Addressing Interest in Gerontological Practice: A Systematic Review of 20 Years of Pedagogical Intervention Literature

Background: Many disciplines, including social work, medicine, and allied health are looking toward the future of professional practice. The U.S. population is rapidly aging, and more gerontological practitioners will be needed; however, students often rank this area of practice at the bottom of their future professional life. Over the past 20 years, a variety of pedagogical strategies to improve attitudes toward older adults and gerontological practice have been tested. Instructors are seeking methods that are evidence based to incorporate into their curriculum and programs of study. Thus, a need for a systematic review of this literature is needed to help navigate this large literature base.

Methods: Inclusion criteria for this systematic review was limited to those studies with student sample that evaluated a pedagogical intervention for change in attitudes toward older people, interest in gerontological practice, and/or knowledge about aging. The search for articles was limited to articles published in English between 1995-2014. Both quantitative and qualitative articles were included. An initial 1,576 articles were identified, and 58 were found to meet inclusion criteria. Data were extracted using a form based on Petticrew and Roberts (2006), and utilized the methodology described by Littell, Corcoran, and Pillai (2008). Once data were extracted from all of the articles and entered into the table, the table was checked again with the original article.

Results: Most studies aimed to change both knowledge and attitudes. Interventions to change knowledge were the most straightforward with support for aging courses, modules, and infusion approaches. A combination of information with an experiential activity (e.g., service learning) was the most common pedagogical approach across these studies, and the evidence suggested that this approach does change student attitudes. Addressing gerontological interest appears to be more challenging with fewer studies reporting a positive change, but it was also the least studied area for intervention. 

Implications: The results of this systematic review overwhelming point to the conclusion that pedagogical interventions aimed at changing student attitudes are working. Direct experiences with older adults likely play a role in a desire to work with older people. Pedagogical interventions cannot compete with positive, and likely ongoing, personal experiences with older people; however, interventions may be able to open students up to the prospect of having them. Many students start their studies with ideas of what population with whom they would eventually like to work, often children. How can instructors impart the notion that the wonderment that is often associated with pediatric work can also be found in gerontology? Some care must be taken when using this approach because these experiences have the potential to reinforce stereotypes. Arranging contact with community dwelling older adults instead of those that may be frail/sick will likely improve the likelihood of achieving the desired impact. Future research should seek to test additional approaches that may influence student interest in gerontological practice, and additional studies that seek to test online strategies should be conducted given the prominence of these courses.