Innovations in Geriatric Education:
Considering Cross-Disciplinary Applications of the HPPAE Model
Geriatric Competencies Provide Curricula for and
Evaluation of Geriatric Education
JoAnn Damron-Rodriguez, LCSW, PhD
University of California, Los Angeles
Mandate for Competence
 Council on Higher Education Accreditation (CHEA),
oversees standards for 76 professions adopted a
competency model for accreditation
(National Center for Higher Education Management Systems, 2000)
 Growing necessity for Evidence-based Practice
(EBP), Best Practices, Practice Guidelines
 Competence Based Education and Evaluation
(CBE) is the educational equivalent of EBP
Competency-Based Education and Evaluation
(CBE)
Definition of Competence
Competence: The state of being adequately or well qualified… a specific
range of knowledge, values and skills
Geriatric Competence: Continuing programs in order to effectively
prepare practitioners to address the need of older adults and their
families
Essential Elements CBE
1)
Adoption of a defined set of specific skills (competencies) as a
framework for education in a field of practice
2)
Applying the competencies to individual student learning goals
2)
Assessment of student skill level, at the beginning of
training and upon completion, using the identified set of competencies
(Bogo et al, 2004)
National Incorporation of Gero Social
Work Competencies
I. Council on Social Work Education (CSWE) 2008
Educational Policy and Accreditation Standards
(EPAS)

a competency-based outcome approach to
curriculum design

a focus on student outcomes based in
practice behaviors

competencies are measurable practice
behaviors
II. Hartford Geriatric Social Work Initiative
Task Force for Advanced Gero Practice (2009)
Relating Gero Social Work Knowledge and Practice
Behaviors to EPAS
EXAMPLE CBE APPLICATION
EPAS Competence: Apply critical thinking to inform
and communicate professional judgments
ACTIVITIES, ASSIGNMENTS, READINGS
ADVANCED GERO
PRACTICE
BEHAVIORS
Relate concepts and
theories of aging to
social work practice
(e.g., cohorts, normal
aging, and life course
perspective).
CLASS EXERCISES
Multigenerational
Issues in Caregiving
ASSIGNMENTS/
MEASUREMENT*
Perspectives on
Older Adults and
the Aging Family
Safety
Checklist/Home
visit interview
(page 7 of
syllabus)
Relating Gero Social Work Knowledge
and Practice Behaviors to EPAS
EVIDENCE BASED PRACTICE
Toseland, R. W.; Blanchard, C. G.;
Mccallon, P. (1995). A ProblemSolving Intervention for Caregivers of
Cancer-Patients. Social Science &
Medicine, 40:4, 517.
Cross Disciplinary Geriatric
Competencies
Nursing
American Association of Colleges of Nursing and the Institute for Geriatric Nursing
Older Adults: Recommended Baccalaureate Competencies and Curricular
Guidelines
Geropsychiatric Nursing Competencies
Adult/Gero Primary Care Nurse Practitioner Competencies
Adult/Gero Nurse Practitioner Competencies
http://www.aacn.nche.edu/Education/adultgerocomp.htm
Medicine
American Geriatric Society
Geriatric Competencies for Medical Students
Internal Medicine/Family Practice Residency Training
Surgical and Related Medical Specialties
http://www.americangeriatrics.ogr/health_care_professionals/education/curric
ulum_guidelines
COMPETENCY EDUCATION FRAMEWORK
Dimension
Application
Level
Generalist vs. Specialist
Foundation vs. Advanced
Discipline
Specific
Cross Disciplinary
Interdisciplinary
Domain
Content
Topic
Context
Process
Medicine, Nursing, Social Work
Multi-disciplines same skill set
Skills for disciplines in relation to other
disciplines
Geriatrics/Gerontology
i.e. Depression, Falls
SNF, HCBS
Specifically identified for a program
vs. broadly consensus based
Forms of Cross-Disciplinary Education for Practice
and HPPAE Implications
Multidisciplinary
Interdisciplinary
Transdiciplinary
Common goals
Individual efforts
Discipline expertise
Responsibility for group
effort
Requires skills in effective
group integration
Each member
supports/enhances
programs and activities
Examples of Cross-Disciplinary Competencies
SUPPORTING FAMILY CAREGIVERS
American Journal of Nursing
Gold Award for Special Supplement
Nursing
Assessment
Assess family knowledge of
skills necessary to deliver
care to older adults
Social Work
Assess caregivers’ needs and
level of stress
Family Education
Involve, educate, and,
when appropriate,
supervise family, friends,
and assistive personnel in
implementing best practices
for older adults.
Use educational strategies
to provide older persons
and their families
with information for
wellness and disease
management.
Damron-Rodriguez, J.A. (2008). Developing competence for nurses and social workers:
evidence-based approaches to education. American Journal of Nursing, Vol. 108, No. 9,
40-46.
Rationale and Need
for Multidisciplinary
Competency-based
Professional Education
 Focus on skills needed in real-world practice
 Assess trainees’ skills to:
 Enhance learning
 Inform curriculum development
 Evaluate training effectiveness
 IOM recommendation: “All licensure,
certification, and maintenance of certification
for healthcare professionals should include
demonstration of competence in the care of
older adults…”
Partnership for Health in Aging
www.americangeriatrics.org/pha
Consensus Based
Geriatric Competencies
A PHA Workgroup organized by the American Geriatric Society
built from the geriatric competencies from social work, medicine
and nursing
 Over 25 healthcare professional organizations endorsed the
competencies
The following 10 disciplines were represented:
Six Multidisciplinary Domains
& 23 Foundational Competencies
1. Health Promotion and Safety
2. Evaluation and Assessment
3. Care Planning and Coordination Across
the Care Spectrum (including End-of-Life
Care)
4. Interdisciplinary and Team Care
5. Caregiver Support
6. Healthcare Systems and Benefits
Partnership for Health in Aging
www.americangeriatrics.org/pha
Adopting
National consensus-based identification of competencies
Prioritization of core skill set
Infusion generalist practice and enrichment specialist
practice
Applying to Curricula and Pedagogy
-
To define learning objectives based on outcomes
To structure student contracts identifying competencies
Develop modules and teaching resources
To train field instructors
Assessing Outcomes
-
Classroom assignments
Field Practice including instrumentation
Substantive Cross Site Evaluation of
HPPAE
 Total 67 Graduate Schools of Social Work Participated
 Baseline data included year in program, specialization, prior
aging courses, prior work experience with older adults,
practicum placement and demographic information
 Students took on-line survey at PRE, INTERIM, & POST
HPPAE to assess:
 Knowledge (Knowledge of Aging for Social Work Quiz)
 Knowledge of Community-based Services for Older Adults
 GSW Competency Scale II
 Field Instructors also assessed their students’ competency
PRE (Student INTERIM) & POST HPPAE
Geriatric Social Work Competency
Scale II

Domains of geriatric social work with 10 skills in each






I. Values, ethics and theoretical perspectives
II. Assessment
III. Intervention
IV. Aging services, programs and policies
V. Leadership in the Field of Aging
Rating on 5-point Likert scale
0 ----------------- 1 ------------------ 2 ------------------ 3 ---------------- 4
Not skilled at all - Beginning skill - Moderate skill - Advanced skill - Expert skill

“Cannot Assess” for Field Instructors
Social Work Leadership Institute
www.socialworkleadership.org
Student Self-Assessment
of Geriatric Competencies
Field Instructor Rating of
Student Competence
50
50
45
45
40
40
35
35
30
30
25
25
20
20
Pre-test
Post-test
15
15
10
10
5
5
0
0
Values
p<.001***
Assessment
p<.001***
Intervention
p<.05*
Aging services
p<.05*
Values
p<.001***
Assessment
p<.001***
Intervention
p<.001***
Aging services
p<.001***
An Example of a Systems Level Use of the
Hartford Social Work and Nursing Competencies
Improving Education on Aging in California
USDE Fund for the Improvement of Postsecondary Education (FIPSE)
 UCLA lead community college, California State University, and
University of California collaboration
 SAGE partners in nursing, social work and gerontology programs
assessed competencies
 Rated disciplinary program based on competencies
 How well it was addressed
 What classes supported/taught on the competency
 How students were assessed
GeroNet www.geronet.ucla.edu
UCLA
SAGE Gerontology Competency
Mapping Strategy
Competency
Rating
Supported by Courses:
CRITICAL
Student evaluation methods
utilized
THINKING
5. Appreciate the
contributions that aging
persons make to each
other, families and
society.
2
SOC 440 (Soc of Aging)
PSY 365 (Intro to Gero)
FCS 543
(Intergenerational
Caregiving)
Papers, exams, service
learning activities,
presentations, projects
6. Identify and define/describe
bio/psycho/social
concepts and theories
used to study aging.
2
SOC 440 (Soc of Aging)
PSY 365 (Intro to Gero)
HSCI 418OL (Health and
Aging)
Papers, exams, service
learning activities,
presentations,
discussions
0 = Not skilled at all (no experience with this skill)
1 = Beginning skill (have to consciously work at this skill)
2 = GeroNet
Moderate skillwww.geronet.ucla.edu
(skill is becoming more integrated into practice)
UCLA
3 = Advanced skill (skill is done with confidence and is an integral part of practice)
4 = Expert skill (completes skill with sufficient mastery to teach others)
Competencies
to Learner Outcomes
Professional Competency

Educational Program: Integration
of Classroom and Field

CBE Learning Objectives

Learning Activities to Support Objectives

Assessing Competency-based Learner Outcomes
IOM Recommendation:
Geriatric Interdisciplinary Practice
Medical
Cognitive
Affective
Social Support
Environment
Functional
Status
Economic
Spirituality
GRECC Demographics and Profiles
GERIATRIC RESEARCH EDUCATION CLINICAL CENTERS (GRECC) AND CARE
MANAGEMENT & SOCIAL WORK SERVICES PARTNER TO CREATE VA HPPAE MODEL
VA IS AN EXAMPLE OF EBP IN
HEALTHCARE BUILT ON
INTERDISCIPLINARY TEAMS
22
Interacting Elements of HPPAE Model
Potential Building Blocks
for Cross Disciplinary Education
1.University-Community Partnerships
2. Competency-Driven Field Education
3. Integrated Field Education Across Multiple Programs,
Populations and Interventions
4. Expanded Field Instructor Role
5. Focused Recruitment for Geriatric Social Work
6. Leadership Development in Geriatrics
Social Work Leadership Institute
 www.socialworkleadership.org