Pilot program made first-year medical students more sensitive to older people

Creating art with older "teammates" made first-year medical students more sensitive to older people, according to results of the Vital Visionaries Collaboration (VV), a pilot program developed by the National Institute on Aging in conjunction with the Johns Hopkins School of Medicine and the American Visionary Art Museum in Baltimore, MD.

"Medical students who participated in this program had a more positive attitude towards older people and the older participants had a chance to explore their creative sides. It's wonderful when serious learning can be achieved amid a great deal of laughter and good will," said Judith A. Salerno, M.D., M.S., NIA Deputy Director. "Too often medical students only interact with ill and frail older people. The first step towards improving care for older people is to improve how medical students view them."

Launched in March 2004 as a pilot project, the VV program paired 15 first-year medical students from Johns Hopkins with 15 older people from the Baltimore area. The two-person teams met and learned from older visionary artists, took a contour drawing class, and worked on various art projects at AVAM in conjunction with its year-long exhibition, "Golden Blessings of Old Age/Out of the Mouths of Babes." Visionary art is produced by self-taught individuals, usually without formal training, whose works arise from an innate personal vision that revels foremost in the creative act itself, according to AVAM (www.avam.org).

Compared to non-participating students, the VV medical students showed a statistically significant improvement in their attitudes towards aging and older people in most areas tested by the Aging Semantic Differential scale. After participating in the 4-part art program, 11 of the 15 participating students said they would like to have greater numbers of older patients in their future practices compared to only 2 non-participating medical students. All of the Vital Visionary medical students disagreed with the statements that working with older patients would be less interesting than working with younger patients and that older people are difficult to talk to.

However, among the non-participating medical students, only 60% disagreed with the statement that older patients would be less interesting to work with and 80% disagreed that older patients are difficult to talk to. The number of VV students who were interested in obtaining specialized training in geriatrics doubled in comparison to their interest prior to the program. While still a pilot program, the results were encouraging, Salerno said. The NIA plans to make information available to others interested in starting a similar program.

"We have been looking for ways to improve the way medical students are educated about the world around them and to better connect with people who are coming to them for help. The Vital Visionaries has been a great way to forge those connections," said Jean Ogborn, M.D., who coordinates the JHM's Physician in Society class. "We hope to keep the Vital Visionaries going in some fashion."

The numbers of physicians who specialize in medical problems associated with aging are declining just as the need for their services is increasing, according to a 2004 study contracted by the Association of Directors of Geriatric Academic Programs. Currently, there are about 7,500 geriatricians in the U.S. The group estimates 36,000 geriatricians will be needed by 2030 to treat the growing numbers of older people.

"Can anyone imagine the good that would come from museums across the country celebrating the creativity and vibrancy of their community's oldest citizens? By enlightening a new generation of physicians with first-hand knowledge that 'old' can mean the best, the wisest, and the most fun that one can be, our Vital Visionaries experience surpassed all our expectations and made great use of the museum as an agent of positive change," said Rebecca Hoffberger, AVAM founder and director.

The Vital Visionaries program was based on a study conducted by Dr. Marie A. Bernard and investigators at the University of Oklahoma's Reynolds Department of Geriatric Medicine. Their study, published in the Journal of the American Geriatrics Society (March 2003), observed that "healthcare professionals tend to believe that most older individuals are frail and dependent and that those who are not are atypical" despite data showing that most elders are in good health and live in the community.

To view the final report, please go to http://www.nia.nih.gov/research/meetings/vvcreport.htm.