Some of my best friends are old: Medical students' perceptions of older patients.

This dissertation includes three studies of medical students' perceptions of older adults. Attitude theory informs and is informed by all of the studies, two of which focus on students' intention to pursue geriatric medicine, the third examining students' intended support of older and younger patients' medical decisions. The entering cohort of medical students at a large, Midwestern university are the respondents for all three studies. The first study uses structural equation modeling to examine the impact of attitudes and other factors on students' interest in geriatrics. The data indicate that a model which mainly predicts behavioral intentions from attitudes is inadequate to describe the data, but that allowing experiences and behaviors to have direct effects on intended behaviors, as well as indirect effects via attitudes, result in a robust model. While few first-year students express interest in geriatric medicine, more experience with older adults is related to increased negative beliefs about older patients, but also to increased positive attitudes toward older adults and more interest in geriatrics. These relationships were further explored in the second study, in which 20 of the same medical students were interviewed individually about their interest in geriatrics. These interviews also revealed that a variety of experiences with older adults, both positive and negative, result in more interest in geriatrics, in part because students with those experiences can empathize with older patients and their fears about growing older. Indeed, students who were most interested in geriatrics manifested the most fear of aging and death. The interviews indicated that students on the whole enjoy working with older adults, but are reluctant to limit their practices to that population only. The third study describes the development of a series of vignettes used to assess students' support of older and younger patients' medical decisions. The data, both quantitative and qualitative, reveal little difference in students' support of younger and older patients' medical decisions, but that overall students are more supportive of aggressive treatments than of non-aggressive ones.Ph.D.GerontologyHealth Sciences, EducationHealth and Environmental SciencesSocial SciencesSocial workUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/123944/2/3106156.pd

Building capacity in ageing research: Implications from a survey of emerging researchers in Australia

Objective: The National Emerging Researchers in Ageing Study (NERAS) set out to inform capacity-building efforts in ageing research. Its purpose was to identify the interest, attitudes and motives of PhD students to enter the field and factors influencing intention to remain. Method: A web-based survey was sent to 267 PhD students in ageing. It assessed attitudes towards older people and the importance of a variety of factors influencing students' interest and decision to engage in ageing research. Results: The response rate was 60% (n = 161). Positive attitudes, interest in ageing issues and concern for older people were key motivating factors to work or study in the field. Supervisors in ageing and initial interest in the field were key predictors of intention to remain in the field. Conclusions: NERAS is the first national study of emerging researchers in ageing and it provides important new knowledge with implications for capacity-building efforts

Why medical students do not choose a career in geriatrics: a systematic review

Background: While the demand for doctors specialised in the medical care of elderly patients is increasing, the interest among medical students for a career in geriatrics is lagging behind. Methods: To get an overview of the different factors reported in the literature that affect the (low) interest among medical students for a career in geriatrics, a systematic literature search was conducted using PubMed, Embase, PsycINFO, and ERIC. Quality assessment criteria were applied. Results: Twenty studies met the criteria and were included in the review. In relation to the nature of the work, the preference of medical students is young patients, and acute somatic diseases that can be cured. The complexity of the geriatric patient deters students from choosing this specialty. Exposure by means of pre-clinical and particularly clinical education increases interest. The lack of status and the financial aspects have a negative influence on interest. Conclusion: Exposure to geriatrics by means of education is necessary. The challenge in geriatric education is to show the rewarding aspects of the specialty