After several COVID-related delays, Houston medical institutions piloted an Interprofessional Elder Abuse and Mistreatment Simulation in mid-June, bringing together more than 190 students from five different professions to learn best practices for a vulnerable community.

The Southeast Texas Geriatrics Workforce Enhancement Program (SETxGWEP) at Baylor College of Medicine, in collaboration with the University of Texas Cizik School of Nursing at UTHealth Houston, piloted an Interprofessional Elder Abuse and Mistreatment Simulation. The activity brought together SETxGWEP partners from throughout Houston, including the University of Houston College of Pharmacy, UH College of Medicine, UH-Downtown College of Public Service and the Michael E. DeBakey VA Medical Center Physician Assistant Geriatrics Residency.

The simulation was a hybrid activity where learners and faculty facilitators participated in-person at the UTHealth Cizik School of Nursing simulation laboratory and virtually used a real-time platform. For most students, this was the first time they participated in an interprofessional simulation activity.

SETxGWEP at Baylor, in collaboration with the University of Texas Cizik School of Nursing at UTHealth Houston, piloted an Interprofessional Elder Abuse and Mistreatment Simulation.

The simulation case centered around an older adult living independently in the community who had been found unconscious at home by a neighbor and who had been admitted to the hospital.  The patient had multiple chronic medical conditions, displayed signs of cognitive impairment, and information in the patient’s chart indicated ongoing neglect.

A standardized patient was trained to play the role of the vulnerable older adult, including preparation for responses to any questions asked by the interprofessional student team. The learning objectives of the simulation included identifying the risk factors that lead to elder abuse and self-neglect; learning how to assess for elder abuse and mistreatment; and identifying the roles and responsibilities of members of the interprofessional team when responding to cases of elder self-neglect.

Each team also practiced working as a cohesive unit by using active listening to encourage the ideas of each team member.

“The recent simulation experience for interprofessional learners was well-planned and executed, especially given the complexity of coordinating a relatively large number of sim-lab students, role-playing clinical faculty and standardized patients. Also, it was a hybrid experience, giving those who could not be physically present the opportunity to be remote learners moderated by SETxGWEP faculty. I might add, that as a remote faculty observer, I learned much from this excellent learning opportunity,” said Dr. Robert Roush, professor of medicine – geriatrics at Baylor.

Overall, the feedback received from the participants was overwhelmingly positive. Multiple trainees noted that they were amazed and gratified to witness the helpful contributions of other disciplines in an interprofessional setting and commented on the importance of considering other specialties in patient care.

“After multiple COVID-related delays, the SETxGWEP at Baylor was thrilled to bring together interprofessional trainees from across the city to participate in this important simulation event. Learners had the opportunity to not only engage with a case on elder neglect but to work together as an interprofessional team, learning about communication and collaboration. We look forward to hosting similar events moving forward,” said Dr. Angela Catic, director of the SETxGWEP and assistant professor in the Huffington Center on Aging at Baylor.

Dr. Mary Ellen Ross, geriatric nurse educator at UT Health Houston, and Dr. Sabina Pickens, associate professor of nursing at Texas Woman’s University, developed the simulation and led the activity. Faculty from the participating programs served as facilitators for the simulation:

• Robert Roush, professor of medicine – geriatrics at Baylor
• Catherine Hadfield, director of interprofessional learning at University of Houston
• Brian Reed, chair of the Department of Clinical Sciences at UH College of Medicine
• Angela Goins, lecturer of social work in the Social Work Program at UH-Downtown College of Public Service.
• Vaunette Fay, professor of nursing at UT Health Houston Cizik School of Nursing
• Julianna Fernandez, clinical associate professor and vice chair of pharmacy practice and translational research at UH
• Nancy Ordonez, assistant dean of experiential programs at UH
• Jason Burnett, associate professor of geriatric and palliative medicine at UT Health McGovern Medical School
• Joel Blumberg, associate professor in the Department of Clinical Sciences at UH College of Medicine

By Dr. Angela Catic, assistant professor in the Huffington Center On Aging and fellowship director in geriatric medicine