Learning Eldercare in Nongeriatric Clerkship is a Myth

I see a lot of elderly patients while treating severe depression. I do. According to recent research during medical clerkship on an internal ward is not the same as a specialized geriatric rotation. A geriatric rotation is more effective than a traditional clerkship for medical students to understand and to care for an aging population.

So why is this important. Well the authors do have a point. In these days and in the coming decades in Western societies the proportion of elderly well outnumber the amount of children. Nevertheless, our medical students receive clerkship on pediatrics but not in geriatrics.

Moreover,

Many students and faculty believe that, because students see older adults in most clinical rotations, the students are acquiring the knowledge and skills needed to work with older adults, and, thus, they consider further specialized training to be redundant

Well according to this study those clinical rotations are not sufficient to teach the unique issues in the care of the elderly such as: multiple comorbidities, polypharmacy, and the varied presentation and prognosis of different conditions common to older adults.

What did they do?

Due to curricular reorganization the authors seized the opportunity to implement a two week clinical clerkship in elder care. The department of geriatric psychiatry and geriatric medicine collaborated in this new clerkship. Medical students (n= 262) were randomly assigned to either a mandatory rotation in specialized geriatric training or a traditional nongeriatric clerkship ( a two week rotation in otolaryngology or ophthalmology). These clerkships were all mandatory. Students took surveys previous to their clerkship years and at the end of the said clerkship year. The survey consisted of validated tests for geriatric knowledge and attitudes. All students also completed an objective structured clinical examination (OSCE) including a clinical station focused on geriatrics.

students who completed a clerkship year containing a specialized rotation acquired more knowledge and demonstrated significantly better skills in geriatric care than did students who did not complete such a rotation

So get busy organizing a geriatric clerkship, preferably with the department of geriatric psychiatry. You can read more about their geriatric clerkship on their website, download the program

ResearchBlogging.org
Diachun L, Van Bussel L, Hansen KT, Charise A, & Rieder MJ (2010). “But I see old people everywhere”: dispelling the myth that eldercare is learned in nongeriatric clerkships. Academic medicine : journal of the Association of American Medical Colleges, 85 (7), 1221-8 PMID: 20592520