Improving Medical Student Attitudes Toward Older Patients Through a “Council of Elders” and Reflective Writing Experience

Authors

  • Glenda R. Westmoreland MD, MPH,

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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  • Steven R. Counsell MD,

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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  • Youcef Sennour MD,

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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  • Cathy C. Schubert MD,

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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  • Kathryn I. Frank RN, DNS,

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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  • Jingwei Wu MS,

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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  • Richard M. Frankel PhD,

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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  • Debra K. Litzelman MD,

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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  • Stephen P. Bogdewic PhD,

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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  • Thomas S. Inui ScM, MD

    1. From the *Department of Medicine, School of Medicine, Center for Aging Research Indiana University, Indianapolis, IndianaRegenstrief Institute, Indianapolis, Indiana§Richard Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.
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Address correspondence to Glenda R. Westmoreland, Indiana University School of Medicine, Wishard Health Services, Department of Medicine OPWM M200, Indianapolis, IN 46202. E-mail: gwestmor@iupui.edu

Abstract

In an effort to reduce “agism” which is prevalent among medical trainees, a new geriatrics educational experience for medical students aimed at improving attitudes toward older patients was developed. Each 90-minute Older Adult Session included four components: initial reflective writing exercise; introduction to the session; 75-minute dialogue with the “Council of Elders,” a group of active, “well” older adults; and final reflective writing exercise. The new session was provided to 237 first- and second-year medical students during the 2006/07 academic year at Indiana University School of Medicine. Session evaluation included comparing scores on the 14-item Geriatrics Attitude Scale administered before and after the session, identifying attitude changes in the reflective writing exercises, and a student satisfaction survey. Student responses on the Geriatrics Attitude Scale after the session were significantly improved in seven of 14 items, demonstrating better attitudes toward being with and listening to older people and caring for older patients. Analysis of the reflective writings revealed changing of negative to positive or reinforced positive attitudes in 27% of medical students, with attitudes not discernable in the remaining 73% (except one student, in whom positive attitudes changed to negative). Learner satisfaction with the Older Adult Session was high, with 98% agreeing that the session had a positive effect on insight into the care of older adults. A Council of Elders coupled with a reflective writing exercise is a promising new approach to improving attitudes of medical students toward their geriatric patients.

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