Medical students’ experiences of the Senior Citizen Partnership Program: Evaluation of a five-year longitudinal program

Figures & data

Table 1. Focus group questions.

We would like to hear about your experiences with the Senior Citizen Partnership Program. What insights about older people has your partnership provided? How has your partnership contributed to your learning? What else do you think is helpful about this program? What else would you like to share about your experiences with the SCPP?

Table 2. Analysis of open-ended questions.

Themes and subthemes		Illustrative quotes
Q: What are the SCPP’s highlights for you?
A refreshing encounter
	Challenging bias	Being able to unlearn the prior unconscious judgement or stereotypes I may have had (Year 1)
	A novel opportunity to connect	My grandparents are dead/overseas and I have no other older people in my life (Year 1)
	Story-telling	It is quite eye-opening listening to his stories (Year 1)
Friendship and mentoring
	Wisdom	Their myriad experiences are truly invigorating and intriguing, and their wisdom is engaging (Year 1)
	Authenticity	The interaction feels honest and meaningful (Year 1)
	Enduring friendship	Sharing gardening tips and cuttings, which I grow at home - a lovely reminder throughout the years of our relationship (Year 5)
Contribution to learning
	Understanding healthy ageing	I gained a deeper understanding of ageing, both the positive aspects as well as the more challenging (Year 3)
	Understanding older lives	First-hand information about the different factors that impact the day-to-day life for an older person (Year 3)
	Practicing communication skills	To apply clinical skills knowledge and to reflect upon how I respond to cues that my senior citizen gives me (Year 2)
	Professional identity formation	Helps me prepare for my future career interacting and caring for our older generations (Year 5)
Q: Is there anything else about the SCPP you would like to share?
	A worthy program	I think it was a valuable program, and would recommend it to future students (Year 5)
	Assignment of partners	The location that you live was not taken into account (Year 1)
	Additional meetings	More opportunities to interact (Year 5)
	Review of logging attendance requirements	The log sheet can make my senior feel as though seeing her is an obligation rather than something I really enjoy (Year 2)

Table 3. Main themes and subthemes.

Theme	Subtheme	No. refs	Illustrative quote
1. Perception of older adults			Acknowledgement of perception prior to SCPP	Challenge to perception after SCPP
1.1	Healthy ageing	11	I assumed everyone that’s in a retirement village is in full-time care and they need a carer to look after their bodily functions. Y5FG1FA1*	The program helped me understand how a person who might look unwell on paper, they can still be very well 95% of the time. Y5FG2FA2
1.2	Ageing process	5	I didn’t have a good idea of how age does deteriorate a person at the end. I almost saw it as like, ‘oh well, they’re just not looking after themselves.’ Y4FG1MC2	My senior citizen who, through no fault of his own, had this very big deterioration in his health due to age and conditions and just general loss of function. Y4FG1MC2
1.3	Activity	15	I thought they’d be just sitting at home. Y1FG3FA2	They’re booked up for weeks on end. Y1FG1MC1 She’s a lot fitter than I am. She does like weight lifting, ballet, she teaches dance classes. Y1FG2FC1
1.4	Health literacy	3	I thought like they’re not really knowing much about what a doctor’s talking about. Y1FG1MC3	Her health literacy was very surprising. She knew what she was talking about. Y1FG3MC3
1.5	Up-to-date	10	I felt the older population is generally more conservative and have more traditional beliefs. Y1FG3FA1	When I got to know her, I realized, ‘Hang on a second. You’re actually pretty cool.’ Y5FG3MA4
1.6	Friendliness	13	They just seem a little more approachable than they did before. Y1FG1FX1	Older people can be your friends as well. Y5FG2FA2
1.7	Life challenges	7	I thought, ‘you retire, you get to kick your feet up and that’s it. You’ve had a hard life and now you get to relax.’ Y5FG1MA4	I didn’t realize how much ongoing financial stress older people have. Y5FG1MA4 I probably learned about the loneliness and slowly not being able to do things. Y5FG3MC5
1.8	Individuality	11	I didn’t really properly appreciate that each old person has such a long and rich story behind them. Y5FG3MA4	You really start to see how individual they can be. It really humanizes an entire population of people. Y1FG1FC2
2. SCPP impact on medical education
2.1	Holistic understanding	8	It’s not looking at them [older patients] like a problem to solve but treating them holistically. Y1FG2FC3 Behind every patient number, there’s a person who has a life outside the hospital … when I talk to patients, [the SCPP] helps me to be a bit less goal-and-outcome oriented. Y5FG2FA2
2.2	Empathy	11	You get to see what it’s like walking in their shoes a bit, I guess. And if you know about the elderly people, rather than just seeing slides and reading a textbook, and that’s just going to lead to better care. Y1FG2MC2 His values are so different to mine. However I can see where they’re coming from, of course, but I need to be able to understand and respect that and not make assumptions of any patient I have in the future. Y4FG1MC2
2.3	Building rapport	21	It’s important as future physicians to be able to build those relationships with only a few encounters with your patients, and learn about not just the medical side of things, but also their life in a way that doesn’t make them feel uncomfortable. Y1FG2FA1 It’s one of the hard things of medicine, which is getting to know people quickly and eliciting these concerns that they might not tell you if they don’t know you very well. Y5FG1MA4
2.4	Identity formation	6	They see us as doctors in training even though we, at that point, don’t think that we are fit to wear that crown. So I have learned that we have to conduct ourselves with a certain level of dignity and maturity. Y5FG1MA4
2.5	Setting boundaries	6	There’s a generational gap in what’s deemed appropriate and what’s deemed inappropriate, and I had to navigate that a few times with my senior citizen while keeping the rapport that we’ve built. Y4FG1MC2 You might have a particularly strong stance on things, but you can still take care of every other element of that patient’s care. Y4FG1FC3
2.6	Caring	9	I get it, sometimes you’re busy. But you can take time to just check those [services] and have a discussion with that patient about that, and put that on the discharge letter for the patient’s information. Y5FF3MC6 I'm more likely to check in on my older patients more often, even like on ward rounds, right, you go from one patient to another and you scroll quickly. Y5FG3FA3
2.7	Health systems	13	It’s things like the public health system and he wasn’t potentially the best at navigating it. Y4FG1MC2 Just having awareness about the challenges at home that elderly people face, like ‘do they have access to the support services they need?’ Y5FG3MA4
2.8	Longitudinal	6	You watch their medical history like unveil itself over the next five years, and as you go through med school you learn about the medications they’re on … you’ll actually be able to learn it all like as an experience to like become a good GP. Y5FG3MC4
3. SCPP impact on personal development
3.1	Friendship	8	It’s like hanging out with a friend, but like a grandparent. Y1FGFX1 Like last time he called me, I was having the worst day, and he’s like, ‘would you like to come over for coffee?,’ and it just made a really big impact on me. Y4FG1FC3
3.2	Inspired to take action	8	Sometimes I think, ‘oh, I can’t be bothered doing this thing.’ I kind of remember, ‘oh, she’s got however many conditions, I should probably go do that thing.’ Y1FG2FA1 He literally goes on hikes all the time. He does swimming. He does gym stuff. He does tandem bike. Yeah. And the thing is, he’s blind. I was like, ‘wow, if he can do all these things with the disability and being elderly, I should literally start.’ It’s a challenge. Y1FG3FA2
3.3	Life perspective	8	Speaking with somebody who’s been alive for three times as long as I have has helped me just see things in a little bit of a broader timeframe. And I would say that’s had a little bit of a calming effect on me. Y1FG3MC3 She was diagnosed with multiple terminal illnesses and chronic diseases. She was like, ‘right oh, I've been here 88 years, I'll just crack on.’ If that was said to me, I would be running around like a headless chick. Y5FG1MA4
3.4	Facilitating personal growth	9	This is a great program where 17-year-olds actually learn how to behave like an adult. Y5FG1MA4
3.5	Impact on other relationships	5	I started writing my grandparents letters, but I didn’t before the program. Y5FG3MC5 [SCPP] is like ingraining maybe even more to stay connected as I get older … like everyone has conditions, but what matters for them is that not only are they in pain, they’re in pain alone. Y5FG3MC6

* Y5FG1FA1: This indicates Year 5, focus group 1, female and remaining letters anonymise students.