Aging with Grace: Intraprofessional Nursing Simulation to Improve Geriatrics Workforce Readiness

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2025

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In 2020, approximately 17% of the United States population was over the age of 65 years, projected to double by the year 2050. In Hawai‘i, the kūpuna (older adult) population percentage is higher than the national average, with 19% of the state’s population being 65 years or older. Additionally, life expectancy in Hawai‘i is the highest in the US, with an average lifespan of 81 years, compared to the national average of 77 years, and 71 years in the state with the lowest life expectancy. The rapidly growing proportion of the population over the age of 65 makes it vitally important that the US and Hawai‘i prepare a workforce of highly skilled, competent and confident health care professionals who can provide geriatric care.
The purpose of this poster is to describe an innovative, evidence-based geriatrics curriculum called “Aging With Grace.” The learning activity fostered intraprofessional collaboration, defined as a collaboration among individuals from varied backgrounds within the same discipline, including Nurse Practitioner and pre-licensure Registered Nurse (RN) students. This curriculum was designed to: 1) improve knowledge and competency in caring for kūpuna (older adults), 2) apply skills to a simulated scenario caring for a kūpuna with complex needs in a safe and positive environment, 3) build competency in intraprofessional collaboration and promote career ladder growth for RN students, and 4) develop competency in telehealth.
Miller’s Pyramid of Clinical Competence was utilized to scaffold learning activities. Students engaged in asynchronous preparatory work to build knowledge competence, and then progressed to a three-part intraprofessional simulation activity with Simulated Patient (SP) actors to demonstrate competencies. The scenario involved an older adult and unfolded over three distinct time periods, which followed the patient as they transitioned through different health care settings: 1) independence at home, 2) post-acute skilled nursing, and 3) long-term care. The scenarios engaged students to assess and manage common geriatric syndromes, utilize telehealth, and practice addressing patient care holistically, applying the 5Ms model for age-friendly care. Each part was followed with a faculty-led debrief to allow for self-reflection and growth.
Evaluation results demonstrated students quantitatively evaluated the simulation exercise process well, with good scores on the Student Survey of Simulation Standards for Continuous Improvement (S4CI). Students demonstrated improvement in pre-post confidence in telehealth with statistically significant improvements in all Confidence in Telehealth Domains scores after the simulation exercise (all p <0.0001). Students qualitatively evaluated the simulation well, reporting no major problems or recommendations for improvement. Problem areas identified were related to time management and technology challenges.
In conclusion, as the aging population in the United States and Hawai‘i continues to grow, the demand for a skilled geriatric health care workforce becomes increasingly urgent. The implementation of targeted educational interventions, such as this innovative simulation, offers a promising strategy to prepare future health care providers for the complexities of geriatric care. Continued efforts are needed to enhance student recruitment into geriatric specialties and to address systemic barriers that hinder their entry into the field. By fostering a supportive, intraprofessional, psychologically safe, and competency-focused learning environment, nursing schools can improve new graduate competencies and workforce readiness in geriatrics.

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