Reflections of medical students regarding the care of geriatric patients in the continuing care retirement community.

OBJECTIVE: There is growing recognition that students training to provide care for older adults need to be trained in all settings where older adults receive care, including retirement communities. The purpose of this study was to allow medical students to see older patients living and participating in activities in the long-term care setting and examine the effects that this experience had on the students. METHODS: Medical students were assigned to write an open-ended reflection paper about a community health experience. Forty-eight students wrote their reflection papers on their experience in a continuing care retirement facility. Three independent reviewers examined these reflective narratives for common themes. RESULTS: After analyzing the students' narratives, 6 themes emerged: (1) The initial exposure to dementia, (2) confronting death and dying, (3) the diversity of care and services for the elderly, (4) the cost of care for the elderly, (5) seniors can lead active lives if given the opportunity, and (6) the rewards of the health care team-patient relationship. CONCLUSION: The students' reflective narratives provide valuable insights into how medical students view retirement communities, the physician's role in the care of geriatric patients, the importance of interdisciplinary health care, the cost of care for elderly patients, and their views on dementia and dying. Through this experience, students received valuable lessons about taking care of older adults in the community that their interactions with patients in the hospital and ambulatory medical offices had not provided.

Attitudes of students in medicine, nursing, occupational therapy, and physical therapy toward interprofessional education.

With the growing interest in interprofessional education and practice, methods to evaluate the effectiveness of related curricular activities are essential. The purpose of this study was twofold: (1) to assess the attitudes of students in medicine, nursing, occupational therapy, and physical therapy toward interprofessional education using the Interdisciplinary Education Perception Scale and Readiness for Interprofessional Learning Scale and (2) to compare data with normative data previously reported. The two instruments were administered to 474 first-year students in medicine, nursing, occupational therapy, and physical therapy who completed the forms in the context of a workshop at the conclusion of the first year of an interprofessional health mentor program. Differences among professions were reported. Students in medicine and physical therapy rated members of their own professions significantly higher in the areas of competence/autonomy and need for cooperation as compared with those in nursing and occupational therapy. Along with reporting similarities and differences, the results provide additional normative data on these tools that can be used when choosing tools to evaluate interprofessional education attitudes.

Cross-sectional assessment of medical and nursing students' attitudes toward chronic illness at matriculation and graduation.

BACKGROUND: It is important to assess students' attitudes toward chronic illness to enhance curriculum and support interprofessional learning. METHOD: A 40-item questionnaire was administered to 704 medical and nursing students. Qualitative and quantitative analyses examined their attitudes and understanding of chronic illness as well as differences between medical and nursing students. RESULTS: Content analysis and factor analysis indicated that entering students were more positive about chronic illness than graduates. Most underestimated its economic impact. Positive attitudes toward chronic illness were associated with taking a personal interest in patients. The attitudes of nursing students were generally similar to those of medical students, but there were differences related to patient adherence, the role of nurses in patient education, managing comorbidities, and confidentiality of electronic medical records. CONCLUSIONS: Entering students were more positive about chronic illness than graduates. Although medical and nursing students' attitudes were very similar, differences have implications for interprofessional education.

Overview of geriatrics.

The care of older adults offers many challenges and many rewards. As we move into the twenty-first century, health care providers will increasingly be called on to provide high-quality, comprehensive care for seniors. Health care professionals, including physicians, nurses, podiatrists, and therapists, need to remain current in the breadth of special issues facing the elderly. Though many seniors are fully functional, healthy, and active, a growing number, especially of the very old, suffer from multiple chronic conditions, polypharmacy, and functional dependency. Though younger patients typically present for medical care, which is focused on a single problem, seniors often have multiple, interacting conditions and competing agendas for their medical care. Professionals need to be prepared to recognize the complex interplay of aging, illness, medications, and social stressors that affect the health of their patients. Today's health care providers, more than ever, must learn to function as members of health care teams, assembled around the specific needs of individual patients in a variety of settings. Foot care is a critical part of the health of older adults, primarily to maintain an active lifestyle and secondarily as a marker of a variety of systemic diseases. Podiatrists are important members of this team and have a special role to play in the diagnosis and treatment of disease as well as helping seniors maintain a high quality of life and maximum function.