WHEN PATIENTS TEACH THEIR DOCTORS: A CURRICULUM FOR GERIATRIC EDUCATION

In response to aging patient demographics and a call for increased formal geriatric training in medical schools, a community volunteer geriatric mentor program, Bridging Generations, was developed to shape attitudes of medical students caring for the elderly. The geriatric mentor experience provided students with unique insight into the challenges and joys that accompany aging and encouraged the medical students to become empathetic and knowledgeable providers of care for geriatric patients.     

BUILDING A LEARNING EXPERIENCE: THE IMPLEMENTATION OF A CLERKSHIP IN GERIATRIC MEDICINE

Recent curriculum changes at McGill University include a mandatory 4-week clerkship for third-year medical students. The basis of this clerkship is the assessment and management of frail elderly who have a combination of complex acute and chronic medical problems and functional disabilities. It includes the understanding of the need for continuity of care across settings and the transition from hospital to the community. Our main purpose is to offer students a learning experience based upon self-reflection, access to technology, interactive learning and permanent feedback. To accomplish the technological goals, didactic sessions were mostly electronic-based with two main components: web-based interactive modules that include the contents in seven web-based interactive lectures complemented with pre- and post-tests, and an electronic portfolio to assess students' acquisition of skills and attitudes. We expect that implementation of this model of clinical clerkship will prepare future physicians, not only for the practice of geriatric medicine, but also for different medical and surgical specialties, and will enhance the attitudes, knowledge, and skills practitioners need to care for older people.     

Attitudes of Medical Students and Residents Toward Care of the Elderly

The research reported in this article examined attitudes toward the care of the elderly between and among medical students and residents in training. Data were collected with a 16-item attitude questionnaire. Participants were medical students in their introduction period (prior to clinical experience) and residents of the Department of Internal Medicine, Faculty of Medicine at Siriraj Hospital to answer. There was no difference in the attitudes toward the care for the elderly between medical students and residents. Prior exposure to the elderly may have an influence on attitudes toward the care of the elderly. The geriatric curriculum should be developed to correct misunderstandings and improve the attitudes of the students and residents.     

Using a Geriatric Mentoring Narrative Program to Improve Medical Student Attitudes Towards the Elderly

This study examined first-year medical student attitudes concerning the elderly before and after instituting a geriatric mentoring program. The program began and ended with a survey designed to assess students' attitudes toward the elderly. During the mentoring program, students visited the same senior for four visits throughout the academic year. After each visit, students were required to write a narrative that included reflections on assigned themes. Comparisons of pre- and postsurvey data indicated that students became more positive in their attitudes toward older patients after the geriatric experience. Narratives indicated students were highly engaged in the visits with their seniors.     

COMMUNITY‐BASED SETTINGS FOR TRAINING IN GERIATRIC MEDICINE

Service‐learning clinical experiences in community‐based sites are an important approach to providing medical, nurse practitioner, allied health and other professional students with an opportunity to acquire knowledge, attitudes and skills necessary for working effectively with the elderly. Such experiences provide a balance to the clinical experiences more traditionally provided to students in nursing homes and chronic care hospitals. In community‐based settings, students gain knowledge and skills in working with older people, develop a more balanced view about growing old, and learn about community resources and effective teamwork. The experiences of the George Washington University Medical School in providing these learning experiences has led to student enthusiasm for work with the elderly and has improved access to medical care for elderly persons who participate in programs in community‐based settings.     

THE DEVELOPMENT OF A MEDICAL STUDENT INTEREST GROUP IN GERIATRICS

As society ages, there is an increasing demand for knowledge and skills to care for the elderly. Innovative ways to stimulate the interest of medical students in geriatric medicine present an important challenge to medical schools today. This article discusses the value of a student interest group in meeting this challenge. In 1988, the Department of Geriatrics at the Mount Sinai School of Medicine in New York City initiated a student interest group in geriatrics. Over the ensuing years, this group has provided medical students with a forum for pursuing research interests in geriatrics, networking with other students, and interacting with faculty role models interested in geriatric medicine.     

NASTY,BRUTISH AND LONG: ADVENTURES IN OLD AGE AND THE WORLD OF ELDERCARE By Ira Rosofsky

Nurses play a significant role in geriatric care. However, as the aging population and demand for geriatric nurses increase worldwide, shortages of nurses seem to arise. This creates the need to assess and address the motivation and attitudes of nurses toward geriatric care. The intent of this qualitative study is to surface the essence or the “lebenswelt” that describe the motivation and attitudes of a selected group of Filipino nurses toward geriatric care. A total of six registered nurses who had experienced taking care of elderly patients voluntarily participated as respondents of this study. A two-part instrument developed by the researchers was made to elicit necessary data and information. The first part comprised of the robotfoto intended to establish the baseline characteristics of nurses under study. The second part consisted of a semistructured individual in-depth interview using “aide memoire” to probe into the motivation and attitudes of the nurse respondents. Field texts were phenomenologically reduced via repertory grid. Two distinct and interesting themes, namely Geriatric Service Motivation Typology and the Yin-Yang of Geriatric Attitudes emerged. The first theme includes the Single Loop and Double Loop type of motivation The former involves a transactional and unidirectional process, while the latter constitutes a two-way relational and transformational process. The second theme consists of a harmonious combination of the two sides of the nurses' attitudes toward geriatric care. Through this study, the human side of nursing is seen and captured, thus increasing the awareness and knowledge of nurses, improving provision of optimum geriatric care, and inspiring nurses to pursue geriatric nursing with a yearning to serve the elderly with and from the heart.     

A Review of: “VITAL CONNECTIONS IN LONG-TERM CARE SPIRITUAL RESOURCES FOR STAFF AND RESIDENTS”

This study identified dietetic students' knowledge of aging, attitudes, and intentions to provide services to the elderly and compared the cross-cultural differences between the United States and South Korea. The results show that knowledge about aging and the elderly, coursework experiences, and internship experiences are much greater among American college students than among Korean college students. Stepwise regression results found positive attitudes toward working for the elderly, as well as internship experiences, influenced behavioral intentions among both Korean and U.S. students. Effective education programs should integrate sufficient knowledge, positively reflect student attitudes toward aging populations, and control the quality of contact with the elderly.     

GERONTOLOGICAL EDUCATION FOR STUDENTS IN NURSING AND SOCIAL WORK: KNOWLEDGE,ATTITUDES, AND PERCEIVED BARRIERS

Most health care and social service providers are routinely required to work with elderly clients and clients’ aging family members. Research suggests that students entering these professions have knowledge deficits and lack positive attitudes toward older people. Few prefer to work with aging clients. Professional curricula are not providing students with adequate training to serve the current needs of this population, much less to meet projected increases in demand for services. To examine this issue, 67 master's students in nursing and social work completed questionnaires assessing (1) knowledge about aging, (2) attitudes toward old people, and (3) perceived barriers to gerontological education. Results confirmed the existence of knowledge deficits among respondents. Attitudes tended to be neutral rather than strongly positive or negative. Knowledge scores were related to attitudes, to respondents’ ages, and to their having lived in households with older relatives. Nursing students identified the greatest barriers in gerontological education as insufficient curriculum time and lack of academic role models. Social work students perceived lower status of work with the elderly and limited experience with healthy older people as the greatest barriers. The two groups agreed that fragmentation of services contributes to inadequate gerontological preparation. Findings suggest a need for didactic and experiential learning opportunities, reinforced by appropriate academic role models, for students in service professions.     

Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a consistent experience and enlightens students to the heterogeneity of the older adult population. Cost of the Elder Specialist Program is minimal. Without exception, the Elder Specialist component of each geriatric session has been rated by students as the highest. Measures of attitudes toward older adults are showing a positive trend.     

STAFF AND ELDERLY KNOWLEDGE AND ATTITUDES TOWARD ELDERLY SEXUALITY

This study compared staff and elderly knowledge, attitudes, and practices related to sexual expression by elderly persons in a long‐term care setting. Volunteers (N = 194) responded agree or disagree to 159 items. Significant differences were observed between the staff and elderly responses on 36 items. Areas of greatest differences involved knowledge and attitudes about consensual sex and sexual abuse, issues related to family attitudes toward remarriage and sexual expression, and age‐related changes and health problems related to sexuality. Items related to masturbation received the greatest percentage of no response. The staff had significantly higher total scores as compared to the elderly reflecting more knowledge, positive attitudes, and support for more proactive responses toward elderly sexuality. Findings have major implications for staff training in long‐term care settings.     

Leveraging learning technologies for collaborative writing in an online pharmacotherapy course

The purpose of this project was to evaluate the development and delivery of a hypertext case scenario document to be used as the capstone assessment tool for doctoral-level physical therapy students. The integration of Web-based collaborative tools (PBworks? and Google Sites?) allowed students in this all-online course to apply their pharmacotherapy knowledge in a physical therapy patient scenario, while working with colleagues to determine the best route of patient care. Students developed digital writing skills imperative to a patient-centered, collaborative health-care field, and practiced evidence-based patient care. The findings demonstrate that the implementation of collaborative digital writing with a hypertext document case scenario assessment as the primary assessment tool in this online pharmacotherapy course delivered to doctoral-level physical therapy students is a feasible and effective educational strategy.     

Learning anatomy through Thiel‐ vs. formalin‐embalmed cadavers: Student perceptions of embalming methods and effect on functional anatomy knowledge

Thiel‐embalmed cadavers, which have been adopted for use in anatomy teaching in relatively few universities, show greater flexibility and color retention compared to formalin‐embalmed cadavers, properties which might be considered advantageous for anatomy teaching. This study aimed to investigate student attitudes toward the dissection experience with Thiel‐ compared to formalin/ethanol‐embalmed cadavers. It also aimed to determine if one embalming method is more advantageous in terms of learning functional anatomy through the comparison of student anterior forearm functional anatomy knowledge. Student opinions and functional anatomy knowledge were obtained through use of a questionnaire from students at two medical schools, one using Thiel‐, and one using more traditional formalin/ethanol‐embalmed cadavers. Both the Thiel group and the formalin group of students were surveyed shortly after completing an anterior forearm dissection session. Significant differences (P‐values <0.01) in some attitudes were found toward the dissection experience between cohorts using Thiel‐ vs. formalin‐embalmed cadavers. The Thiel group of students felt more confident about recognizing anatomy in the living individual, found it easier to identify and dissect anatomical structures, and indicated more active exploration of functional anatomy due to the retained flexibility of the cadaver. However, on testing, no significant difference in functional anatomy knowledge was found between the two cohorts. Overall, although Thiel embalming may provide an advantageous learning experience in some investigated areas, more research needs to be carried out, especially to establish whether student perception is based on reality, at least in terms of structure identification. Anat Sci Educ 11: 166–174. © 2017 American Association of Anatomists.     

Between two stories: assessment of and for learning

The study was conducted in a school for special education with small classes of six to 12 students. The aim was to illuminate how students’ understanding of written assessments could be related to assessment for learning. Twenty-nine students were asked to describe their understanding of written assessment in three different subjects and, further, to describe their perceptions in follow-up interviews. The two-step analysis first focused on individual understanding. Thereafter Vygotsky’s zone of proximal development (ZPD) was used as analytical tool. In the first analysis three categories were identified. Students’ understandings were related to subject matter knowledge, generic skills and attitudes. The findings of the second analysis indicated that written assessment often lacked formative features and cannot be seen as learning in the ZPD. Difficulties with schoolwork were seen as problems of the individual and the measures were directed towards the student. Even though the guidelines ask for a relational perspective a categorical perspective sometimes was adopted in the assessments. The implications of the study relate to the ways teacher’s assessment competences can encompass students’ understanding and how this can be translated into action.     

Homophobia in medical students of the University of Hong Kong

Homosexuality is now accepted as a normal variant of human sexuality, but homophobia among healthcare professionals is well documented. Establishment of trustful doctor–patient relationships is impossible in the presence of homophobia. We were interested to examine the extent of homophobia among medical students, the future doctors. This article aims to study attitudes of medical students of the University of Hong Kong towards homosexuality and to identify significant factors affecting their attitudes. A cross‐sectional study was performed on students of the University of Hong Kong. Attitudes towards homosexuality were compared between medical and non‐medical students. More than 25% of the medical students agreed with the statement ‘homosexuality is a psychological disorder that requires therapy’. More than 15% would avoid any physical contact with homosexuals to minimise the chance of contracting diseases, especially AIDS. Comparison between the medical students and non‐medical students showed that the attitudes of the medical students were significantly more homophobic. Factors explaining the difference included the importance of religion in the formation of moral values, gender, experience of working closely with homosexual friends, sexual orientation, experience of the heterosexual sexual act, acquaintance of homosexual friends, and experience of homosexual love relationships. In conclusion, there appeared to be a certain level of homophobia among the medical students. This could possibly be explained by their lack of experience of working closely with homosexual friends. Relevant curriculum modification and development are urgently needed, to provide ongoing opportunities for students to realise their own values that could unconsciously affect their clinical judgements.     

University staff mental health literacy,stigma and their experience of students with mental health problems

Despite high rates of mental disorders in university students, very few seek professional help. University teaching staff are well placed to connect students with mental health care. However, little is known about university staff attitudes to and knowledge about mental health problems, or whether these factors influence their experience with and assistance of students with these problems. A total of 224 teaching staff members at the Australian National University, Canberra completed an anonymous online survey via an email link (16.4% response rate from N ~ 1370). Measures included demographic and professional information, experiences with student mental health, knowledge of depression (literacy) and attitudes to depression (stigma). Strength of stigmatising attitude did not predict whether a teaching staff member would approach a student to assist with mental health problems. Teaching staff with higher levels of depression literacy (OR = 1.14, p = 0.007) were more likely to feel sufficiently informed to help students with mental health problems. Ensuring staff complete mental health literacy training and have adequate skills to respond appropriately to students with mental health problems may help in connecting young people to appropriate care in a university context.     

PREDICTORS OF COLLEGE STUDENTS’ KNOWLEDGE OF AND ATTITUDES TOWARD ELDERLY SEXUALITY: THE RELEVANCE OF GRANDPARENTAL CONTACT

In this study, 241 young and middle‐aged adult college students completed the Aging Sexuality Knowledge and Attitude Scale, and provided information about their demographic and grandparental relationship qualities. Findings showed that greater age was associated with increased knowledge of elderly sexuality. Both the presence of contact and greater than average perceptions of closeness with at least one grandparent were predictive of more permissive attitudes toward elderly sexuality. Among the total sample, greater knowledge was related to more permissive attitudes toward elderly sexuality. However, the presence of contact with at least one grandparent moderated this relationship; young adults without grandparental contact presented a nonsignificant knowledge /attitude relationship. These findings suggest that future studies of younger age cohorts’ attitudes toward elderly sexuality should assess grandparental contact and relationship characteristics, as well as general demographic information such as chronological age. Health‐care educators also may need to reconsider the commonly held assumption that greater knowledge of elderly sexuality is associated exclusively with more permissive attitudes.     

Scientific Skills as Core Competences in Medical Education: What do medical students think?

Background: Scientific excellence is one of the most fundamental underpinnings of medical education and its relevance is unquestionable. To be involved in research activities enhances students' critical thinking and problem-solving capacities, which are mandatory competences for new achievements in patient care and consequently to the improvement of clinical practice. Purposes: This work aimed to study the relevance given by Portuguese medical students to a core of scientific skills, and their judgment about their own ability to execute those skills. Methods: A cross-sectional study was conducted on students attending the first, fourth and sixth years of medical course in the same period. An assessment istrument, exploring the importance given by Portuguese medical students to scientific skills in high school, to clinical practice and to their own ability to execute them, was designed, adapted and applied specifically to this study. Results: Students' perceptions were associated with gender, academic year, previous participation in research activities, positive and negative attitudes toward science, research integration into the curriculum and motivation to undertake research. The viewpoint of medical students about the relevance of scientific skills overall, and the ability to execute them, was independently associated with motivation to be enrolled in research. Conclusions: These findings have meaningful implications in medical education regarding the inclusion of a structural research program in the medical curriculum. Students should be aware that clinical practice would greatly benefit from the enrollment in research activities. By developing a solid scientific literacy future physicians will be able to apply new knowledge in patient care.     

Assessment of health-care professionals’ knowledge and attitudes on sexuality and aging: an integrative review

ABSTRACT

This study aims to establish an understanding of (a) health-care professionals’ knowledge and attitudes; and (b) tools used to assess sexuality in older people living with/(out) dementia and those identified as lesbian, gay, bisexual, trans, or intersex (LGBTI) individuals. An integrative review of the literature, as registered on the PROSPERO international Prospective Register of Systematic Reviews (CRD42019129589), was conducted. A comprehensive and systematic literature search was performed for the period between 2009 to 2019 across eight electronic databases: CINAHL, PubMed, MEDLINE, Web of Science, Cochrane library, Embase, PsycINFO, and Scopus, together with a manual search of reference lists. Screening of titles, abstracts, and full texts of eligible studies plus quality appraisal (using the Mixed Methods Appraisal Tool) were independently conducted by two reviewers with disagreements resolved via discussion with a third reviewer. Nineteen articles were reviewed with three themes identified from the synthesis: 1) varying knowledge and attitudes amongst health-care professionals; 2) needs for professional development opportunities and support from workplace and 3) lack of recent validated tools to assess knowledge and attitudes. Health-care professionals’ knowledge and attitudes toward sexuality in older people living with/(out) dementia and those identified as LGBTI individuals are varying. Sexuality education and professional development training are needed to enhance their knowledge and attitudes and build skills in order to manage sexuality concerns. Current assessment tools are inadequate, highlighting the need for an appropriate assessment tool to be developed.