Grosse Anna, Kokorelias Kristina
Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
National Institute on Ageing, Toronto Metropolitan University, Toronto, Ontario, Canada.
Australas J Ageing. 2025 Mar;44(1):e70016. doi: 10.1111/ajag.70016.
Ageism is a significant issue in health care and exists among medical learners in the teaching hospital setting. To highlight potential strategies and interventions that may address ageism among medical students and junior doctors, we aimed to explore and understand the educational factors within hospital training environments that influence the attitudes of medical students and junior doctors towards older inpatients.
A scoping review of academic peer-reviewed English literature was conducted using seven academic databases. The first 100 results of an advanced Google Scholar search were also screened. One researcher screened identified articles and extracted relevant data from those that were included. Two researchers analysed the data using a modified content analysis.
A total of 18 articles were included for review, published between 1982 and 2023, mostly from English-speaking countries. The articles described factors contributing to both positive and negative attitudes of medical students and junior doctors towards older inpatients. Four themes regarding these attitudes were identified: (1) the intersectionality of patient age, comorbidity and complex care needs; (2) the hospital environment; (3) clinical interactions; and (4) training in and exposure to Geriatric Medicine.
There are several educational factors in the hospital training environment that affect the attitudes of medical students and junior doctors towards older inpatients. Exposure to and training in Geriatric Medicine may promote more positive attitudes towards older inpatients, but further research is required to determine whether this is of clinical significance.
年龄歧视是医疗保健中的一个重要问题，在教学医院环境中的医学学习者中也存在。为了突出可能解决医学生和初级医生中年龄歧视问题的潜在策略和干预措施，我们旨在探索和了解医院培训环境中影响医学生和初级医生对老年住院患者态度的教育因素。
使用七个学术数据库对学术同行评审的英文文献进行了范围综述。还筛选了谷歌学术高级搜索的前100个结果。一名研究人员筛选了已识别的文章，并从纳入的文章中提取了相关数据。两名研究人员使用改进的内容分析法对数据进行了分析。
共纳入18篇文章进行综述，发表时间为1982年至2023年，大部分来自英语国家。这些文章描述了导致医学生和初级医生对老年住院患者产生积极和消极态度的因素。确定了关于这些态度的四个主题：（1）患者年龄、合并症和复杂护理需求的交叉性；（2）医院环境；（3）临床互动；以及（4）老年医学培训和接触。
医院培训环境中有几个教育因素会影响医学生和初级医生对老年住院患者的态度。老年医学培训和接触可能会促进对老年住院患者更积极的态度，但需要进一步研究以确定这是否具有临床意义。
