347 Competency frameworks for non-geriatric medicine physicians caring for older adults: a scoping review

Abstract Background The scale of our ageing demographic is such that specialist geriatric medicine services are unable to keep pace with the growing demand. An exclusive reliance on geriatricians to treat older adults is not always appropriate as their care may necessitate the involvement of other specialties. Consequently, many of the interactions with frail older adults will be carried out by professionals who have not received specialised training in gerontological principles. There is an urgent requirement to ensure that all physicians are trained in the competencies to care for older adults. We aimed to summarise the available literature on the competencies required by non-geriatric medicine physicians 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) as a guide. 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 or entrustable professional activities and geriatric medicine or gerontology were included. Results We identified 5,177 records. Four hundred and forty-six full texts were screened for eligibility. Thirty sources of evidence were included in the review. Most studies were from the United States and used quantitative methods. Competency frameworks primarily focused on internal medicine trainees with few targeting other specialties. Seventeen cited the purpose as addressing a specific competency. The most common competencies explored related to medication management, palliative care and cognitive impairment followed by bone health, transitions of care and falls and syncope. Conclusion Many frameworks attempt to outline gerontological competencies for specific specialties. However it is evident that a dedicated competency framework is necessary to define the required competencies for all non-geriatric medicine physicians caring for older adults.