Summary

The Hartford Institute for Geriatric Nursing (HIGN) at NYU Meyers College of Nursing, the Montefiore Medical Center, the Bronx-based delivery system of Montefiore Health System and Jewish Association Serving the Aging (JASA) have partnered to develop an asynchronous, immersive learning experience on geriatric care for nurses, social workers, and physicians. 

For the development of the experience, the group is leveraging Wonda, an advanced training platform designed to create interactive, AI-powered simulations and assessments. 

This work was part of a larger $5 million grant awarded to the group and Montefiore Medical Center, the Bronx-based delivery system of Montefiore Health System, by the Geriatrics Workforce Enhancement Program at the Health Resources and Services Administration (HRSA).

‍

‍

Objective

The purpose of this initiative is to improve the care delivered to the older adult population in the Bronx by expanding the capacity of the primary care and the community-based workforce to provide age-friendly and dementia-friendly care and mitigate the impact of social determinants of health.

For the immersive learning component specifically, the intention was to give learners an opportunity to better understand the complexity of elderly care through immersive practice:

• Familiarizing themselves with age-friendly care and the 4Ms framework in a real-life scenario 
• Identifying what matters to the patient rather than imposing their own goals and/or intentions. 
• Communicating with older adults using best practices that are age-friendly and reflects respect and dignity. 
• Considering how social determinants of health or external factors impact a person’s engagement with healthcare systems and the self-management of their healthcare needs. 

Solution

The team is designing a four-step program that guides learners through a full authentic case, including: 

1. Introduction where they receive a refresher on the 4Ms framework;
2. Bronx Virtual Tour to immerse learners in the community and encourage them to consider environmental factors that may impact the daily lives of older adults;
3. Home Visit at including Patient Conversation that requires learners to deploy the 4Ms framework in order to collect information and clues from the patient conversation and her environment; and receive a feedback report.
4. Debrief and Reflection in which the learner tailors the patient’s care plan and provides evidence for the decisions and reflects on their choices and performance.

‍

‍

Throughout the program, learners interact with two AI Characters: (1) Lili, a guide and coach who introduces the program and then helps the learner debrief and reflect after the tour and home visit; and (2) the patient Ms. Jane Thomas, an 80-year-old Jamaican woman who has lived in the Bronx for the past few decades. Several methods of interaction are embedded to allow for different learning styles and needs.

‍

‍

Outcome

With this learning experience, NYU Meyers and HIGN seek to educate over 5,000 physicians, medical residents and fellows, nurses, social workers, pharmacists, community health workers, home health aides, medical, nursing, and social work students and provide training in the Bronx in primary care sites, nursing homes, home care agencies and community-based organizations.

‍