Preparing medical graduates to care for geriatric patients: A case study of the undergraduate medical curriculum at a South African university

Abstract

Background: Medical schools in South Africa must be responsive to the health needs of the rapidly ageing population. Reports of the poor quality of care received by elderly patients raises concerns about the training of medical students. A review of the curriculum can help to assess current geriatric care training and identify the areas in need of improvement. This study was conducted to describe the nature and scope of undergraduate medical education in geriatric care at a South African university. Methods: An exploratory, descriptive case study was conducted to analyse the learning objectives, opportunities and outcomes of the 6-year undergraduate medical program. Data included an electronic curriculum supported by student and teacher guides. Semi-structured interviews were conducted with health professions educators. Results: The curriculum covered key geriatric competencies that included addressing geriatric syndromes and conducting a comprehensive geriatric assessment. Teaching on geriatric competencies occurred mainly in the clinical years, was integrated and no sub-minima was applied in its assessment. Teaching occurred in disciplinary silos with little involvement of the multidisciplinary team. Learning objectives and assessments focussed on geriatric knowledge and skills. Conclusion: The curriculum targets the development of student geriatric knowledge and skills, but not student attitudes towards caring for older patients. However, a national curriculum will ensure greater coverage of geriatric care competencies, particularly advocacy and attitudes towards caring for geriatric patients. Greater engagement with stakeholders in geriatric health care will inform suitable educational guidelines for undergraduate medical education in geriatric care at this institution. This may also contribute to a standardised national curriculum.