The Effects of an Experiential Learning and Mentorship Program Pairing Medical Students and Persons with Cognitive Impairment: A Qualitative Content Analysis

Background and Purpose:  The United States population is aging rapidly and with it comes a tremendous rise in the number of people with dementia. In the future, as now, physicians and other health care professionals will likely provide the majority of health care for older people and those with dementia.  The non-geriatric trained workforce must have the attitudes, knowledge and skills needed to provide high quality care for this aging and increasingly cognitively impaired population.  There is evidence that prevailing stigma regarding older adults can be modified with experiential opportunities early in students’ careers.  Few of these programs are aimed at persons with dementia.  

The purpose of this study was to obtain an understanding of the impact of an experiential learning and mentorship program, the Buddy Program, with persons diagnosed with early stage dementia on first year medical students.

Methods:  This study is a qualitative content analysis of medical students’ narrative reflections following their interaction and activity with a person with dementia over the course of an academic year.   A convenience sampling of narrative data gathered during years 2009-2012 was analyzed.   The student sample  (N=27) was 56% male, primarily White (76% White, 22% Asian).  Seven percent were of Hispanic ethnicity.  Mean age was 23±2.  Students submitted 4±2 journals a month for a total N=107.  Journal entries were coded thematically using qualitative data analysis software, QSR International’s NVivo 10 to manage and aid in data analysis. 

Findings:  The results of this study yielded insights into what the students experienced over the course of the year.  Themes that emerged in their reflections of this experience included (a) seeing the person with dementia as a mentor; (b) expressing a range of feelings regarding the relationship from discomfort to enjoyment, friendship and increasing comfort over time; (c) demonstrating perceptions of mood and development of empathy toward the person with dementia; (d) recognizing and learning the various symptoms manifested in persons with dementia; (e) developing an awareness of their preconceptions and changing attitudes, along with their own emotional response to the experience; and (f) understanding the family caregivers’ experience through interaction.  Findings suggest that this experiential program served to influence first-year medical students’ understanding of persons with dementia, providing them with a more holistic view of the person and family and challenging and altering students’ preconceptions of dementia and what it is like to live with it. 

Conclusion and Implications:  The impact of dementia in our society is expected to be catastrophic.  Social workers, whose focus and skills relate to the individual and environment and the interactions between them are some of the most appropriate professionals to serve this growing population.  In order to do so, social workers must be knowledgeable about the illness, its course and its effects on the individual family.  An experiential mentorship program for social workers like the one described in this study has the potential to impact and broaden social work education and practice.  Further research is needed to develop the program within schools of social work.