4Ms for age-friendly chiropractic care: student perceptions following a brief educational intervention

Health care organizations and professionals are encouraged to adopt the 4Ms of age-friendly health systems to improve clinical care for older adults. This project explored chiropractic student perceptions of the 4Ms (what matters, mobility, mentation, medication) before and after a brief educational intervention. This study used a pretest, posttest design with multiple student cohorts enrolled in a required geriatrics course. Over 4 cohorts, 298 students participated in 50-minute 4Ms training and in-class discussions, 295 self-rated their 4Ms knowledge on a 5-point scale, and 182 provided written feedback. The percentage of students who self-rated their 4Ms knowledge as high/very high before versus after training were: 4Ms description (0% vs. 74.5%); 4Ms general use (0.3% vs. 66.3%); teach others about 4Ms (0% vs. 50.5%); and implement 4Ms in clinical practice (0.3% vs. 55.6%). In the written feedback, 133 students described 1 M (n = 63), 2 Ms (n = 27), 3 Ms (n = 14), 4Ms (n = 14), or the 4Ms general framework (n = 15). Feedback included examples of welcoming older adult clients, age-friendly office layout, care protocols, and changes in knowledge or confidence. Students who participated in an educational intervention reported higher 4Ms self-knowledge and identified ways to integrate 4Ms into age-friendly chiropractic care. Targeted, skills-based training may enhance 4Ms implementation into clinical practice.