In this study, we found that instruction employed in this geriatric clerkship was useful for medical students regardless of their career choice. To our knowledge, this is the first study to report a geriatric clerkship in post-acute care settings. Post-acute care is a valuable aspect of healthcare for patients with an array of medical and surgical problems such as injury, surgery, illness and exacerbation of chronic disease,2
and is relevant to both medical and surgical specialties. Thus, post-acute care provides a unique learning experience to students with various career choices, either in medical or surgical specialties.
Another novel aspect of this clerkship is the Geriatric Interdisciplinary Care Summary (GICS), a newly developed tool that helps students integrate their knowledge and skills into overall management of medically complex older patients. Previous research reveals that the quality of interdisciplinary care documentation is associated with an improved comprehensiveness and accuracy of care planning processes for medically complex patients in nursing homes.14–17
While written interdisciplinary care plans have been previously used as a didactic tool for nursing education,18–20
to our knowledge interdisciplinary care plans have not been employed in medical school education. Our study provides evidence that the GICS is a useful tool in training medical students on post-acute care of older patients.
Our study was limited because the results of this study may not be applicable to the general population of U.S. medical students. The study participants were a cohort of fourth-year medical students from a single medical school. Additionally, the response rate from students was 75 %. Because their participation in the online survey was voluntary, students who had a low interest in geriatrics or rehabilitative care might not have participated in a survey. Nevertheless, results of this study provide evidence that instruction employed in this geriatric clerkship was acceptable to most medical students.
In our study, students rated the web-based interactive learning modules as good to excellent, but not unanymously excellent. Previously, web-based learning modules on geriatrics have been primarily used for training residents and faculty physicians.21–25
Web-based learning modules have been used to train medical students in other clerkships such as pediatrics and emergency medicine.18,26
In these clerkships, medical students rated web-based learning modules as good to excellent, which is similar to our results. In our geriatric clerkship, the web-based learning modules cover only two aging syndromes on falls and dementia. Students’ rating for the web-based learning modules may improve if we provide additional modules on other common aging topics such as delirium, urinary incontinence, and pressure ulcer.
Students also rated the overall geriatric clerkship as good to excellent, but not unanymously excellent. This may be because our geriatric clerkship was a discrete two-week course offered during the fourth-year in medical school. Previously, a vertically integrated curriculum intervention throughout the entire 4-year undergraduate medical education demonstrated improved medical students’ knwoledge, skills and positive attitudes toward medically complex older patients.27
Students’ rating on overall geriatric clerkship may improve if instruction in the clerkship is presented to medical students throughout the entire 4-years in medical school.
Our goal of this initial study was to describe the newly developed geriatric clerkship and evaluate students’ perceptions about the clerkship. Other learning outcomes specific to post-acute care training have not been implemented at the time when this study was conducted. Future research is needed to implement learning outcomes such as medical students’ knowledge, skills and behaviors in providing better care to older patients in post-acute care. Additionally, the web-based learning modules, the GICS, and the scales used in this study were newly developed for this clerkship, and have not been previously validated. Future research is needed to test the validity of these instructional methods and scales for post-acute care training.
Despite these limitations, this study’s findings show that learning experiences in our geriatric clerkship were useful to medical students. Even among students whose career choices were not in primary care, geriatrics was an effective modality providing interdisciplinary care training. Future studies are needed to explore whether geriatric clerkships such as this will improve students’ ability to provide quality care to medically complex older patients.