Lessons learned from narrative feedback of students on a geriatric training program.

Geriatrics continues to draw insufficient numbers of medical students today. Currently, little is known regarding how education can motivate students to choose geriatrics. The authors' aim was to examine geriatrics from the students' perspective to identify elements that can be useful in education and improving attitudes toward, interest in, and knowledge about geriatrics. The authors analyzed narrative reflection essays of 36 students and clarified the themes from the essays during focus group sessions. Four overarching themes that influenced students' perspective on geriatrics were identified: professional identity, perception of geriatrics, geriatric-specific problems, and learning environment. Students have an inaccurate image of clinical practice and the medical professional identity, which has a negative impact on their attitude toward, interest in, and knowledge of geriatrics. Furthermore, this study yielded the important role of the hidden curriculum on professional identity, the novelty of geriatric-specific problems to students, and the importance of educational approach and good role models.

A Heart Set on Living.

Quality of life is a highly subjective element on which to base health care decision making. This narrative reflection after the death of a family member uses poetry as a prompt to explore themes related to quality of life-including symptom burden, interpersonal relationships in the face of illness, and the will to live. Through penetrating inquiry and reflection, physicians and other care providers can gain insight into the underlying motivations, loyalties, and abilities that lend meaning to patients' lives and shape attitudes toward death and dying. By better recognizing and appreciating these factors, clinicians can develop patient-centered quality-of-life constructs that empower them to honor patient goals and preferences at the end of life. Physicians are encouraged to explore poetry and other artistic media to help foster the reflective capacity required to deeply understand and faithfully serve patients in this regard.