[Medical students' image of the elderly and the effect of medical education: a literature review].

In American studies in the sixties and seventies caregivers, including physicians, showed a negative attitude towards the elderly. There are indications that such a negative attitude affects the quality of care and the communication with the elderly. Based on predominantly American literature this article reviews research on medical students' knowledge about and attitudes towards older people as well as the impact of geriatric training on the image of older patients and physician-patient communication. In medical students who did not receive a geriatric training, attitudes improved in the eighties and nineties up till a slightly positive level but general gerontological knowledge displayed as many shortcomings as in former days. A few studies show that instructional modules in geriatrics do not have an impact on the attitude towards the elderly. Several studies show that contact with aged persons has a positive influence. Rather than geriatric residency or work in a nursing home, contact with healthy elderly has favourable effects. Attitude improvement based on interactions with older people is maintained during medical education. A program in gerontology as well as geriatric instructional modules can lead to knowledge improvement. Since significantly positive correlations between knowledge and attitude are sometimes demonstrated, increasing gerontological knowledge may lead to more positive attitudes.