Medical student perspectives on geriatrics and geriatric education.

摘要

OBJECTIVE: To ascertain medical students' perspectives on geriatrics. DESIGN: Interpretative phenomenological analysis. SETTING: An allopathic, Liaison Committee on Medical Education-accredited, former Donald W. Reynolds Foundation grant recipient, U.S. medical school. PARTICIPANTS: Thirty fourth-year medical students who completed geriatric educational activities in all 4 years of medical school. MEASUREMENTS: Two researchers independently reviewed verbatim transcripts from five focus groups and identified themes using the constant comparative method. RESULTS: Seventeen themes that elaborate on students' perspectives on geriatrics were identified. Students reported not feeling appropriately engaged in geriatrics, despaired at the futility of care, were depressed by the decline and death of their patients, were frustrated by low reimbursement rates and low prestige despite fellowship training, were concerned about patients' unrealistic expectations and opportunities for litigation, felt unsure how to handle ethical dilemmas, and found communicating with older adults to be enjoyable but time consuming and challenging. They felt they had too much exposure to geriatrics in medical school. CONCLUSION: Current attitude scales fail to capture some of the dimensions uncovered in this study, whereas students did not mention other dimensions commonly included in attitude scales. Regarding curriculum development, students may find an integrated preclinical geriatric curriculum to be more relevant to their careers than a stand-alone curriculum. Clinical clerkships might be in a better position to emphasize the positive aspects of geriatrics and develop strategies to address students' negative attitudes.