Train and support a workforce skilled in care of older people
Respondents articulated the need for both a formal gerontology
curriculum and opportunities for interacting with older people from
early undergraduate years. Limited undergraduate training in care of
older people was recognised across all professions, attributed to low
priority by teaching institutions. Gerontology content was generally
delivered as elective rather than core curriculum, clinical placements
were limited, and there were minimal opportunities for post-graduate
study in gerontology.
“Part of the challenge in preparing a workforce is that you need to
develop [teamwork] skills just as much as the development of the
technical and know-how skills that fascinate accrediting authorities but
actually don’t really serve people well in terms of being work-ready.”
P18, AHP, academic
Consequently, most training was occurring in the workplace. The
importance of experiential learning was well articulated, but exposure
to training was generally ad hoc, depending on early placements on
geriatric wards or exposure to passionate champions. There was a
recognised lack of skilled teachers and mentors with dedicated time to
provide training and support, and reliance on individually-sought
external conferences and courses.
“If you don’t go through a geriatric unit or work with a geriatrician
who is maybe working as a general physician, other than that, I don’t
think they will get formal geriatric training.” P5, geriatrician,
clinician
“It’s just where you end up working. You’re provided with on-the-job
training… There’s lots of external courses and conferences but
there’s nothing specific here.” P6, nurse, manager
There were challenges in delivering hospital-based education including
multi-level learning needs, competing mandatory training, limited
education time, high staff numbers and turnover, and the limited value
of traditional ‘in-service’ approaches for complex education and skills
training. External agencies provided some educational opportunities, but
there was a need for continuing support and ‘hands-on’ training,
particularly in caring for people with cognitive impairment.
“If the skill mix is poor and you haven’t got those other people with
experience, then how do you actually get that?” P13, nurse, clinician
“It’s educating staff… coaching them and mentoring them is the
difference. It’s constant follow-up. All this in-service and interest
groups and stuff like that, it’s great. It’s not enough. It’s not enough
to create change and keep motivating people.” P16, nurse, clinician