Do photographs, older adults' narratives and collaborative dialogue foster anticipatory reflection (preflection) in medical students?

Background: In changing higher education environments, medical educators are increasingly challenged to prepare new doctors to care for ageing populations. The Depth of Field: Exploring Ageing resource (DOF) uses photographs, reflective questioning prompts, older adults' narratives and collaborative dialogue to foster anticipatory reflection or 'preflection' in medical students prior to their first geriatric medicine clinical placement. The aim of this research is to explore whether photographs, narratives and small group collaborative dialogue fosters reflective learning, enhances reflective capacity and has the potential to shift medical students' attitudes towards caring for older adults. Methods: This study used a mixed method evaluation design, measuring attitudes using pre and post questionnaire responses and individual written reflections drawn from 128 second year medical students, exploring their perceptions toward older adults. Results: Quantitative and qualitative data indicated that the DOF session generated reflective learning that resulted in positive shifts in medical students' perceptions towards older adults. The qualitative reflections were captured in four main themes: the opportunity provided to Envision working with older adults; the Tension created to challenge learners' misinformed assumptions, and the work of Dismantling those assumptions, leading to Seeing older people as individuals. Conclusions: These findings highlight how visual and narrative methodologies can be used as an effective reflective learning tool to challenge medical students' assumptions around ageing and how these may influence their care of older adults.