Dr. Bensadon is adjunct instructor, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Dr. Teasdale is professor and vice chair, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Dr. Odenheimer is associate professor and clerkship director, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, and staff physician, Oklahoma City VA Medical Center, Oklahoma City, Oklahoma.
Acad Med. 2013 Nov;88(11):1630-4. doi: 10.1097/ACM.0b013e3182a7f071.
For more than half a century, scientific research has documented widespread avoidance and even denial of aging. Though nothing new, aversive reactions to the elderly are not only unfortunate but dangerous today, as increasing life expectancy and consequent demand for specialized geriatric medical care vastly outpace the supply of qualified clinicians equipped to provide it. This discrepancy has led to a crisis that is not easily resolved. At the same time, geriatrics reports the highest level of physician satisfaction among medical specialties. How can this apparent disconnect be explained, and what can be done about it? Citing evidence from medicine and other health care disciplines, the authors address these questions by emphasizing the role of aging-related attitudes, a complex but theoretically modifiable construct. Successful educational interventions are described, including the authors' experience at the helm of a monthlong geriatrics clerkship for fourth-year medical students. Novel suggestions are provided to combat the daunting challenges to achieving a workforce that is sufficient both in number and training to effectively meet the needs of the fastest-growing segment of the U.S. population. As patients continue to age across most medical specialties, the importance of geriatric curricula, particularly those sensitizing learners to the need for a systems-based, biopsychosocial (i.e., interdisciplinary) model of care, cannot be overemphasized. Such training, it is argued, should be a standard component of medical education, and future research should focus on identifying specific curricular content and teaching methods that most effectively achieve this end.
半个多世纪以来，科学研究已经证明了广泛存在的回避甚至否认衰老的现象。尽管这并非新鲜事，但对老年人的反感不仅不幸，而且在今天还很危险，因为预期寿命的延长以及随之而来的对专门老年医学护理的需求，大大超过了能够提供这种护理的合格临床医生的供应。这种差异导致了一场不易解决的危机。与此同时，老年医学报告称，在医学专业中，医生的满意度最高。如何解释这种明显的脱节现象，又能对此做些什么呢？作者通过强调与衰老相关的态度这一复杂但理论上可改变的概念，引用医学和其他医疗保健学科的证据来回答这些问题。作者描述了成功的教育干预措施，包括他们在为四年级医学生开设为期一个月的老年医学实习课程中的经验。作者还提出了一些新颖的建议，以应对实现足够数量和培训的劳动力的艰巨挑战，以有效满足美国人口增长最快部分的需求。随着患者在大多数医学专业中继续老龄化，老年课程的重要性，特别是那些使学习者认识到需要基于系统的、生物心理社会（即跨学科）护理模式的课程，怎么强调都不为过。有人认为，这种培训应该成为医学教育的一个标准组成部分，未来的研究应该集中于确定最有效地实现这一目标的具体课程内容和教学方法。
