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
