Southern Cross Care SA and NT
Medical students learning from us
Southern Cross Care SA and NT
Pines Lodge Nursing Home
Pines Rehabilitation Service
Residential and Home Care - Metropolitan, 80 + beds
Workforce, Health and wellbeing, Communication and engagement
About the program
Every three weeks a group of 4th and 5th year medical students spend one day with our aged care service to learn about exercise from older adults who embrace healthy ageing.The students join three exercise groups of varying functional levels across community and residential services. All groups are made up of motivated older adults who are passionate about sharing their knowledge with the next generation of medical professionals. Students are encouraged to learn as much as possible from the older adults; to try their exercises, to ask why they exercise, the benefits they gain from exercising and their advice for other older adults.
83 students and over 83 customers have participated in the program since January 2015. From this one day of engagement with healthy older adults, 60% of students report an increased interest in working with older adults. We believe the success of the program is because of the energy, enthusiasm and wisdom of the older adults who share their expertise with the students. The positive change can be explained by the theory of inter-generational learning – the belief that older adults have much to teach younger people and that when younger people have positive experiences with older adults they attain more positive attitudes and are more willing to work with older adults into the future. Our customers are proud of the impacts they are having and believe this program will contribute to future medical professionals in South Australia who promote healthy ageing and exercise for all older adults.
What we did
During Healthy Ageing training staff frequently asked, “Are doctors getting this training too?” So in December 2014 meetings were held with Adelaide University’s G-TRAC centre about hosting placements to promote healthy ageing to medical students.
This idea was welcomed by the University as:
1. It aligned with their philosophy of two-way learning between older adults and medical students
2. They were seeking organisations to host students for their geriatric and community services rotations
We agreed that the learning focus of the placement would be:
- Exercise for healthy ageing
- Across community and residential aged care services
- Interpersonal interaction between older adults and the students to learn from each other
Next we sought older adults willing to teach the students. We approached several community exercise groups and discussed the medical student idea with them. We:
• Showed the G-TRAC video about their mutual learning philosophy
• Asked if students could join their class over the year
• Asked if they would be happy to share their stories with students
• Asked if they would like to join a morning tea with students
Two groups were enthusiastic and volunteered to be the medical student hosts. As one member of the advanced exercise group said, “We’ll show them what we can do!”
Staff were invited to share their knowledge with the students. Nursing, physiotherapy, occupational therapy and fitness professionals volunteered to be part of the programme.
The student learning plan was developed around these exercise groups, staff expertise and embedding the concept of inter-generational learning to:
- Recognise the wisdom of older adults
- Provide students with the opportunity to meet healthy older adults
- Promote the right to health and best practice for healthy ageing
- Create an enjoyable experience for the students to foster more positive attitudes about older adults (Heo et al. 2014)
The one-day learning programme included participation in exercises, informal discussion opportunities, workshop on healthy ageing theory and practice, written resources, morning tea with customers, resident interview and case study and reflection. The customers in each of the community exercise groups were provided with a timetable of the dates the students would be joining them.
On the day it is reinforced to students that these older adults are healthy ageing champions. Students are asked to engage with them as much as possible to learn how and why they exercise and to gain advice they could use with patients in the future.
The evaluation plan for the programme included:
- Reflection and evaluation by students at the end of each placement – written and group discussion
- Annual customer survey
- Ongoing informal customer and staff feedback
In addition, the university independently undertook research on the impact medical student placement with healthy older adults.
In the later half of 2015 the student programme was modified from a case study in the residential facility to joining customers in the newly opened Wellbeing Centre gym to strengthen learning that exercise is possible and beneficial for all older adults.
Why we did it
Many of our customers and staff relate stories of medical professionals projecting ageist attitudes – it is just your age, there is nothing we can do, you can’t expect more at your age, you’ll have to get used to it are just some of the limiting opinions medical professionals have told older adults receiving our services. These statements from respected medical professionals have negative impacts and prevent older adults from achieving their healthy ageing potential.
The aim of this project was to demonstrate the abilities of older adults to the students so they will promote healthy ageing throughout their medical career. Early in their studies medical students are only exposed to sick older adults in hospital beds where they focus on pathologies. This reinforces negative ageist stereotypes about older adults. Our strategy used the theory of inter-generational learning where older adults are educational partners. Students are provided with positive experiences of meeting and working with older adults to create more positive attitudes and a willingness to work with older adults in their careers (Reitmaier et al. 2014).
- For students to meet and engage with healthy and positive older adults
- For older adults to demonstrate their capabilities and teach their healthy ageing strategies to the students
- To illustrate how exercise services can create benefits for all older adults across the life-course and for people at all functional levels
- Introduce medical students to the aged care services available for the health promotion and recovery of older adults
Who worked with us
Key participants in this initiative are the community and residential customers who welcome the students into their exercise group and share their knowledge and experience with them.
53 older adults have taught the medical students in the advanced and intermediate community exercise groups. The average age of these customers is 80, with the oldest community exercise participant being 95 years of age. 77% of exercise group customers are female.
One community customer now participates in delivering the information workshops to the students, including involvement in the workshops and leading discussion in the morning tea with the students.
21 residential aged care customers participated in an interview and case study with the medical students in 2015.
9 residents have been part of the student learning in the Wellness Centre gym in 2016. These are people who attend the Wellness Centre two to four times a week and have a regular booking for Thursday afternoons when the medical students are present.
2. University – G-TRAC staff
The G-TRAC university staff organise the students’ attendance, provide support and evaluate the programme. We work with medical teaching and administration staff from G-TRAC.
The aged care staff participating in the programme are:
– Physiotherapy x3 residential aged care
– Occupational therapy x1 community and x1 residential
– Fitness community x2 and residential x2
– Nursing residential x2
– Management x3
4. Medical students
83 medical students from 4th and 5th year have participated in the programme.
What we learned
Our ultimate objective to improve healthy ageing knowledge and attitudes in medical students was achieved - 60% of students report increased interest in working with older adults after spending time with our customers.
Students learnt what motivates older adults to exercise:
- Engagement in life – “Multiple reasons – they want to look after their grandchildren, move around, do activities with their partner”
- Recovery and health maintenance – “Many were motivated by seeing improvements in their health and recovery after surgery”
- Doctor’s recommendation – “One woman said she was partly here because her GP told her to come”
- Independence – “Wanting to stay independent and living in their own home”
- Success of others – “Hearing inspiring stories from other clients who have improved their health through exercising”
- Social – “They like the social aspect of the exercise group having many opportunities for fun, to chat and catch up with each other”
- Energy – “Some found it relieves pain and gives energy”
Insights gained to use in their clinical practice include:
- “Knowing about these services and advising older adults on how to access them”
- “Understanding what motivates an individual to stay active and encourage them with this”
- “Describe more specifically what kinds of exercise are possible and beneficial in the older generation
- “I have learnt that health promotion is not only for the young. Frailty can be managed, reversed and shortened through exercise and effort on the part of both the client and health professionals”
- “Encouragement of mobilisation and physical activity within the hospital to prevent decline”
- “Include exercise groups in treatment plan for depression”
Common reflection themes included:
- Many had never been in a residential facility before and the students were impressed by the quality and thoroughness of the care plans
- Surprised by how old, strong and fit members of the advanced group were
- Opened their eyes to life after discharge and rehabilitation potential
In November 2015 customers from the community exercise groups provided verbal and written feedback about their experience. Survey results were overwhelmingly positive with almost everyone saying they found the experience positive, and and felt that they contributed to the medical students’ learning.
Mrs F is 93 and has lived in our residential facility for four years. She has always been active; from her days in the RAF during WW2 and through lifelong exercise. Mrs F now attends the Wellness Centre twice a week, including on Thursdays when the medical students are present. She enjoys the social aspect of meeting the students and likes to share her advice with the next generation coming through. Mrs F’s advice – Have a healthy lifestyle, keep exercising and drink in moderation.
As part of mutual learning, the medical students made recommendations from their resident interviews. They identified individual care recommendations and broader whole of service suggestions. For example, the students recognized the importance of socialising in community exercise groups, but in residential exercise was individual. They recommended social engagement be included in all exercise in the residential facility. As a result, social wellbeing objectives were included in the new Wellness Centre policy and procedures.
We also learnt that just one positive day can make a real difference to attitudes about older adults. We were surprised by how surprised the medical students were at the abilities of our customers. We see what older adults can achieve every day, but it was a new and unexpected experience for these young students. The enjoyment of exercising and talking with the older adults created new opinions and attitudes that we hope will have healthy ageing benefits for all the older adults they work with in the future.
More information on this program:
Kate Kennett, email@example.com or phone 1800 852 772.