Implementation of a Healthcare of Elderly Course With Multi-Professional Teachers for Undergraduate Medical Students in a Public University in Malaysia—A Quasi-Experimental Pre and Post Study

Abstract

Clinical practise in the ageing population is changing from organ-specific specialty care to holistic care. This is done through comprehensive geriatric assessment and multi-disciplinary team management. Hence, we adopted an approach consisting of multi-professional teachers teaching a Healthcare of Elderly Course (HEC), in a public university in Malaysia. We aimed to analyze the students' attitude, self-perceived competency and interest in geriatric medicine as a career before and after the course. We also investigated variables that might influence this interest among these students. All 96 students in the course were invited to participate in the survey. Sixty-eight (70.8%) completed both pre and post-course questionnaires. Although most students (93%) have a positive attitude (University of California at Los Angeles Geriatric Attitude Scale >3) toward older adults at baseline, it did not significantly increase post-course. We found that the mean scores for self-perceived competency increased from 3.62 (±0.76) to 3.81 (±0.56) post-course (p < 0.01). However, the students remained neutral with no significant change in the mean interest in pursuing a geriatric medicine career after the course. Students with higher self-perceived competency post-course were found to be more interested in geriatric medicine (β = 0.56, p < 0.001). In conclusion, the HEC in our centre could sustain a positive attitude and increase self-perceived competency in students. It is important to increase the preparedness of our graduates in managing older adults with frailty and multimorbidity. Future studies may involve inter-professional education of students from multiple disciplines undergoing the same course to nurture real-life collaborations in managing the ageing population.

How do ageism, death anxiety and ageing anxiety among medical students and residents affect their attitude towards medical care for older patients: a systematic review

“…Some trainees were scared by death, resulting in a negative perception of elderly care medicine during their medical education 63% Merrill [ 21 ] To investigate the reason some caregivers desire to avoid patients with terminal illnesses Quantitative; cross-sectional survey 718; RR unknown; Caregivers (medical students (first and fourth year; n = 616), primary care physicians ( n = 55), nurse students (undergraduate and graduate; n = 47)) Unknown, except for physicians; practicing in the community health clinics of Houston, Texas USA Thanatophobia using a rewritten Thanatophobia Scale (7 items)[ 33 ] Self-esteem in caring for elderly patients using an unnamed scale (10 items)[ 34 ] Significant negative relationship between fourth year medical students’ thanatophobia scores and self-esteem when treating elderly persons ( p < 0.0001). Relationship between thanatophobia among first year students and their self-esteem when treating elderly persons was not reported 50% Ng [ 28 ] To analyze medical students’ attitude towards older adults and interest in geriatric medicine as a career before and after implementation of a course Quantitative; pretest–posttest study 68; RR 71%; Medical students (third year, before and after Healthcare of Elderly course) Medical school; Universiti Putra Malaysia Malaysia Attitude towards older adults using UCLA-GAS (14 items)[ 27 ] Interest to pursue geriatric medicine as a career (number of items unknown) No significant relationship between post course third year medical students’ attitude toward older adults and their interest in a future career in geriatric medicine (β(SE) = 0.38 (0.26), 95% CI = 0.14, 0.90, p = 0.152) 39% Perrotta [ 17 ] To examine the influence of medical students’ general attitudes toward the aged on their attitudes toward geriatric patients and geriatric medicine Quantitative; cross-sectional survey 127; RR 100%; Medical students (first-year) Medical school; attendees of the first-year student orientation program at the State University of New York at Buffalo School of Medicine USA …”

“…Included quantitative studies assessed the attitudes towards older people using different questionnaires. The University of California at Los Angeles Geriatric Attitude Scale (UCLA-GAS) [ 27 ] was used in four of the included studies [ 15 , 16 , 20 , 28 ]. The UCLA-GAS assesses attitudes toward older people and geriatric patient care in four dimensions: i) perceived social value of older people (e.g., “In general, old people act too slow for modern society”), ii) medical care provided to geriatric patients (e.g., “Taking a medical history from elderly patients is frequently an ordeal”), iii) compassion toward older people (e.g., “I tend to pay more attention and have more sympathy toward my elderly patients than my younger patients”), iv) distribution of societal resources for older people (e.g., “Old people in general do not contribute much to society”).…”

“…Three included articles measured the attitude towards providing medical care to older patients using different scales [ 21 – 23 ]. Last, seven articles measured the interest in geriatric medicine as a future career among medical trainees, which we interpreted as a positive attitude towards medical care for older patients [ 15 – 17 , 19 , 20 , 24 , 28 ]. These articles used a single question ( n = 4), a scale ( n = 1) or an unknown number of items ( n = 2).…”

“…Zhao et al [ 24 ], who had the largest sample size ( n = 1022) among the included studies, found that first to fifth year medical students with a more positive attitude towards older people had more interest in specializing in geriatric medicine. Ng et al [ 28 ] implemented an ageing and geriatric medicine course for third year medical students. No significant post course relationship was found between attitude towards older people and interest in specializing in geriatric medicine among third year medical students.…”

“…No significant relationship was found between their attitude towards older people and post course rise in interest in specializing in geriatric medicine. Both the studies of Ng et al [ 28 ] and Hughes et al scored poor on methodological quality. In a qualitative study, Meiboom et al [ 26 ] found that some elderly care medicine trainees were drawn to older patients because of their wisdom and stories.…”