The involvement of older inpatients in medical student education

Abstract

ObjectivesTo examine older inpatients’ experiences with medical student education, their views on future interactions, and to seek their opinion on the most important curricular topics related to geriatric medicine.MethodsThe study involved 112 non-confused inpatients older than 65 years of age, who completed a uniformed questionnaire on the day of their discharge from a teaching hospital.ResultsThe mean age was 81 years, with equal number of male and female participants. 57% interacted with the students during their admission, the majority being interviewed and examined. Almost all (92%) of these patients described their experience as positive, some described it as time-consuming (23%), repetitive (19%) and tiresome (9%). 92% of all participants agreed that the older patients should be part of medical students’ education. Dementia, cardiac conditions, cancer, arthritis, isolation/loneliness were highlighted as the most important topics to teach medical students related to geriatric medicine, while patience and listening were listed as important skills. They suggested practical, easily implemented advice for the improvement of the interaction between students and older patients; including allowing more time for interactions and for students to speak louder.ConclusionsOlder patients felt positively about their interactions with medical students, and believed that older patients should be involved in medical student education. As well as medical conditions such as dementia, cardiac disease and cancer, these patients highlighted isolation and loneliness as important topics for undergraduate geriatric medical education, implying that students should learn about broader aspects of older patients’ health and wellbeing.

Patient participation in medical student teaching: a survey of hospital patients

“…More research is needed to delineate this balance. Only one of 110 patients said the worst part of the teaching was that it was too long, while Aquilina et al found that 23% of patients said their experience was time consuming [19].…”

“…and N.R. after reviewing the questions asked of patients in previous studies that assessed their experiences [8,10,13,[18][19][20]22] and creating questions that answered specific components of our hypothesis: factors that may affect motivation for participation (adequacy of informed consent, desire to teach students, sense of obligation, boredom), and examination of the quality of the experience (effect on happiness, pain, perception of hospital stay). The survey included 19 statements that were rated by patients on a Likert scale from 1 to 5, and three short answer questions which allowed for free-text answers and comments.…”

“…Furthermore, the patients all filled in their own survey without assistance or presence of preceptors, study staff or medical students and placed anonymous responses in a sealed envelope thus lessening the chance of bias. Additionally, unlike other surveys in the literature [19,20,22], this study asked patients about a specific teaching experience directly after it happened, rather than surveying patients in general about their attitudes towards medical student's involvement in patient care or collecting information about the teaching experience as part of a discharge questionnaire. Our survey was brief and patients overwhelmingly were able to complete the entire survey leading to little missing data.…”

“…Only two prior studies have focused specifically on medical students in the hospital and combined included only 150 patients who had interacted with a student, of which 73 were from a geriatric population. The 73 geriatric patients generally had a positive outlook on in-hospital participation in medical student teaching, although 9 and 23% of patients noted the process was tiresome or time-consuming respectively [19]. Furthermore, in a survey of 77 patients who either independently or with assistance of the medical student filled a 4 page survey, only 50% patients felt that previous interactions with medical students positively influenced their time in the hospital [20].…”

“…However, it is not clear whether patients in the hospital view interactions with medical students as a burden. The data on patients' perspectives on participating in medical student or junior medical staff teaching in the in-patient setting is limited [18][19][20][21]. For example, Nair et al [18] found that patients generally had a positive outlook on participating in bed-side teaching with junior medical trainees including interns, residents and medical students, but only 37.5% of the learners in the study were medical students.…”