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Mi Casa o Su Casa? Assessing function and values in the home
Annette Medina-Walpole1, Brian Heppard, Nancy S Clark
1Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. annette_medinawalpole@urmc.rochester.edu <annette_medinawalpole@urmc.rochester.edu>
Journal of the American Geriatrics Society
|January 28, 2005
Summary
Integrating home visits into medical training enhances student understanding of geriatrics, chronic illness, and palliative care. This experience improves patient-centered skills and attitudes toward homebound patients.
Area of Science:
- Medical Education
- Geriatric Medicine
- Palliative Care
Background:
- Traditional clinical training for medical students primarily occurs in hospitals and offices.
- Home environments present unique health challenges for patients, especially older adults, those with chronic illnesses, and end-of-life patients.
Purpose of the Study:
- To integrate geriatrics, primary care, and palliative care into medical student education through home visits.
- To enhance ambulatory clerkship curriculum with a home visit experience.
Main Methods:
- Medical students conducted three home visits per patient, guided by faculty.
- Visits focused sequentially on medical diagnoses, functional assessment/geriatric syndromes, and psychosocial/end-of-life values.
- Students submitted a 2,000-word write-up and presented cases in facilitated small groups.
Main Results:
- 83% of students reported positive feedback on the home visit experience.
- Students demonstrated improved knowledge of functional assessment, geriatric syndromes, and chronic illness progression.
- Students recognized the value of home visits for understanding psychosocial aspects, patient-centered care, and patient beliefs.
Conclusions:
- Longitudinal home visit experiences can effectively enhance geriatric, ambulatory, and palliative care education for medical students.
- This approach positively influences students' attitudes towards chronically ill and homebound populations.
- The experience may encourage students to pursue careers in house calls.