The aging of the US population is creating an increased need for physicians who are skilled in the care of older adults. However, many surveys suggest that physicians and medical students hold negative attitudes toward working with older adult patients, or lack knowledge on the treatment of older adults.
Interventions designed to improve physicians’ attitudes toward older adult patients have seen mixed success. To address this, a group of researchers conducted a systematic review of literature on attitude-focused interventions for physicians and medical students, examining which traits and conditions are associated with greater success among interventions to improve physicians’ attitudes about older adult patients.
The primary author screened over 12,000 potentially relevant research publications, identifying a total of 27 studies that were relevant for the research question. To be included in the review, studies had to assess a geriatric-based intervention, measure medical students’ or physicians’ attitudes toward older adult patients both before and after the intervention, and report the relevant statistical information. For each of the 27 studies, the authors identified the type of intervention, the length of the intervention, and whether the content of each intervention focused on increasing empathy, increasing knowledge, or both. (Other methodological variables were identified and assessed as well.)
The authors found that the only factor that was significantly associated with positive attitude change was the content of the intervention. Interventions that included empathy-building components, such as aging simulation exercises and time spent with healthy older adults, were significantly more likely to improve attitudes to older adults. Eleven of the 16 studies that included empathy-building improved doctors’ attitudes, and only three of the 11 studies that focused solely on knowledge-building, were successful.
The authors claim that the overall body of research on this topic shows several methodological weaknesses. Over half of the studies lacked a comparison or control group, while several used inappropriate statistical analyses or used measures that were not formally validated (or assessed as to whether a test meaningfully measures the phenomenon that it is intended to measure).
This review suggests that empathy-building may be a useful tool for improving physicians’ attitudes toward working with older adult patients, but that improved research methods are needed in the assessment of such interventions.
Samra R, Griffiths A, Cox T, et al. Changes in medical student and doctor attitudes toward older adults after an intervention: a systematic review. Journal of the American Geriatrics Society. (2013). DOI: 10.1111/jgs.12312