Multiethnic perspectives on elder mistreatment.

PURPOSE: We conducted this study to understand the interpretations of elder mistreatment (EM) in multiethnic older adults. DESIGN AND METHODS: Focus group sessions were held with three ethnically homogenous groups (n = 18) and a group of elder care professionals (n = 6) eliciting responses to vignettes depicting various types of elder mistreatment. Qualitative analysis of focus group transcripts was performed to define EM occurrence, its severity, and to identify the perpetrator and victim. RESULTS: Four main categories emerged: social expectations, caregiver expectations, victim characteristics, and characteristics of the interaction. Themes included issues of gender roles, filial obligations, martial commitments, and ageism as features of the vignette discussions. Professional and lay caregiver issues were features of the caregiver expectations. Mental capacity, physical dependency, physical attributes, and complicity were the victim characteristics discussed. The characteristics of the interaction that were identified included resistance to care, retaliation, habitual occurrence, and perpetrator intent. IMPLICATIONS: Older adults identify multiple factors influencing the interpretation of elder mistreatment. These factors may determine strategies for future EM intervention.

Introducing first-year medical students to clinical practice by having them "shadow" third-year clerks.

BACKGROUND: A new clinical experience was developed in which 1st-year medical students (MS1s) shadowed 3rd-year medical students (MS3s) as they performed their usual clerkship duties for 6 half-days, 1 in each clerkship. Researchers wanted to determine whether this was a worthwhile experience for MS1s and what they learned. DESCRIPTION: MS1s documented their experiences shadowing MS3s in confidential responses to open-ended questions on a course Web site. Researchers conducted a qualitative analysis of student comments. EVALUATION: The analysis showed the students to be perceptive, thoughtful observers and yielded 5 broad categories of learning. Students learned about the practice of medicine, the process of becoming a doctor, providers of health care, the nature of real patients, and the procedures of medicine. Students rated the experience as "excellent." CONCLUSION: Shadowing an MS3 in clinical settings is a beneficial and valued learning experience for beginning medical students.