Effect of extracurricular geriatric medicine training: a model based on student reflections on healthcare delivery to elderly people.

Although many professional and accrediting bodies have identified competencies for medical students pertaining to caring for older patients, including understanding the basics of the healthcare delivery system, the highly structured curriculum in medical school provides few opportunities for these competencies to be achieved. One possible solution is to let students participate in geriatrics-related extracurricular educational and clinical activities and ask them to reflect on their experiences. This article presents the results of a qualitative analysis of student reflections from participating in such a program implemented at the University of Cincinnati College of Medicine. One hundred thirty of 321 student journal entries (collected over 3 academic years) containing any mention of the healthcare system were qualitatively analyzed. The themes and resulting model that emerged from the data includes three distinct levels of healthcare delivery: individual, organizational, and systems. Each level is presented and explained using illustrative student quotes. As a whole, the model indicates that students in this innovative extracurricular experience gained important knowledge about how medical care is provided to elderly people. The model developed may provide additional structure for future medical students as they reflect on their early encounters with the complex health and social forces affecting the quality of care received by older adults.