Building Ontario's Workforce Capacity for Integrated Geriatric Services: Findings from a Provincial Training Needs Assessment

Background: The growth of Ontario’s aging population continues to outpace the current workforce’s ability to meet their increasingly complex health and social needs. Health systems face critical shortages of trained clinicians with the requisite specialized geriatric expertise, which is compounded by both inconsistent gerontological and geriatric education across health disciplines, and limited access to suitable continuing professional development (CPD).

 

In collaboration with the Regional Geriatric Programs of Ontario and Provincial Geriatrics Leadership Ontario, a province-wide Training Needs Assessment (TNA) was completed to guide workforce planning and quality improvement, including understanding current clinical competencies, and identification of learning and skills development needs and priorities among clinicians and providers who care for older adults.

 

Approach:Two provincial online surveys were conducted between November 2021 and April 2022, targeting: (1) Clinicians/health care providers working in Specialized Geriatric Services (SGS); and (2) Non-SGS healthcare providers who regularly care for older adults in other settings.

The surveys collected data on: demographics and practice characteristics; perceived competence against the provincial Interprofessional Comprehensive Geriatric Assessment (iCGA) Competency Framework; barriers and facilitators to shared decision-making and goal-setting; and colleagues’ geriatric competence.

 

Quantitative data were analyzed descriptively in SPSS, and qualitative data was thematically analyzed using inductive content analysis. The study was reviewed by the Ontario Tech University Research Ethics Board (File #16336).

 

Results:A total of 203 clinicians met inclusion criteria (SGS n=107; non-SGS n=96). Respondents represented every health region and sector of Ontario, and a broad range of professions including nursing, medicine, occupational therapy, social work, pharmacy, and physiotherapy.

Across all domains, SGS clinicians scored higher on the iCGA competencies (MEAN 3.9/5) than non-SGS providers (MEAN 3.6/5). Highest-rated competencies included compassionate, person-centred care and interprofessional collaboration; lowest-rated areas related to ethical decision-making, risk assessment for elder abuse, and mediating family conflict.

Common knowledge gaps spanned delirium recognition, geriatric pharmacology, and mental-health and addictions care for older adults. Skill gaps were noted in communication (particularly with language barriers), supportive and shared decision-making, and management of behavioural and psychological symptoms of dementia.

 

Both groups expressed a strong desire for experiential learning—such as mentorships or fellowships with experienced clinicians—to build skills. Non-SGS clinicians prioritized system navigation, consent and capacity law, and documentation standards; SGS clinicians emphasized opportunities for interprofessional teamwork, research collaboration, and leadership skill-building.

Overall, participants reported high motivation for professional growth (mean 3.8/5 for CPD engagement) but found limited opportunities to access geriatric-specific training. Respondents endorsed expanding cross-sector learning networks to strengthen shared competencies in person-centred, interprofessional, and team-based care.

 

Implications: Findings: underscore a pressing need for coordinated, provincial strategies to build geriatric care capacity across all sectors. Embedding the iCGA Competency Framework and resources into ongoing CPD can create a common language for integrated. Workforce investments should prioritize mentorship, cross-training, and collaborative learning models that bridge SGS and non-SGS settings, to foster a skilled, confident workforce capable of delivering equitable care across the system.

This assessment offers a replicable model for other jurisdictions/systems seeking to align competency frameworks with integrated-care workforce planning and continuous professional development.