title: What students experienced: a narrative analysis of essays written by first-year medical students participating in a geriatrics home visit.
abstract: OBJECTIVE
  To develop a house call experience for first-year medical students introducing them to challenges that homebound, chronically ill elderly adults face.
  
  
  METHODS
  During the semester, two students were paired with a preceptor to see two to three patients.
  
  
  METHODS
  The house call practices of the Division of Geriatric Medicine at the University of Pennsylvania and the Philadelphia Veterans Affairs Hospital.
  
  
  METHODS
  One hundred sixty-five first-year medical students.
  
  
  METHODS
  Pairs of students worked together to write an essay after the visit. Essays addressed specific areas, as detailed in a provided checklist, including noting patients' functional limitations, identifying community supports available to patients, and writing about general surprises that the students discovered during their visit. These data were then measured using narrative analysis.
  
  
  RESULTS
  In all domains, students identified core goals and objectives. In the first domain (meeting challenges of functional limitations), students recognized the importance of family support. In the second domain (mentioning of functional limitation), high levels of compliance were seen. In the third domain (community support), students mentioned specific formal supports. In the fourth domain (surprises during the visit), students identified many important geriatrics concepts.
  
  
  CONCLUSIONS
  In writing their essays, students demonstrated a high level of recognition of functional impairment and noted the importance of family, social networks, and home environment in enabling homebound, chronically ill elderly adults to stay in their homes. Many students also demonstrated an awareness of the possibilities of independence and happiness despite significant illness and disability.
authors.affiliation: Department of Family and Community Medicine, Christiana Care Health System, Wilmington, Delaware.
authors.forename: Linsey
authors.initials: L
authors.lastname: O'Donnell
authors.forename: Lesley
authors.initials: L
authors.lastname: Carson
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Forciea
authors.forename: Bruce
authors.initials: B
authors.lastname: Kinosian
authors.forename: Judy
authors.initials: J
authors.lastname: Shea
authors.forename: Jean
authors.initials: J
authors.lastname: Yudin
authors.forename: Rachel K
authors.initials: RK
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D005853:Geriatrics / Q000193:education*; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015143:Philadelphia; D013337:Students, Medical
keywords: house calls; medical education; medical students; narrative analysis