When Contact Is Not Enough: Affecting First Year Medical Students' Image towards Older Persons

TY - JOUR

T1 - When Contact Is Not Enough

T2 - Affecting First Year Medical Students' Image towards Older Persons

AU - Kusumastuti, Sasmita

AU - van Fenema, Esther

AU - Stratum, Eugenie C. F. Polman-van

AU - Achterberg, Wilco

AU - Lindenberg, Jolanda

AU - Westendorp, Rudi G. J.

PY - 2017/1/20

Y1 - 2017/1/20

N2 - Context: Many medical schools have initiated care internships to familiarize their students with older persons and to instil a professional attitude.Objective: To examine the impact of care internships on the image that first-year medical students have of older persons and to explore the underlying concepts that may play a role in shaping this image.Design: Survey before and after a two-week compulsory care internship using the Aging Semantic Differential (ASD; 32 adjectives) and the Attitudes toward Old People (AOP; 34 positions) questionnaires.Participants: Before and after a care internship involving interpersonal contact, 252 and 244 first-year medical students at the Leiden University Medical Centre (LUMC) in the academic year 2012–2013 participated.Method: Descriptive statistics, analyses of variance, and principal component analysis were used; clusters of adjectives and positions were reduced into concepts to examine dominant patterns of views. Changes in image were investigated as mean differences of the total and concept scores.Results:Both the ASD and the AOP questionnaires showed a poor general image of older persons that significantly worsened after the care internship (p < 0.01). The percentage of students considering over 75 years as being old increased from 17.2% to 31.2% (p < 0.01) and those who thought they would find as much satisfaction in care for older as for younger patients decreased from 78.5% to 62.1% (p < 0.001). Exploratory principal component analysis showed particularly low scores on ‘comportment’ and ‘pleasurable interaction’ whereas the scores on ‘personality traits’ and ‘habitual behaviour’ significantly deteriorated (both p < 0.001). These patterns were irrespective of the student’s gender and previous contact experience.Conclusion: Medical schools should carefully consider care internships to ensure that students do not worsen their views on older patients, which may occur due to inadequate contact depth and quality within a rather unsupportive context.

AB - Context: Many medical schools have initiated care internships to familiarize their students with older persons and to instil a professional attitude.Objective: To examine the impact of care internships on the image that first-year medical students have of older persons and to explore the underlying concepts that may play a role in shaping this image.Design: Survey before and after a two-week compulsory care internship using the Aging Semantic Differential (ASD; 32 adjectives) and the Attitudes toward Old People (AOP; 34 positions) questionnaires.Participants: Before and after a care internship involving interpersonal contact, 252 and 244 first-year medical students at the Leiden University Medical Centre (LUMC) in the academic year 2012–2013 participated.Method: Descriptive statistics, analyses of variance, and principal component analysis were used; clusters of adjectives and positions were reduced into concepts to examine dominant patterns of views. Changes in image were investigated as mean differences of the total and concept scores.Results:Both the ASD and the AOP questionnaires showed a poor general image of older persons that significantly worsened after the care internship (p < 0.01). The percentage of students considering over 75 years as being old increased from 17.2% to 31.2% (p < 0.01) and those who thought they would find as much satisfaction in care for older as for younger patients decreased from 78.5% to 62.1% (p < 0.001). Exploratory principal component analysis showed particularly low scores on ‘comportment’ and ‘pleasurable interaction’ whereas the scores on ‘personality traits’ and ‘habitual behaviour’ significantly deteriorated (both p < 0.001). These patterns were irrespective of the student’s gender and previous contact experience.Conclusion: Medical schools should carefully consider care internships to ensure that students do not worsen their views on older patients, which may occur due to inadequate contact depth and quality within a rather unsupportive context.

U2 - 10.1371/journal.pone.0169977

DO - 10.1371/journal.pone.0169977

M3 - Journal article

C2 - 28107400

SN - 1932-6203

VL - 12

SP - 1

EP - 15

JO - PLOS ONE

JF - PLOS ONE

IS - 1

M1 - e0169977

ER -