FINDINGS FROM A THREE YEAR REVIEW OF MEDICAL STUDENT ATTITUDES TOWARD A GERIATRIC TRAINING PROGRAM AND AN EARLY PRACTICE MODEL IN THE CARE OF OLDER ADULTS

This research study identified and evaluated the attitudes and confidence level of medical students’ knowledge, skills, and perceptions related to the health care of older adults. A survey was administered as a pre-test during first year orientation and then as a post-test after student exposure to a total of 163 hours of geriatric curriculum in Y1 and Y2. Information gained from this research could improve the development and delivery of medical education curriculum related to provision and care of older adults. Purpose (a): Between 2005 and 2030, the number of adults in the US aged 65 and older will almost double from 12% to almost 20% of the population, with those who are 80 and over, “the oldest old” expected to nearly double from 11 million to 20 million. This group, along with changes in the US Health Care System, will place increased demand on the patchwork of health care services due to the epidemic of chronic disease such as dementing disorders, arthritic conditions, diabetes, hypertension, and heart disease. The Reynolds Geriatric Education & Training in Texas (GET-IT) Program sought to better address the medical needs of the growing geriatric population. The two objectives of the study were: 1) Increase the content of geriatric education in the medical education curriculum; a total of 163 hours of geriatric education were added to Y1 and Y2; and, 2) Identify and evaluate the attitudes of student perceptions related to the health care of older adults in response to the geriatric curricular content. Methods (b): The study used a 52 item questionnaire Aging and Healthcare Survey Medical Students Perceptions that contains a 5-point Likert Scale for measurement. Surveys were administered twice over a three year period (2009-2011); once at orientation as a pre-test and again as a post-test at the end of Y2 after medical students were exposed to geriatric curriculum and the SAGE Program. A selected sample of surveys (n=95) were used for this review. Results (c): Only responses that contained significance at p ≤ 0.005 related to changes in student perceptions of aging and healthcare between Y1 and Y2 of medical school were included in this report. Selected Survey Items from Aging & Healthcare Study. 5= Strongly Agree; 4= Agree; 3= Neutral; 2= Disagree; 1= Strongly Disagree. Year 1 Mean. Year 2 Mean. P-value. Q14 There is not enough course content on the evaluation and care of older adults. 4.44. 2.70. < .001. Q21 I am comfortable talking with an older patient about their death. 4.20. 3.59. < .001. Q23 Physicians need to learn special skills to care for older patients. 4.23. 3.75. < .001. Q30 Learning about how to care for older patients should be a priority for people in Medicine. 2.53. 3.40. < .001. Q31 I know a lot about growing older. 2.12. 3.06. < .001. Q38 I would prefer not to provide medical care to older adults. 3.37. 2.52. < .001. Q29 Physicians need to understand issues of quality of life for an older adult. 3.03. 4.05. 0.002. Q16 As people become older, most become depressed. 3.19. 2.75. 0.004. Conclusions (d): Our findings showed some mixed results. Exposure to the geriatric curriculum had a positive impact on student’s awareness, understanding, and treating of older adults including psycho-social awareness. Students reported more confidence in and an appreciation of the need for communication with older adults in the areas medical history and quality of life issues but less confidence with older adults in areas of palliative care and end of life issues. The data obtained from the survey supports the integrative model of geriatrics curricula into undergraduate medical education.