Dementia Care

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This is Fiona Calvert’s final Research News after almost four years as Contributing Editor. Fiona joined AJDC in early 2013
and has been an integral part of the team since then. I sincerely thank Fiona for her contribution to the journal and wish her
all the best as she leaves to concentrate on her career as a clinical psychologist.
AJDC Executive Editor Professor Richard Fleming
Vol 5 No 5 October/November 2016 Australian Journal of Dementia Care 65
RESEARCH NEWS
Fiona Calvert reports on the latest published dementia
research from Australia and worldwide
Arecent study examined howmedical
students engage with the learning
experiences of completing clinical
placements in residential aged care facilities
(RACFs). In particular, the Tasmanian
researchers were interested in exploring
students’ experiences of exposure to multiple
comorbidity, cognitive impairment and
palliative care.
This research adds to a growing body of
literature attempting to increase engagement
with the dementia-care sector in medical
education programs. For this study 61 fifth-
year medical students completed five-day
clinical placements at twoAustralian RACFs
in 2013 and 2014. The placements were
supported by a semi-structured program and
academic teaching staff to ensure
appropriate educational experiences.
The students completed surveys of
dementia knowledge as well as questions
about attitudes to the aged care sector and
working with older adults. These measures
were completed both before and after the
placements. Focus group discussions were
also held to explore medical student
expectations, learning opportunities, and
challenges to engagement in the dementia-
care sector.
The results showed that the students
generally had good dementia knowledge,
but poor attitudes towards aged care and
older adults prior to their placements.
Negative placement experiences were
associated with a struggle to understand case
complexity and a perception of the aged care
placement as less valuable than hospital-
based training.
Regardless of negative attitudes, the post-
placement surveys showed significant
improvements in the students’ attitudes to
working with older people and dementia
knowledge. Positive student experiences
seemed to be linked to in-depth engagement
with clinically challenging cases and
opportunities to practice independent
clinical decision making and contribute to
resident care.
It was found that aged care placements can
improve medical student attitudes to
working with older people and dementia
knowledge. Clinical placements in RACFs
can challenge students to become more
resourceful and independent in their clinical
assessment and decision-making with older
adults. However, more work is required to
create a cultural change across medical
curricula to further include important issues
around ageing and dementia.
Annear MJ, Lea E, Lo A, Tierney L, Robinson A
(2016) Encountering aged care: a mixed methods
investigation of medical students’ clinical placement
experiences. BMC Geriatrics 16(38) 1-13.
Fiona Calvert is
a practising
psychologist,
PhD candidate
and lecturer at
the University
of Wollongong.
Contact her at:
fcalvert@
Positive results for aged care placements
Researchers fromTasmania have
developed a reliable and
preliminary validmeasure of
General Practitioner (GP)
attitudes and confidence around
dementia.
This project is important
because previous research has
suggested that GPs are often
reluctant to engage to their
fullest capacity with patients
who exhibit cognitive symptoms
that may be indicative of
dementia. This could suggest
GPs lack knowledge about
dementia, but it is also
recognised that attitudes and
confidence are important factors
in how a GP approaches a
person with dementia.
The researchers developed
The General Practitioner
Attitudes and Confidence Scale
for Dementia (GPACS-D) using a
four-stage process. The research
team constructed the questions
in the scale using research and
theoretical literature on attitudes
and confidence in working with
people with dementia. Afocus
group of GPs collaborated with
the research group to help refine
the scale and ensure that each
question was worded
adequately.
The GPACS-D included items
such as: “I feel confident in my
ability to provide advice about
managing risky behaviours
associated with dementia” and
“Much can be done to improve
the quality of life for people with
dementia”. Participants were
asked to indicate their level of
agreement with each statement
on a numbered scale. Atotal of
270 GPs then participated in
pilot testing of the GPACS-D
measure, including 55 in a test-
retest administration and 215
who completed the scale before
and after a dementia workshop.
This helped the researchers
further refine the questions in
the scale, resulting in a final scale
containing 20 items.
Statistical testing showed that
the scale had good sensitivity, as
significant differences were
observed in GPs’ ratings before
and after the dementia
workshop. Researchers found
the GPACS-D produced a
reliable and preliminarily valid
measure of GP attitudes and
confidence towards dementia.
The scale provides useful
information for medical
educators and researchers in
evaluating and intervening in
GP perceptions of dementia as
well as their capacity to provide
effective care.
Mason RL, Annear MJ, Lo A,
McInerney F, Tierney L, Robinson A
(2016) Development and preliminary
psychometric properties of the General
Practitioner Attitudes and Confidence
Scale (GPACS-D) for dementia. BMC
Family Practice 17 105-112.
Measuring GPs’ attitudes, confidence