1. Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation
Donald W. Reynolds
Foundation

2. Increasing Need for Geriatrics Expertise
Source: census.gov
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

3. Proportion of Work Within Surgical Specialty by Age Group,%
< 65 yrs
> 65 yrs
Orthopedics 49 51
General Surgery 40 60
Urology 35 65
Cardiothoracic 30 70
Ophthalmology 12 88
In fact, in several surgical specialties, the majority of their patient population is at least 65 years of age, as demonstrated by this slide.
Source: National Hospital Discharge Survey, National Survey of Ambulatory Surgery, 1996
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

4. What is CRIT?
Weekend session to enhance chief residents’ knowledge in the care of older patients.
“Training the trainer”
Case-based discussions
Interactive approach with many small group “breakout” sessions
Informal and relaxed atmosphere of learning.
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

5. Chief Resident Skills
Very high proportion of their patients are older adults
Approach to special problems of older patients
Each chief resident will choose an area of geriatric focus for his/her chief residency year.
Chief resident mentored by geriatrics faculty members throughout the year.
Focus on enhancing skills of chief resident as leader and mentor to junior residents.
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

6. CRIT Background
Focus on inter-specialty coordination of care for older patients.
Since its inception at BUMC in 2003, the CRIT program has been disseminated over 30 times at 16 institutions nationwide.
Funded by the Hearst Foundations and Donald W. Reynolds Foundation; no participant expenses for chief residents, program directors, and families.
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

7. CRIT History
2003: BUMC develops CRIT with support from the Reynolds Foundation
2005: First BUMC CRIT Program held
2007: BUMC/ADGAP receives Hartford grant for CRIT national demonstration
2008: BUMC partners with two Reynolds-funded institutions to replicate CRIT
2010: Univ. of Arizona Center on Aging puts on institutionally funded version of CRIT
2011: Four institutions continue CRIT in the most recent round of Reynolds geriatrics training grants
2011: BUMC/ADGAP receives Hearst and Reynolds funding for continued national dissemination
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

8. National CRIT Dissemination
Since 2005, 16 institutions have implemented CRIT programs a total of 30 times
Baystate Medical Center
Cooper University Hospital
Marshall University/Joan C. Edwards School of Medicine
Medical College of Wisconsin
Northeast Ohio Medical University
Stony Brook School of Medicine
University of Arizona
University of Cincinnati
University of Colorado
University of Kansas 
University of Nebraska 
University of Rochester
University of South
Carolina/Palmetto Health
Wake Forest University School of Medicine
Warren Alpert School of Medicine of Brown University
Yale University
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

9. CRIT Schedule Insert Your Program Schedule HERE
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

10. CRIT Schedule (cont’d)
Insert Your Program Schedule HERE
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

11. Sample Chief Resident Action Projects
Algorithm for Management of Epistaxis in the Older Patient and Implementation of Geriatric Topics in Otolaryngology Grand Rounds
Implementing Focused Geriatrics Teaching for Family Medicine Residents
Physical Activity Plan for Older Adults (PM&R)
Functional Assessment of the Older Adult in the ED: Alerting the PCP

12. Sample Chief Resident Action Projects (Cont’d)
Incorporating Geriatric Principles into Gynecologic Care: Teaching Modules & Tools and Addressing Goals of Care and Code Status on Gyn Oncology
Eye Medication Application and Resources
Restoring Your Smile at Any Age: Geriatric Dentistry

13. Outcomes
Six-month follow-up surveys with chief residents who have participated in CRIT showed that they:
Were more confident in their application of clinical skills related to the care of older adults
Were more likely to teach geriatrics principles to residents and medical students
Had an increased recognition of the importance of interdisciplinary approaches to the care of older adults
Had more confidence to coordinate care across disciplines and specialties, facilitate small groups, give feedback, connect with reluctant learners, and resolve conflicts in their roles as chief residents.
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

14. Testimonials
Great materials provided that I have already gone back to for reference.
It was a great experience learning from peers and passing on the information to the house-staff. It feels like I achieved something.
The CRIT experience helped me develop a more robust set of leadership skills that I was able to utilize throughout the year. Having the geriatrics training at the CRIT was a fantastic review of geriatric clinical pearls. This was highly valuable.
This was a great experience to have a focused education session on a topic that we deal with frequently in surgery but do not have much formal training in. There was a good mix of leadership education topics as well.
Chief Resident Immersion Training (CRIT) Co-Sponsored By Boston Medical Center & The Association of Directors of Geriatric Academic Programs Supported by the Hearst Foundations and Donald W. Reynolds Foundation

15. Save the Date! Insert your program date HERE
Donald W. Reynolds
Foundation