRECC AHT interprofessional programs involved an average of 11 disciplines. GRECC AHT programs provide a vital infrastructure for building workforce capacity through robust, interprofessional training that engages diverse disciplines across a variety of care settings representing the continuum of care for older Veterans. GRECC and OAA efforts are critical to enhancing the quality, and expanding the capacity, of this workforce to meet increasing needs for patient-directed, team-based care for older adults.

existing curriculum, were integrated to create a new lesson plan, including a "flipped classroom" component using 2D vector animation, as well as animation-assisted, interactive, case-based lecture and discussion format. Media was designed through an iterative process including review of content outline, objectives, storyboards, and concept art by stakeholders and content experts throughout the design process. This novel approach to interdisciplinary, blended-learning curriculum design has the potential to improve nursing student attitudes and foundational knowledge about dementia and cognition.

TRAINING PROGRAM IN POPULATION NEUROSCIENCE OF ALZHEIMER'S DISEASE AND AGE-RELATED DEMENTIAS Caterina Rosano, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
The recent successes of medical science in extending lifespan, with marginal improvements in healthspan, have increased the number of adults reaching very old ages, but also their burden of age-related comorbidities. For these "new" populations of older adults, cumulative exposure to chronic conditions, biological and chronological aging as well as lifelong environmental factors, interact with each other in ways that are both very complex and not yet well understood. Understanding these complex pathways and their contribution to brain aging is fundamentally important to conduct rigorous etiological research into the causes of ADRD. We are also seeing great technological advances in measuring health factors in general and brain characteristics in particular, the application of which is providing ever more precise phenotypes but also very large and complex datasets. Such "big" data require careful sampling designs and analytical approaches infused with an understanding of the condition being studied to effectively produce new knowledge to move research to treatment and prevention. We propose that the successful clinical neuroepidemiological investigators of the future must be able to link comorbidities, environmental exposures, lifestyles, genomics, e.g. host susceptibility, with knowledge of modern technology of neurosciences and measurement of brain disease and data science. We will describe our experience at the University of Pittsburgh in leading a new training program in Population Neuroscience of ADRD. Our curriculum responds to the changing landscape of career pathways, technological innovations, and demographic shifts in the aging population.
The Veterans Health Administration (VHA) contributes more to training healthcare professionals in geriatrics/gerontology than any other entity nationally, with the Geriatric Research Education and Clinical Center (GRECC) network serving as a leader in geriatric-/gerontology-specific interprofessional education. The Associated Health Training (AHT) Program is supported by all GRECCs, training ~427 trainees annually (FY17). Each AHT program brings together a diverse array of trainees -the specific constellation of disciplines unique to each GRECC based on local capacity/expertise. Common to all programs is intentional interprofessional training, aligned with Interprofessional Education Collaborative (IPEC) competencies. In 2016, the VA Office of Academic Affiliations (OAA) administered a 22-item survey to characterize the depth and breadth of geriatric-/gerontologic-specific interprofessional education across GRECCs. Questions explored how AHT programs addressed each of the four IPEC competency domains. Responses were de-identified; at least 2 coders independently applied directed coding to responses. Across GRECCs (n=18), 323 interprofessional training activities were coded, of which 9% were didactic; 27%, clinical; and, 63%, combination. Interprofessional education activities were integrated with profession-specific curricula (65.3%) or featured as part of GRECC-specific core curricula (5.4%). GRECC AHT interprofessional programs involved an average of 11 disciplines. GRECC AHT programs provide a vital infrastructure for building workforce capacity through robust, interprofessional training that engages diverse disciplines across a variety of care settings representing the continuum of care for older Veterans. GRECC and OAA efforts are critical to enhancing the quality, and expanding the capacity, of this workforce to meet increasing needs for patient-directed, team-based care for older adults.

INTERPROFESSIONAL EDUCATION ACTIVITY TO IMPROVE COMMUNICATION WITH OLDER ADULTS WITH HEARING LOSS Laura Gaeta, and Tara Sharpp, California State University, Sacramento, Sacramento, California, United States
The purpose of this study was to determine how an interprofessional education (IPE) intervention with Communication Sciences and Disorders (CSAD) and Nursing students can affect their ability to communicate effectively with older adults who have hearing loss. As the older adult demographic increases, healthcare professionals must provide competent care, which includes effectively managing hearing-related communication difficulties in an increasingly diverse population. Faculty received IRB approval to conduct a descriptive mixed-methods study to determine knowledge and satisfaction of students completing an IPE activity. Students were divided into teams of CSAD and Nursing students. Students listened to a brief presentation on IPE before they were introduced to a complex case study of an 84-yearold male with age-related hearing loss. We administered a knowledge assessment questionnaire (KAQ) we created regarding communication with older adults before and after the activity. A total of 92 participants in the two programs (n=36 CSAD, n=56 Nursing) completed the KAQ before and after the activity and an evaluation with a Likert-type scale and open-ended questions. CSAD students scored significantly higher than Nursing students on the KAQ at baseline (F=25.69, p<0.001) and KAQ scores increased significantly (F=57.04, p<0.001) among both groups from pretest to posttest. The evaluation data indicated students were able to learn other perspectives and found the experience valuable. Based on the improvement in scores on the KAQ and evaluation data, this IPE activity increased knowledge related to communication with older adults with hearing loss and awareness of the roles of other professions.

INTERPROFESSIONAL EDUCATION: A MODEL FOR ACADEMIC AND COMMUNITY COLLABORATION FOR PROFESSIONAL EDUCATION Elaine Jurkowski, Southern Illinois University at Carbondale, Saint Charles, Missouri, United States
Teamwork and collaboration across disciplines is becoming critically important as we meet the health and human service needs of people growing older and their families. The myriad of competencies, language and tasks specific to each discipline are not easily or intuitively mastered within discipline specific curricula. This presentation aims to provide a model that addresses the curricular needs for course preparation through inter-professional educational strategies. While the traditional IPE components are address, this model also integrates in the training process, education through the lens of the social determinants of health, community collaboration through health and human service networks, population health and public policy. This presentation will lay out the model and articulate specific educational strategies to address each of the dimensions of the model, to include the flip classroom, experiential activities, assessment and intervention tools, panel discussions with community and agency partners and epidemiologic/population health data. This model identifies a unique approach to teaching students and professionals about collaboration across disciplines for the benefits of addressing the needs of an older adult target group. This model also moves the process of teaching interprofessional collaboration and education beyond understanding values and ethics, roles and responsibilities, team care and communication. As Alzheimer's disease increases in prevalence among older adults, there is an increased need for health professionals to effectively communicate with patients and their caregivers. Interactions between providers and Alzheimer's patients differ from a typical patient-physician encounter. The project created a virtual learning environment (VLE) to better prepare students to engage with Alzheimer's patients and their caregivers. The VLE includes a clinical space, clinical office, and a patient's home environment for