Social Learning: Medical Student Perceptions of Geriatric House Calls

Abstract

Bandura's social learning theory provides a useful conceptual framework to understand medical students' perceptions of a house calls experience at Virginia Commonwealth University School of Medicine. Social learning and role modeling reflect Liaison Committee on Medical Education guidelines for “Medical schools (to) ensure that the learning environment for medical students promotes the development of explicit and appropriate professional attributes (attitudes, behaviors, and identity) in their medical students.” This qualitative study reports findings from open-ended survey questions from 123 medical students who observed a preceptor during house calls to elderly homebound patients. Their comments included reflections on the medical treatment as well as interactions with family and professional care providers. Student insights about the social learning process they experienced during house calls to geriatric patients characterized physician role models as dedicated, compassionate, and communicative. They also described patient care in the home environment as comprehensive, personalized, more relaxed, and comfortable. Student perceptions reflect an appreciation of the richness and complexity of details learned from home visits and social interaction with patients, families, and caregivers.

KEYWORDS:

• geriatric
• medical education
• house calls
• preceptors
• social learning
• modeling

The authors wish to thank Dr. Peter Boling for his foresight in establishing the Virginia Commonwealth University (VCU) House Calls Program in 1984, his continuing leadership in geriatrics and geriatric education, and his personal involvement in this medical student experience; Pamela Parsons for her critical manuscript review and comments; Beth Meyers for meeting the constant challenges of scheduling and program coordination; the faculty preceptors who have devoted many hours of time teaching and providing care in the home setting; VCU medical students who have participated in the program with such enthusiasm; and the many patients, families, and caregivers who continue to teach us and our learners. The House Calls Experience was supported by a grant from the Donald W. Reynolds Foundation.