PURPOSE: To determine the impact of a geriatrics home
visit program for third-year medical students on attitudes,
skills, and knowledge.
METHODS: Using a mixed methods, prospective, controlled
trial, volunteer control group students (n=17) at
two sites and intervention group students (n=16) at two
different sites within the same internal medicine clerkship
were given Internet and CDROM-based geriatric
self-study materials. Intervention group students identified
a geriatrics patient from their clinical experience,
performed one “home” visit (home, nursing home, or
rehabilitation facility) to practice geriatric assessment
skills, wrote a structured, reflective paper, and presented
their findings in small-group teaching settings.
Papers were qualitatively analyzed using the constant
comparative method for themes. All students took a
pre-test and post-test to measure changes in geriatrics
knowledge and attitudes.
RESULTS: General attitudes towards caring for the
elderly improved more in the intervention group than in
the control group (9.8 vs 0.5%; p=0.04, effect size 0.78).
Medical student attitudes towards their home care
training in medical school (21.7 vs 3.2%; p=0.02, effect
size 0.94) improved, as did attitudes towards time and
reimbursement issues surrounding home visits (10.1
vs −0.2%; p=0.02, effect size 0.89). Knowledge of
geriatrics improved in both groups (13.4 vs 15.2%
improvement; p=0.73). Students described performing
a mean of seven separate geriatric assessments (range
4–13) during the home visit. Themes that emerged from
the qualitative analysis of the reflective papers added
depth and understanding to the quantitative data and
supported results concerning attitudinal change.