Introduction to the older patient: a "first exposure" to geriatrics for medical students

Abstract

In 2003, Weill Cornell Medical College developed a 4-hour module to introduce the geriatric patient within the required first-year doctoring course. The educational intervention highlights the importance of communication between older patients and physicians, the utility of an enhanced social history and functional assessment, and the pitfalls of ageism in the medical setting. The module incorporates film, the performing arts, and small-group exposure to a community-residing older person. To evaluate the module's effect, four successive classes of first-year medical students (2003-2006) responded to a 14-item questionnaire and three opened-ended questions at the end of the 4-hour curriculum. Quantitative and qualitative analysis reveal consistently strong positive student feedback to this module. Almost all students agreed that the learning objectives were clear (99%) and had been met (99%). Several curricular interventions received high endorsement from the respondents in their questionnaire and narrative comments. Most (94%) were in strong agreement that meeting the older patient in the small group was a worthwhile experience. Also, students appreciated observing an example of a substandard interview (76% in strong agreement) and then a demonstration of effective communication (83% in strong agreement) through dramatic enactments. The majority of students (97%) commented that exposure to these presentations enabled them to see ageist behavior firsthand and to observe how ageist attitudes interfere with appropriate diagnosis and medical care. This approach to introducing the older patient may be of use at other medical schools. Future studies will need to evaluate the long-term effect of this educational intervention.