Attitudes of beginning medical students toward older persons: a five-campus study. The University of California Academic Geriatric Resource Program Student Survey Research Group.
OBJECTIVE
To examine the attitudes of beginning medical students toward older persons and their medical care.


METHODS
Cross-sectional survey.


METHODS
Five University of California medical schools.


METHODS
Beginning medical school students from the Class of 1994.


METHODS
Demographic characteristics, personal contacts with older persons, and previous coursework or research experience with older persons were assessed. Knowledge with regard to aging was measured with a group of 10 questions, which were modified from the Facts on Aging Quiz. The attitudes of students toward older persons were assessed using the Aging Semantic Differential (ASD), the Maxwell-Sullivan Attitude Scale (MSAS), and two case scenarios.


RESULTS
Ninety-two percent of the participants (554 of 603) responded; 93% of these responses were usable. Students were much less likely to admit an acutely ill 85-year-old woman to an intensive care unit, intubate her, and treat her aggressively than they were to treat an acutely ill 10-year-old girl with underlying chronic leukemia. In multivariate models, male gender and younger student age were both independently predictive of less favorable attitudes regarding a 70-year-old person on the ASD Instrumental-Ineffective subscale. Asian-Americans and males had less favorable attitudes on the Autonomous-Dependent and the Personal Acceptability-Unacceptability subscales. More knowledge with regard to aging was predictive of more favorable attitudes on the Autonomous-Dependent and Personal Acceptability-Unacceptability subscales. Male gender and Asian-American ethnicity were significantly associated with less favorable attitudes on the two scales derived from the MSASs. Students who had previously visited a long-term care facility were more likely to disagree that it takes too much time to care for older persons.


CONCLUSIONS
Beginning medical students have already formed some unfavorable attitudes about older persons. Few independent predictors (either sociodemographic or students' previous experiences) of student attitudes could be identified that would help in the selection of students who had more favorable attitudes toward older persons. Hence, attempts to generate physicians with good attitudes must rely on curricular efforts during medical school and residency training.
D000328:Adult; D000367:Age Factors; D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D005853:Geriatrics / Q000193:education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D018579:Patient Selection; D011237:Predictive Value of Tests; D011287:Prejudice; D012659:Semantic Differential; D012959:Socioeconomic Factors; D013337:Students, Medical / Q000523:psychology*; D028761:Withholding Treatment