Abstract
Background: An ageing population globally has created an escalating demand for age-attuned healthcare services. There is however an insufficient number of geriatricians to meet this need. Most older adults will therefore continue to receive their medical care from doctors without specialised geriatric medicine training. It is important therefore that all doctors possess fundamental gerontological competencies. Which specific competencies and how they might best be integrated into medical education remain unclear. Our aim was to summarise the literature on the geriatric medical competencies required by all doctors caring for older adults.
Methods: We undertook a scoping review following Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR). We systematically searched the electronic databases PubMed, Cochrane, Cinahl, PsycInfo, ERIC and Embase for eligible records from January 2012 to December 2022. Studies related to physician or doctor or resident and competencies or curriculum or education and geriatric medicine or gerontology were included.
Results: Ninety-three sources were included in the review. The most common competencies explored within the papers included medication management, cognitive impairment and chronic disease and co-morbidity management. Competencies addressing interpersonal communication and subspecialty areas including stroke, orthogeriatrics movement disorders were underrepresented.
Discussion: Multiple attempts to create and implement competency frameworks on local, national, and international levels in addition to educational interventions to address competency gaps locally reflect the wide-ranging challenges faced by healthcare systems in caring for an ageing population. Significant variation in competencies exists amongst the sources included in this scoping review. This vast array of competencies also highlights both the complex and individualised nature of the older adult population faced by all hospital doctors.
Conclusion: Given the significant variability in the competencies described, an overarching competency framework is necessary to define the required competencies for all hospital doctors caring for older adults.