Designing and evaluating an episodic, problem-based geriatric curriculum.
BACKGROUND
Medical school geriatric training has been directed primarily at improving students' attitudes and knowledge about elderly patients. This study evaluated a clinical problem-based geriatric course for medical students.


METHODS
The two-semester geriatric course was presented to 136 second-year medical students. Faculty taught students about clinical reasoning in ambulatory geriatrics using written cases, patient-actors, literature reviews, lectures, and discussions. At the end of the course, students' clinical activity was evaluated using audiotaped interviews with standardized geriatric patients. A questionnaire examined students' knowledge, attitudes, and their evaluation of the course.


RESULTS
All 136 students completed the post-course standardized patient interview, and 105 (77%) completed questionnaires. Students rated the course favorably and had high confidence scores for ability to assess geriatric problems. Students' knowledge increased during the course compared to a precourse examination (P less than .05). Evaluation of post-course standardized patient interviews revealed that students who scored higher on the knowledge test tended to ask more psychosocial questions during the interview (r = 0.38). Students who scored higher on the attitude test spent more time eliciting patients' feelings during the interview (r = 0.38). Those with lower scores on the attitude test spent more time asking factual, nonpsychosocial questions (r = 0.28).


CONCLUSIONS
A clinical problem-based geriatric course for preclinical medical students can be successful in improving students' knowledge. Attitudes and knowledge effect the questions a student asks during the medical interview.
Nieman
L Z
LZ
Office of Medical Education, Medical College of Pennsylvania, Philadelphia 19129.
Vernon
M S
MS
Horner
R D
RD
D001291:Attitude of Health Personnel; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D017050:Episode of Care; D005194:Family Practice; D005853:Geriatrics / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011340:Problem Solving; D015397:Program Evaluation; D011795:Surveys and Questionnaires