Multi-stakeholder needs assessment for community-centered interprofessional geriatric medical education in Punjab, India

Abstract

Background

India’s rapidly ageing population, projected to be nearly 20% over 60 years by 2050, presents complex healthcare needs, including multimorbidity, polypharmacy, and psychosocial vulnerability, that exceed single-discipline approaches. Despite India’s 2019 Competency-Based Medical Education (CBME) reforms outlining geriatric competencies, medical graduates remain inadequately prepared for interprofessional collaborative practice. Community-based interprofessional education offers a pragmatic pathway to bridge this gap, yet systematic approaches aligned with national curricula remain underdeveloped. This study conducted a multi-stakeholder needs assessment to inform the development of a community-centred interprofessional geriatric education module for undergraduate medical students in Punjab, India.

Methods

We employed a convergent mixed-methods design guided by Kern’s curriculum development approach, the 4Ms framework (What Matters, Medication, Mentation, Mobility), and Interprofessional Education Collaborative (IPEC) competencies. Qualitative data were collected from 35 older adults (≥60 years) through two focus group discussions and 20 in-depth interviews across urban and rural Punjab (August–October 2025). A structured expert needs assessment was conducted with 17 purposively selected interprofessional healthcare professionals representing eight disciplines (August 2025). Thematic analysis and descriptive statistics were applied to qualitative and quantitative data, respectively; findings were integrated at the interpretation stage.

Results

Older adults prioritised dignity, respectful communication, and coordinated care. Key concerns included polypharmacy and medication confusion (43% reported ≥3 chronic conditions), loneliness, under-addressed mental health needs, fear of falls, and fragmented care. Healthcare professionals identified significant curriculum gaps: 94% cited inadequate geriatric preparation, 88% insufficient interprofessional education, and 82% limited community-based learning. Despite high perceived importance of geriatric competencies (mean 4.6 - 4.9), confidence remained moderate in psychosocial care (3.1±0.9) and interprofessional collaboration (3.2±0.9). Strong convergence emerged across all 4Ms domains between older adults’ experiences and professionals’ identified competency gaps.

Conclusions

This multi-stakeholder needs assessment demonstrates convergence between older adults’ priorities and professionals’ competency gaps across all 4Ms domains, providing evidence-informed direction for curriculum reform. Findings support integrating the 4Ms framework within India’s CBME to address gaps in person-centred communication, medication safety, psychosocial care, and interprofessional collaboration. The Family Adoption Programme offers a pragmatic platform for longitudinal community-based interprofessional learning aligned with the National Programme for Health Care of the Elderly.