Office of
Medical Student Education
Optimal Aging Program
A MENTORING
EXPERIENCE FOR MEDICAL STUDENTS
4th Year elective credit
Dean’s letter entry
The Optimal Aging Program has proven to be a unique and valuable elective experience for many students in a wide range of specialties. Through this innovative elective, The University of Arizona College of Medicine has responded to the need to enhance geriatric-related education in all four years of medical school. Such educational efforts are imperative: In Arizona, the population of individuals over age 65 increased 62% between 1990 and 2005! Nation-wide, the increase was 18%. It is clear that future physicians must be trained to provide competent and compassionate care for older adults.
The Optimal Aging Program provides students with the opportunity to:
Ø develop a relationship with an older adult who continues to be active in their community;
Ø expand their concepts of aging to include the increasing reality of healthy, active older adulthood;
Ø define what successful aging means to an older adult;
Ø identify the role of exercise, nutrition, spirituality and mental attitude in reducing risk factors and preventing premature aging;
Ø develop an appreciation of the heterogeneity of older adults’ levels of activity, social engagement, intellectual ability and overall health;
Ø reflect and document their own thoughts about the aging process, influence of ageism, and how societal attitudes shape the way older adults are treated and cared for.
The Optimal Aging Program (INDR 891A) is a longitudinal mentoring experience for medical students spanning their four years of medical school. Based on completing all of the requirements, students earn three (3) elective credits (students enrolled prior to 2006 earn two (2) elective credits). The Program includes:
· One-on-one mentoring with a healthy older adult (65+ years) in the Tucson community (or Phoenix community during clinical years).
· Optional one-on-one precepting with a physician who has a large number of older adult patients.
· Student/Mentor Orientation
· Educational Seminars
· Excursions with Mentor
· Roundtable Discussions and Workshops
· Journal reflections / Yearly papers
For the purposes of the Optimal Aging Program, a healthy older adult is defined as a person 65 years or older who enjoys a physically and mentally active lifestyle. Healthy older adults are recruited through physicians in the University and surrounding community, and through outreach efforts directed toward organizations that host or provide services to elders.
Students meet their mentor in the first month of medical school, and maintain contact with him/her over the course of their undergraduate medical education. This is done through phone calls, emails, social visits, and educational activities with the mentor. Students interact with their mentors a minimum of once a month (see Phone Calls below). During years I and II, at least four (4) of these interactions will be in person. During years III and IV, a minimum of two (2) face-to-face interactions are required.
Students can serve as a resource to their mentors and answer questions they may have about their own health. With their mentors’ permission, students may attend doctors’ appointments and provide support and encouragement for optimum wellness.
If a student decides to complete their 3rd and/or 4th year in Phoenix, then the Program Director should be notified and a mentor can be located for the student in the Phoenix area. It is the students’ responsibility to notify their Tucson mentors of relocation and whether contact will be continued. Often students who relocate choose to stay in contact with their Tucson mentor as an unofficial part of the OAP, but it is not required. Should a student or mentor decide they wish to commute between Tucson and Phoenix to remain in a student/mentor relationship, they may do so.
Phone calls
To develop an increasing rapport with the mentor, students are required to call their mentors one (1) time per month.
Phone contact interaction ideas:
· Completing the “Introductions” page
· Inviting mentor to an educational seminar, roundtable, workshop or conference
· Setting up a time for your next excursion
· Discuss personal / medical history
If the OAP student wishes to have a physician mentor called a “Preceptor” (often this is the mentor’s physician) the OAP Director and/or Advisors can arrange this. To achieve a deeper learning about aging and older adults, students are encouraged to meet with their mentors’ physicians. It is up to the students and the physicians to develop a meeting schedule.
Occasionally it happens that a mentor becomes ill or disabled during their participation in the Optimal Aging Program. This provides an opportunity for a student to learn about 1) the effects of the aging process and the medical care of their mentor, through interactions with their mentor’s physicians; and 2) the coping skills of the mentor, including their psychological or emotional response to the illness or disability.
The College of Medicine and Canyon Ranch Spa co-host an orientation event that provides an opportunity for the students, mentors, advisors and preceptors to get acquainted. In addition, the Orientation addresses the following issues and provides a time for questions and answers:
Students:
· Learning objectives
· Expectations in order to earn elective credit
· Evaluation criteria and assessment of student learning
· Boundaries; your role and obligation to the mentor, as well as the mentors’ role in the program.
Mentors:
· Highlight all that mentors have to offer to medical students
· Boundaries; your role and obligation to the student, as well as the students’ responsibility to you.
Medical students in this program must attend educational seminars offered by the College of Medicine and/or other approved health care providers in the Tucson and Phoenix community targeting issues of aging and/or geriatric care. Each seminar must be at least 1 hour in length and may include applicable conference presentations. The Arizona Geriatric Education Center (AzGEC) and the Department of Medicine offer a variety of Grand Rounds lectures that may count toward this requirement. These seminars may be appropriate for the students and mentors to attend together and discuss afterward.
In year I, educational seminars will be built into the curriculum for the required Issues in Optimal Aging (IOA) class.
In year II, students are required to attend two (2) educational seminars.
During years III and IV, students must view two (2) educational seminars online (or substitute any combination of IOA class, Interprofessional OAP, Roundtable or workshop to meet this requirement).
The website for viewing archived Geriatric Grand Rounds is: http://video.biocom.arizona.edu/video/videolibrary/GeriGR/
Excursions: Students and mentors are encouraged to have fun and learn from one another by participating in four (4) excursions together in years I and II, and two (2) in years III and IV. Excursions should allow the student to see their mentor “in action”, and may include whatever the mentor is currently involved in: volunteering, exercising, attending productions in the arts, health fairs, etc. Each excursion should be a minimum of 1 hour in length.
In addition to observing in the mentor’s active lifestyle, excursions can include:
· Meeting each other’s family
· Completing an adult health questionnaire
· Taking a personal / medical history
· Completing a living will with the mentor
· Completing a home safety check
· Discussing Advance Directives
· Using the information from the personal/medical history help the mentor plan a wellness program that recognizes their lifestyle and culture
· Attending physician office visits with mentor, and assessing the patient-physician interactions
NOTE: Educational seminars and roundtables cannot count toward the required excursions.
Students also will participate in periodic roundtable discussions or workshops with other students, faculty, advisors and preceptors in the Optimal Aging Program to process and share their experiences. Roundtable discussions or workshops are held at least once per semester and students are asked to invite their mentors. Guest speakers may also be invited.
In year I, roundtables will be built into the curriculum for the required Issues in Optimal Aging (IOA) class.
In year II, students are required to attend two (2) roundtables or workshops.
During years III and IV, roundtable attendance is optional, but may serve as a substitution to fulfill the requirement for two (2) educational seminars.
Once per year students will have the opportunity to meet and interact with students from other disciplines who have an interest in healthy aging. This experience will involve a roundtable discussion format.
Literature Review (Required in Year III only)
Students will choose a topic and write a 2-page summary (typed, double-spaced) of a journal article pertaining to healthy aging.
Field Activity (Required in Year IV only)
Students choose from either a home visit to an older patient; attending an event involving a large number of older adults; or surveying the community for evidence of ageism.
Journaling
Using E-Journal forms, students keep an electronic journal of their experiences in the Optimal Aging Program, including documentation of phone contact, attendance at required classes, educational seminars, roundtables, workshops, and excursions with their mentors. Journal entries may be brief, but should include information learned about risk factors associated with premature aging, and the role of exercise, nutrition, spirituality and a positive mental attitude in maintaining optimal health. Students should also record any changes in their attitudes about aging, their personal reflections on these changes, and any ideas for policy changes supporting the care of older adults. The journal entries should relate to the program goals as well as applicable institutional learning objectives. To facilitate documentation and personal reflection, there are links to 1) E-Journal forms, 2) Reflective Questions for Journaling and 3) Examples of Journal Entries, at the beginning of this website.
In the Fall and Spring semesters, each student will submit their journal via email attachment to their advisor by November 10th, 2006 and April 6, 2007, respectively. At those times, they must schedule a 30-minute meeting with their advisor to be completed before the Holiday Break and before mid-May, respectively. The purpose of the meetings is to discuss the student’s journal entries and overall progress in the program.
NOTE: 1st and 2nd year students must meet with their advisors in person, but 3rd and 4th year students may opt to conduct this meeting by phone.
Journal entries serve as the basis of a short reflective paper to be submitted during the Spring Semester of each year. The length of the paper for 1st, 2nd and 3rd year students is 2-3 pages (typed, double-spaced), and 5 pages for 4th year students. During their 4th year, students should interview their mentors and ask them to reflect on their four years together. The mentor’s input should influence the student’s description of how they will apply what they’ve learned to their future work as physicians. At the end of the program, the final paper should be submitted to the student’s Program Advisor 2-3 months prior to graduation.
Evaluation of student performance (Pass/Fail) will be based on completing all of the requirements listed here, as well as on performance evaluations completed by the mentors, program advisors (and preceptors if involved).
In addition to the many benefits listed above, students also receive:
· An enriched experiential education around aging and the care of older adults, who comprise a growing proportion of our nation’s and community’s population.
· An opportunity to learn from their mentors about optimal aging.
· An entry on their Dean’s Letter, which outlines the student’s experiences and contributions over the course of his/her medical education.
· Contact with faculty and community geriatricians who offer special opportunities for OAP students such as shadowing or assisting on home visits, interviewing older adult patients, attending older adult care conferences, and more.
Professionalism Policy:
Although the OAP encourages a level of personal exchange that is much like a friendship, please remember that this is a professional experience. By being in this program you have made obligations to both your mentor and the program. These obligations include communicating with your mentor on a regular basis, making plans and confirming them, being reliable and accountable for all commitments, and communicating any changes in academic plans and/or change of interest in the program immediately to the Program Director. Additionally, dress appropriately and with respect for your mentor.
The success of this program relies on the integrity of the interactions between you and your mentors. Participation in the Optimal Aging Program requires respect for your mentor, exhibiting responsible behavior, and following the College of Medicine Code of Ethics. Remember that the mentors in this program have volunteered to share personal aspects of their lives. This is a very generous opportunity that cannot be taken for granted.
Program Advisors:
The role of the OAP Advisor is to offer direction to the students involved in this program. Each student is assigned an advisor in their first year of the program and continues with that advisor throughout the four years. The advisor will review students’ journals and can advise students regarding the appropriateness of plans for excursions and other interactions, as well as ideas for the article summary and field activity. Advisors may also serve as guest speakers at roundtable events or educational seminars.
Program Advisors - Contact Information
Linda Shear, MA Mindy Fain, MD
Director, Optimal Aging Program Co-Director, Arizona Center on Aging
Office of Medical Student Education Section Head, Geriatrics
626-3684 Assoc. Professor of Clinical Medicine
lshear@email.arizona.edu 626-6854
mindy.fain@med.va.gov
Lynne Tomasa, PhD Patricia Lebensohn, MD
Assistant Professor, Associate Professor,
Clinical Family & Community Medicine Clinical Family & Community Medicine
626-7823 694-1610
ltomasa@email.arizona.edu plebenso@email.arizona.edu
Evan Kligman, MD Janet Campion, MD
Co-Director, AzGEC Assistant Professor, Clinical Medicine
742-2200 626-6854
agewell100@aol.com jcampion@email.arizona.edu
Anne Morrison, MPA Randy Scott, MSW, MBA
Director of Education, Arizona Center on Aging Instructional Specialist, Senior
Project Director, AzGEC Arizona Center on Aging
626-5803 626-5813
morrison@aging.arizona.edu rscott@aging.arizona.edu
Craig McClure, MD Jake Harwood, PhD
Professor, Clinical Family & Community Medicine UA Gerontology Program (former Chair)
626-4509 Professor, Communication
cmcclure@email.arizona.edu 626-8681
jharwood@u.arizona.edu
If you are interested in participating in the Optimal Aging Program, please contact Linda Shear in the College of Medicine Office of Medical Student Education at (520) 626-3684 or lshear@email.arizona.edu
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