Effect of short-term research training programs on medical students' attitudes toward aging

Being old is like…: perceptions of aging among healthcare profession students

BACKGROUND

This research explores the perspectives and attitudes of university students in health sciences towards aging and older adults. Given the intricate interplay of factors influencing attitudes toward aging, coupled with the demographic shift in Turkey from a youthful to an aging population, the study aims to discern how a cohort of university students perceives the aging process.

METHODS

Employing a mixed-methods research strategy, which enhances the depth of data interpretation, the study utilized a questionnaire for quantitative data collection. Additionally, qualitative insights were gathered through a metaphor stem-completion item appended to the questionnaire and semi-structured interviews with students. The participants were selected from the Health Sciences Faculty and School of Medicine at a Turkish university.

RESULTS

The study revealed that participating students generally hold positive attitudes and demonstrate respect towards older adults. However, they also associate old age with negative aspects such as loss of autonomy and a constant need for assistance. Furthermore, older individuals are perceived as emotionally challenging and challenging to work with, irrespective of the nature and duration of interactions during their academic programs. These findings suggest a potential pathologizing perspective towards aging adults among health science students, who are prospective health professionals.

CONCLUSIONS

This paper discusses the implications of the study and offers insights for program coordinators, curriculum designers, and faculty members in health sciences. The results underscore the necessity for a heightened emphasis on gerontology-related subjects within health science curricula. This emphasis is crucial for cultivating a comprehensive understanding among students of the social, psychological, cognitive, and biological changes associated with aging.

We will all age and one day be older adults ourselves: College students' reflections on facilitating compassionate presence (CP) sessions for older adults

College students are likely to hold negative ageist views and attitudes toward older people. The compassionate presence (CP) intervention could be a promising approach to reduce ageist attitudes that younger adults have of older adults. College students were trained virtually in deep, active, and compassionate listening and were matched with older adults living in assisted-living facilities. The partners met virtually for an hour once per week. Students completed weekly reflections throughout the ten-week intervention. The weekly reflections revealed that students had preconceived notions about older adults before the CP training. After the CP training and throughout the intervention, we noted a positive shift in perception, knowledge, and attitudes toward older adults and aging. Students built meaningful social bonds with older adults, developed strong communication and interpersonal skills, and acquired research and core leadership skills needed for future careers and professional practice.

"Aging is beautiful and graceful:" Exploring college students' perceptions of aging, older adults, and future older selves

Perception of one's own age and the aging process can influence healthy aging and encourage younger adults to be more proactive in taking care of themselves. There is a shortage of literature on college students' self-perceptions of aging and old age. This descriptive qualitative study explored how short-term aging research training and activities influenced college students' perceptions of aging, older adults, and their future older selves. Students were exposed to discussions about aging, the aging process, myths, a brief TED talk, and a video on positive age stereotypes in preparation for their encounter with older adults in a more extensive photovoice aging research project. Data for the study were collected using weekly guided reflections and drawing. Findings show that college students improved perceptions of aging and older adults after the short-term research training. We found cultural differences in self-perception of the onset of old age. Students perceived healthy aging in terms of biological, psychological, spiritual, and social dimensions of health. Students presented a hopeful, positive picture of their future older self as opposed to the negative stereotypic views they initially had of older adults. Reflections on one's own aging may be crucial in encouraging younger adults to be more proactive in taking care of themselves for a healthier life in later adulthood.

A scoping review of ageism towards older adults in cancer care

INTRODUCTION

Ageism towards older adults with cancer may impact treatment decisions, healthcare interactions, and shape health/psychosocial outcomes. The purpose of this review is twofold: (1) To synthesize the literature on ageism towards older adults with cancer in oncology and (2) To identify interventions that address ageism in the healthcare context applicable to oncology.

MATERIALS AND METHODS

We conducted a scoping review following Arksey and O'Malley and Levac methods and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted an exhaustive multi-database search, screening 30,926 titles/abstracts. Following data abstraction, we conducted tabular, narrative, and textual synthesis.

RESULTS

We extracted data on 133 papers. Most (n = 44) were expert opinions, reviews, and letters to editors highlighting the negative impacts of ageism, expressing the need for approaches addressing heterogeneity of older adults, and calling for increased clinical trial inclusion for older adults. Qualitative studies (n = 3) described healthcare professionals' perceived influence of age on treatment recommendations, whereas quantitative studies (n = 32) were inconclusive as to whether age-related bias impacted treatment recommendations/outcomes or survival. Intervention studies (n = 54) targeted ageism in pre/post-licensure healthcare professionals and reported participants' improvement in knowledge and/or attitudes towards older adults. No interventions were found that had been implemented in oncology.

DISCUSSION

Concerns relating to ageism in cancer care are consistently described in the literature. Interventions exist to address ageism; however, none have been developed or tested in oncology settings. Addressing ageism in oncology will require integration of geriatric knowledge/interventions to address conscious and unconscious ageist attitudes impacting care and outcomes. Interventions hold promise if tailored for cancer care settings. 249/250.

Perceptions and knowledge of older adults: an analysis of interprofessional education and medically underserved populations

This study explored an academic Interprofessional Geriatric Case Competition (IGCC) experience with a focus on medically underserved populations. Our aims were to assess: the perceptions of and knowledge of older adult populations; and the overall IPE (Interprofessional Education) experience of the IGCC participants. A multi-method study approach was used, the Facts on Aging Quiz assessed knowledge and the Carolina Opinions on Care of Older Adults (COCOA) assessed perceptions. A qualitative thematic approach was utilized to explore the themes of the IPE experience. There was a moderate correlation (0.37, p < .001) between perception and knowledge data of the respondents (N = 94), current professionals (54%) and enrolled students (46%). The three emerged themes were as follows: interprofessional/holistic practice; culturally responsive/older adult centered practice; and the impact of Covid-19. The implementation of IPE that centers medically underserved populations has the potential to: enhance students learning, influence the quality of care, and provide pathways to working within these specific populations.

The Effect of Integrating Service-Learning and Learning Portfolio Construction into the Curriculum of Gerontological Nursing

Background: With the rapid increase in the aging population, a greater number of older individuals will require nursing care in the future. Therefore, it is important for nurses to be willing to engage in gerontological nursing. Nursing students must increase their experience in providing care to older people during their education and must receive education that improves their attitudes toward aging; this will help provide care to the older people, develop positive attitudes toward aging, and increase their empathy and willingness to provide care to older people after graduation. Hence, studies focused on improving the attitude of nursing students toward aging are urgently required. Methods: In this mixed-method experimental study, participants were interviewed individually and observed to better understand the connection between quantitative and qualitative data. Service learning and learning portfolio constructions were integrated in the gerontological nursing curriculum of an experimental group, whereas traditional gerontological nursing curriculum was provided to a control group. Quantitative data on the nursing students were collected using the attitudes toward aging scale (ATAS) and older people behavioral intention scale (OBIS) and analyzed using descriptive and inferential statistics. Result: From the pre- to the post-test, the average ATAS and OBIS scores of the experimental group increased significantly, reaching a statistically significant level. However, the results of the control group indicated that the educational intervention does affect the attitudes toward aging and older people behaviors. A qualitative analysis revealed that educational intervention can improve the students’ attitudes toward aging and older people behavioral intention. Conclusion: Our study results showed that integrating community older people service and learning portfolio construction into the curriculum can effectively improve the attitudes of nursing students toward aging and older people’s behaviors, thus providing substantial assistance to students intending to care for the older people in the future.

Interventions to improve attitudes toward older people in undergraduate health and social sciences students. A systematic review and meta-analysis

OBJECTIVE

To determine which interventions are the most effective in improving attitudes toward older persons in undergraduate health and social sciences students.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

A literature search was made in PubMed, EBSCO and SCOPUS and additional records were identified by manual searching. The selection criteria were studies that evaluated an intervention designed to improve positive attitudes; studies in undergraduate health and social sciences students; and studies using direct instruments to measure attitudes.

REVIEW METHODS

Two independent reviewers extracted study-level data from records using a common data collection spreadsheet. Two reviewers also assessed study quality by using the Cochrane Risk of Bias Tool. The primary outcome was the effect of an intervention upon attitudes toward older people, while the secondary outcome was the effect upon knowledge about aging and older people in those studies that had previously assessed subject attitude. The meta-analysis was carried out based on mixed statistical models.

RESULTS

The search identified 53 eligible studies published during 1982-2020, comprising 35 pre-post studies and 18 randomized clinical trials, of which 14 were included in the meta-analysis. A strongly significant effect upon attitudes was observed for empathy-based interventions (differences of standardized mean differences (d_SMD) = 1.26; 95%CI: 0.04-2.48; p = 0.04), knowledge + empathy-based interventions (d_SMD = 0.22; 95%CI: 0.05-0.39; p = 0.01), and knowledge + clinical skills-based interventions (d_SMD = 0.22; 95%CI: 0.01-0.43; p = 0.04). The overall effect was d_SMD = 0.50; 95%CI: 0.01-0.43; p = 0.004. In addition, a positive effect in terms of increased knowledge about the older was observed after knowledge + empathy-based and knowledge + clinical skills-based interventions (d_SMD = 0.24; 95%CI: 0.07-0.40; p = 0.005).

CONCLUSIONS

Interventions to improve attitudes in health and social sciences students are effective, with those based on empathy having the greatest impact. Improving attitudes among future professionals could improve the management and quality of care of older people. More rigorous and better designed studies are recommended to determine the effect of the interventions. Registered on PROSPERO ID: CRD42021220677.

TWITTABLE ABSTRACT

Ageism is present in healthcare settings. Empathy-based interventions are the most effective strategies in health and social sciences students.

Anti-Ageism Social Actions: Lights and Shadows

Ageism refers to the stereotypes, prejudices and discrimination towards others or oneself due to age, and it is the most prevalent type of social disadvantage, even more so than those due to gender and race, with negative effects worldwide. Ageism is an evidently real social problem that needs to be addressed and fought. Our study has two main objectives: firstly, to study to what extent programmes, projects or actions have been developed to combat ageism around the world; and secondly, to what extent they have been evaluated via the positive outcomes registered by the participants. Two different information sources were used: (a) a literature review of ageism programmes or interventions; and (b) an online questionnaire sent to international and national institutions surveying their policies or programmes against ageism. Our results show a relatively high number of actions combating ageism but a lack of a systematic evaluation of the outcomes of those actions. In conclusion, first, it is necessary to develop programmes and actions combating ageism, and the evaluation of these programmes is urgently needed in order to identify strategies that truly and effectively tackle ageism. There is a need to urge institutions to perform external evaluations of their anti-ageism social policies and to encourage scientists to conduct randomized and controlled studies.

A scoping review of the changing landscape of geriatric medicine in undergraduate medical education: curricula, topics and teaching methods

PURPOSE

The world's population is ageing. Therefore, every doctor should receive geriatric medicine training during their undergraduate education. This review aims to summarise recent developments in geriatric medicine that will potentially inform developments and updating of undergraduate medical curricula for geriatric content.

METHODS

We systematically searched the electronic databases Ovid Medline, Ovid Embase and Pubmed, from 1st January 2009 to 18th May 2021. We included studies related to (1) undergraduate medical students and (2) geriatric medicine or ageing or older adults and (3) curriculum or curriculum topics or learning objectives or competencies or teaching methods or students' attitudes and (4) published in a scientific journal. No language restrictions were applied.

RESULTS

We identified 2503 records and assessed the full texts of 393 records for eligibility with 367 records included in the thematic analysis. Six major themes emerged: curriculum, topics, teaching methods, teaching settings, medical students' skills and medical students' attitudes. New curricula focussed on minimum Geriatrics Competencies, Geriatric Psychiatry and Comprehensive Geriatric Assessment; vertical integration of Geriatric Medicine into the curriculum has been advocated. Emerging or evolving topics included delirium, pharmacotherapeutics, healthy ageing and health promotion, and Telemedicine. Teaching methods emphasised interprofessional education, senior mentor programmes and intergenerational contact, student journaling and reflective writing, simulation, clinical placements and e-learning. Nursing homes featured among new teaching settings. Communication skills, empathy and professionalism were highlighted as essential skills for interacting with older adults.

CONCLUSION

We recommend that future undergraduate medical curricula in Geriatric Medicine should take into account recent developments described in this paper. In addition to including newly emerged topics and advances in existing topics, different teaching settings and methods should also be considered. Employing vertical integration throughout the undergraduate course can usefully supplement learning achieved in a dedicated Geriatric Medicine undergraduate course. Interprofessional education can improve understanding of the roles of other professionals and improve team-working skills. A focus on improving communication skills and empathy should particularly enable better interaction with older patients. Embedding expected levels of Geriatric competencies should ensure that medical students have acquired the skills necessary to effectively treat older patients.

Attitudes towards older adults (80 years and older): A measurement with the ageing semantic differential - A cross-sectional study of Austrian students

INTRODUCTION

The aims of the study were to investigate the four-factor structure of the German version of the Aging Semantic Differential (ASD) and to gain initial insights into the attitudes of nursing, medical and humanities students towards older people in Austria.

METHOD

A cross-sectional study design with a convenience sample was chosen.

RESULTS

The ASD was completed by 255 Austrian nursing, medicine, and humanities students, who described their attitudes towards persons who are 80 years of age and older. The applicability of the four-factor structure (instrumentality, autonomy, acceptability and integrity) of the German version was confirmed by performing a confirmatory factor analysis. The mean age of students in our sample was 23.6 years; 79% of these were female. The sample displayed negative attitudes regarding the factors of autonomy and instrumentality, but more positive attitudes regarding the factors integrity and acceptability. The attitudes of the students in the three study programmes differed, with the medical students displaying the most negative attitudes. Students who displayed positive attitudes had statistically significantly higher levels of knowledge about ageism and better possibilities to hold personal conversations with older people (80+) in the family or circle of friends.

CONCLUSION

We conclude that having more knowledge about ageism and close personal contacts to older persons can support positive attitudes towards older individuals.

What Is the State of Compassion Education? A Systematic Review of Compassion Training in Health Care

PURPOSE

To investigate the current state and quality of compassion education interventions offered to health care providers during training or practice, determine how the components of each education intervention map onto the domains of an empirically based clinical model of compassion, and identify the most common approaches to compassion education.

METHOD

The MEDLINE, Embase, CINAHL Plus with Full Text, Sociological Abstracts, Web of Science, ERIC, and Education Research Complete databases were searched from inception to March 2020 in this systematic review. Studies that evaluated a compassion education intervention for health care providers or those in training to enhance compassion toward patients and/or families were included. A narrative synthesis of the included studies was performed. The components of each intervention were mapped onto the domains of compassion described in the Patient Compassion Model.

RESULTS

One hundred eight peer-reviewed publications describing 103 interventions were included. Modalities ranged from establishing curricula and interventions in clinical settings to programs that used humanities-based reflective practices, clinical simulation, role modeling, and contemplative practices, with many education interventions adopting a multimodal approach. Most interventions mapped to the virtuous response domain of the Patient Compassion Model; very few mapped to the other domains of this model.

CONCLUSIONS

Most interventions were limited as they focused on a single domain of compassion; did not adequately define compassion; were assessed exclusively by self-report; were devoid of a comparator/control group; and did not evaluate retention, sustainability, and translation to clinical practice over time. The authors suggest that compassion education interventions be grounded in an empirically based definition of compassion; use a competency-based approach; employ multimodal teaching methods that address the requisite attitudes, skills, behaviors, and knowledge within the multiple domains of compassion; evaluate learning over time; and incorporate patient, preceptor, and peer evaluations.

Medical students perspectives and consideration of geriatrics for future practice. An exploratory study of a public medical school in Ghana

Ghana has one of the fastest growing aging populations in sub-Sahara Africa, but little is known about the geriatric workforce. A sample of 12 medical students in one Ghanaian public university participated in an exploratory qualitative study to share their perspectives on specialty choices in Ghana, interest in working with older patients, and their consideration of geriatrics for future practice. The findings revealed limited knowledge of geriatrics as well as low interest in its selection as a specialty for future practice. These were attributable to multi-faceted factors, including the lack of both exposure to geriatric medicine and geriatrics-focused training for students in this institution. It is critical that geriatric education be prioritized and incorporated in medical schools to nurture students' interest and future consideration of the specialty. This will help bolster the number of geriatric-oriented physicians and secure specialized care for the aging population.

Stimulators of medical students' interest in geriatric medicine-A Systematic Review

OBJECTIVES

This study is a systematic review on stimulators of interest in pursuing a geriatric career among medical students in different countries. The review also assessed whether there were differences or similarities based on geographic regions or income categorisations.

METHODS

A 20-year (1998-2018) review of quality primary research articles was conducted (n = 10). For analysis, studies were categorised into low- and middle-income countries (LMICs), and high-income countries, based on World Health Organization and World Bank's income grouping for the 2019 fiscal year.

RESULTS

The frequently mentioned stimulators of interest in geriatrics were as follows: cultivating positive attitudes towards older people, participation in geriatric-related interventions and positive experiences during a geriatric training. Lack of published peer-reviewed articles from the LMICs limited the researchers' ability to compare the two income groups.

CONCLUSION

Suggestions to improve future systematic reviews that consider global factors, global participation or any aspect of global inclusion are discussed.