Medical students' experiences in providing medical care to older patients: A rich picture study

INTRODUCTION: With an ageing population, future doctors must be prepared to care for older patients facing complex and often chronic needs. Despite curricular efforts, medical students often report less positive attitudes towards providing this care-shaped not only by knowledge gaps but also by cultural norms and the hidden curriculum. Little is known about how students themselves reflect on their clinical encounters with older patients. This study explores medical students' experiences providing care to older patients, and which aspects they find rewarding or frustrating.

METHODS: We conducted a qualitative study based on a constructivist paradigm, using semi-structured interviews supported by a visual narrative method (rich pictures). Sixteen final-year medical students who had completed their senior internship were purposively sampled. Participants drew two 'rich pictures' representing one positive and one negative clinical experience involving the care of older persons. These drawings were used as prompts for in-depth interviews. Data were analysed using reflexive thematic analysis.

RESULTS: We identified three themes that captured students' experiences: (1) feeling connected, (2) witnessing humane and compassionate care, and (3) making a difference. Rewarding experiences involved human connection, dignity and presence-particularly in end-of-life care or when guided by compassionate role models-leading to a sense of fulfilment. Frustrating experiences arose from poor communication, systemic barriers and unclear goals of care, leaving students feeling powerless, isolated and emotionally burdened.

CONCLUSION: Students experienced care for older patients as emotionally rich and qualitatively distinct from other clinical work. This practice demands patience, presence, and the ability to navigate complexity beyond mere clinical competence. Medical education should support students in valuing care beyond cure-through fostering reflective practice, peer support, and engaged supervision-helping them reframe what it means to make a difference for older patients and their families in complex, chronic and end-of-life care.