Preceptor Guide

Geriatric Depression Scale (GDS)

Printable Versions of Materials needed to create station:

• Preceptor Guide
• Case A
• Case B

Guide for Preceptors:

NOTE: the information posted just below is identical to that in the printable version of the preceptor guide above.

Preparing for this task: First obtain a copy of the GDS from any public site that provides free access to geriatric screening tools.
For example: http://www.healthcare.uiowa.edu/igec/tools/categoryMenu.asp?categoryID=2

Then print off the two case vignettes below, and laminate them if you like. We also suggest you laminate a copy of the GDS tool itself so that students may score it using an erasable white-board type marker, and then it can be erased and used again for each student group to score the vignettes.

Facilitating this station: Students generally have not encountered the GDS before coming to their geriatric medicine rotation. Explanation is thus needed before starting the role plays. We point out:

1. This is only a screening tool. Further evaluation is needed for those who score above 5 points in order to determine a diagnosis.
2. Although this can be done as a paper-pencil tool alone by appropriate patients, the examiner will learn much more about the patient’s overall life situation by listening to the responses given by the patient, so we encourage administering it verbally.
3. If patients give equivocal answers, we coach the students to remind the patient that ‘there is no right or wrong answer’, and then to ask ‘which would you say is more true in the last week?’ with a repeated reading of the question to obtain a yes/no answer.
4. We point out that common themes seen in the low scores of non-depressed patients often include lack of energy and boredom. In contrast, students should recognize the serious nature of empty/hopeless/helpless/worthless themes that may be associated with suicidality.

Students then begin the role-plays. In pairs, one student administers and scores the GDS while the second student role-plays the scripted responses. If there is a third student, then one may read the items, another one may score it, and the third does the role play.

Two cases are available (Case A and Case B), one representing a significantly depressed patient and the other one within normal limits. We often have time for only one vignette per student group, although this depends on the time of year and the size of student groups at each station. When we are limited for time, we generally use the depressed case vignette to highlight symptoms such as anhedonia.

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