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 Table of Contents  
BRIEF COMMUNICATION
Year : 2017  |  Volume : 30  |  Issue : 2  |  Page : 172-175

An interprofessional education program's impact on attitudes toward and desire to work with older adults


1 Department of Health Science, Truman State University, Kirksville, Missouri, USA
2 Department of Communication Disorders, Truman State University, Kirksville, Missouri, USA

Date of Web Publication19-Sep-2017

Correspondence Address:
Julia D Edgar
2241 Health Sciences Building, 100 East Normal Avenue, Kirksville, Missouri 65301
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/efh.EfH_2_15

  Abstract 

Background: Insufficient numbers of health professions students aspire to work with the increasing numbers of the elderly. Although programs exist to promote interest in serving this population, inadequate numbers of health professionals remain an issue. Methods: This study sample consisted of medical (n = 75) and health profession students (n = 210) enrolled in a semester-long interprofessional clinical education program designed to enhance interprofessional teamwork and provide positive exposure to elderly in the community. Each team of three visited an assigned elder three times during the semester. Students were acquainted with their elder and also administered a comprehensive geriatric physical and socioemotional battery of assessments. After each visit, the teams met and held a debriefing with faculty. Attitudes toward older adults and the desire to work with older adults were assessed using the Carolina Opinion of Care of Older Adults. The survey was administered twice: before initiating the semester-long program and immediately after program completion. Results: Total score and subscale scores were compared pre- and post-experience. Scores on the subscale “Early Interest in Geriatrics” were significantly higher postexperience compared to pre-experience. Scores on the remaining subscales and the total score remained unchanged. Discussion: Results indicate that exposure to elderly adults may increase the interest in working with this population and does not diminish attitudes toward the elderly. Longer exposure may be needed to invoke attitudinal changes across additional subtests.

Keywords: Aging, attitudes, gerontology, health professions students, interprofessional clinical education


How to cite this article:
McManus K, Shannon K, Rhodes DL, Edgar JD, Cox C. An interprofessional education program's impact on attitudes toward and desire to work with older adults. Educ Health 2017;30:172-5

How to cite this URL:
McManus K, Shannon K, Rhodes DL, Edgar JD, Cox C. An interprofessional education program's impact on attitudes toward and desire to work with older adults. Educ Health [serial online] 2017 [cited 2020 Nov 29];30:172-5. Available from: https://www.educationforhealth.net/text.asp?2017/30/2/172/215088


  Background Top


Career interest in working with older adults seems to be affected by health profession students' attitudes about this population.[1] Ageism, an international issue, is widespread. How young medical and health profession students from any culture view elders' physical and cognitive skill potential can affect patient care. Ideally, the patient is at the center of an interprofessional health-care team. However, ageism in even one team member can interfere with active listening to the elderly patient, promoting breakdown in team communication and functioning.[2] Unfortunately, many health profession students possess negative attitudes toward older adults. A perceived lack of challenge, low prestige, difficult communication, futility of care, high possibility of lawsuits, and low incomes associated with such work further reduce the desire to work with older adults.[3]

When health profession students enrolled in coursework designed to improve geriatric knowledge and attitudes toward older adults or participated in high-level care experiences with this population, attitudes toward the aging improved.[3] Similarly, interprofessional education programs for health professions students have enhanced attitudes toward both interprofessional teamwork and older adults.[4],[5] Few studies compare attitudes across disciplines.[6]

The purpose of this study was to examine pre-post attitudes toward older adults and the desire to work with older adults of health profession students enrolled in an interprofessional clinical education program that involved team-based visits to elderly participants in their homes.


  Methods Top


Sample

Health profession students from an osteopathic medical school and a public liberal arts university enrolled in the program. Institutional Review Board approval was obtained, and all program participants volunteered for the study [Table 1].
Table 1: Number of program participants from an osteopathic medical school and a public liberal arts university

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Instrument

The Carolina Opinions on Care of Older Adults (COCOA) was used to gather perceptions about working with the elderly and interest in a career in geriatrics. The 42 items comprising the survey are scored on a 1–5 Likert-type scale. The COCOA has been shown to be valid and reliable.[7]

Procedure

All participants completed the COCOA before participating in a semester-long, interprofessional, team-based program that included three home visits with an older adult. All elder participant volunteers lived independently in either their own home or in senior housing. During the home visits, teams administered a comprehensive physical and socioemotional battery of assessments including safety and fall risk, level of independence, health literacy, oral health, nutrition, and social-cognitive status. During subsequent visits, teams provided patient education and appropriate health education resources based on results of prior assessments and then established patient wellness goals. Following each visit, debriefing sessions were held; three to four teams met in a small-group format with health professions faculty to discuss and evaluate interprofessional team communication, collaboration, patient assessment results, and suggestions for patient education materials and information. At the final debriefing meeting, participants again completed the COCOA.

Analysis

Independent t-tests were computed to determine differences in the pre- and post-test scores of the total COCOA scale and the six COCOA subscales for all participants. Paired samples t-tests were not possible for these comparisons due to logistical problems in matching pre- and post-surveys for participants. In addition, independent samples t-tests were computed to determine differences in posttest scores of the total COCOA scale and the six COCOA subscales comparing the osteopathic medical students and the combined health profession students.


  Results Top


Examination of mean scores revealed that the postprogram mean was slightly higher than the preprogram mean for the total scale and five of the six subscales. However, only the Early Interest in Geriatrics subscale was significantly higher [Table 2].
Table 2: Measures of tendency and dispersion for Carolina Opinions On Care Of Older Adults subscales and total scale instrument pre- and post-scores

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Examination of postprogram mean scores for the osteopathic medical students compared to the other health profession students did not reveal any statistically significant differences for any of the subscales or total scale scores.


  Discussion Top


Programs that have focused on aging issues, involved students in assessment and care experiences with older adults,[3] and included home visits have improved attitudes toward older adults.[8] Programs using interprofessional experiences have also improved health profession students' attitudes toward older adults.[4],[5] Although the program in this study followed best practices for elder care and incorporated interprofessional teams, it may not have been of sufficient duration or intensity to facilitate positive attitude changes in these areas.

The primary objective of this program was to demonstrate interdisciplinary professionalism with the patient and the team. The secondary objective was providing participants with training in geriatrics through home visits and team-based assessments. The debriefings following the visits included team presentations regarding the status of the elderly patient, team preparation for the next visit, and teamwork assessment and discussion. Proportionally, more of the debriefing was dedicated to discussing interprofessional effectiveness and interactions between team members. Although time was allotted to discussion of the patients during these debriefings, a geriatric training program with the sole purpose of educating students on geriatric care may generate different results than a program with a dual purpose. In fact, there is some evidence to support that students' attitudes toward the elderly improve with more geriatrics-based curriculum when combined with direct, high-level care.[3] A longer program with more direct contact with elderly patients, more discussion of resources for the elderly, and a more geriatrics-focused curriculum may facilitate more positive attitude changes.

When asked about their early interest in geriatrics and older adult issues at this stage of their education and career, participants in this study significantly improved their attitudes pre-to post-program. Health profession students with more knowledge of older adult issues seem to be interested in careers in geriatrics.[3],[9] The interprofessional program in this study provided student participants with information about older adult physical and psychosocial health concerns and required considerable interaction between participant and patient during assessments and health education resource provision. Possibly because participants in this study were positively exposed to healthy older adults in a clinical geriatric experience at this time in their education and career, they may have viewed the population as novel and interesting.

Previous research has shown that early in their education and careers, health profession students' attitudes were more negative about working with older adults than later in their studies and careers.[1] Exposure in programs such as this one, therefore, may generate more early interest in health careers in geriatrics, leading to more investigation of geriatrics as a future career choice. With further initiatives such as this interprofessional home visit program, additional health profession students may become interested early on about geriatrics as a career.

Although participants may have significantly increased their early interest in geriatrics and older adult's issues, there was no significant difference pre- to post-program in attitudes toward the geriatrics setting as a career choice. It is noteworthy that although attitudes did not improve, neither did they decline. Thus, interactions with the elderly apparently did not generate negative impressions sufficient to lower COCOA scores. In fact, during debriefings, faculty noted that many of the students displayed a caring attitude toward their elder.

Medical and health profession students in this study held comparable attitudes toward the elderly. Perhaps drawing on students from a school of osteopathic medicine with its holistic philosophy contributed to the similarity. During debriefings, participants were asked to assess their roles as team members and strategize what might improve team function. While this type of self-assessment has potential to strengthen team interactions, adding a self-reflection component with journaling about participants' feelings and responses to their elderly patient might also augment their understanding of how their preconceived conceptions regarding the elderly were or were not supported.[10]

Overall, although participant attitudes toward older adults and toward geriatrics as a career choice did not significantly change pre- to post-program, results of this study suggest that a semester-long, geriatric interprofessional clinical education program may be effective in generating early interest in geriatrics and older adult issues in health profession student participants. Studies that examine coursework emphasis versus hands-on exposure would be helpful, as most studies seem to explore one or the other. Use of the same instrument would facilitate comparing results between studies. Adding self-reflection and self-assessment may further enhance positive attitudinal changes toward the elderly. Continued efforts to establish optimal training strategies to improve attitudes toward working with the elderly are needed. Reducing ageism in medical and health profession students worldwide and increasing their knowledge of geriatrics are the keys to providing quality care to the elderly.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Gould ON, MacLennan A, Dupuis-Blanchard S. Career preferences of nursing students. Can J Aging 2012;31:471-82.  Back to cited text no. 1
[PUBMED]    
2.
Hean S, Smith S. Interprofessional collaboration when working with older people. In: Barker S, editor. Caring for Older People in Nursing. Los Angeles: Sage Publishers; 2013. p. 191-209.  Back to cited text no. 2
    
3.
Gonçalves DC. From loving grandma to working with older adults: Promoting positive attitudes towards aging. Gerontol Geriatr Educ 2009;35:202-25.  Back to cited text no. 3
    
4.
Furze J, Lohman H, Mu K. Impact of an interprofessional community-based educational experience on students' perceptions of other health professions and older adults. J Allied Health 2008;37:71-7.  Back to cited text no. 4
[PUBMED]    
5.
Basran JF, Dal Bello-Haas V, Walker D, Macleod P, Allen B, D'Eon M, et al. The longitudinal elderly person shadowing program: Outcomes from an interprofessional senior partner mentoring program. Gerontol Geriatr Educ 2012;33:302-23.  Back to cited text no. 5
    
6.
Liu YE, While AE, Norman IJ, Ye W. Health professionals' attitudes toward older people and older patients: A systematic review. J Interprof Care 2012;26:397-409.  Back to cited text no. 6
    
7.
Hollar D, Roberts E, Busby-Whitehead J. COCOA: A new validated instrument to assess medical students' attitudes towards older adults. Gerontol Geriatr Educ 2011;37:193-209.  Back to cited text no. 7
    
8.
Denton GD, Rodriguez R, Hemmer PA, Harder J, Short P, Hanson JL. A prospective controlled trial of the influence of a geriatrics home visit program on medical student knowledge, skills, and attitudes towards care of the elderly. J Gen Intern Med 2009;24:599-605.  Back to cited text no. 8
    
9.
Clark RB, Flood MT. Exploring knowledge and attitudes toward aging among nursing and nonnursing students. Gerontol Geriatr Educ 2009;35:587-95.  Back to cited text no. 9
    
10.
Desjarlais M, Smith P. A comparative analysis of reflection and self-assessment. Int J Proc Educ 2011;3:3-18.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2]


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