A new study shows that year-long home visits with older adults help first-year medical students build stronger communication skills, rethink assumptions about aging, and understand patient care beyond the clinic.

For many medical students, the earliest years of training are heavy on textbooks and light on real patient contact. But a new study suggests that meaningful clinical learning can begin much earlier, not in hospitals, but in people’s homes.

Published in Medical Education Online, the study examines an eight-year Service-Learning initiative in which first-year medical students visit older adults in the community throughout an academic year. The program gives students the chance to build sustained relationships and engage with aging, health, and vulnerability in a setting far removed from clinical routines.

A program based on sustained personal contact

The study was led by Dr. Adi Finkelstein of the Jerusalem College of Technology; Dr. Tali Sahar of Hebrew University and Prof. Naama Constantini of Hebrew University. The program was initiated at the Hebrew University by Dr. Ohad Avni and Prof. Constantini, in partnership with Randy Gerber of the Joint.

Students visited older adults in pairs, conducting about ten visits over the course of the year. Each visit lasted 60 to 90 minutes and focused on gentle, individualized physical activity alongside open conversation - about everyday challenges, health concerns, and what it means to age.

The program included an introductory workshop and ongoing mentoring from volunteer physicians and physiotherapists.

What students said changed
Through interviews, focus groups, and reflective writing, the researchers found that the experience shaped students in ways that extended far beyond the visits themselves.

Students described learning how to:

• build trust through attentive listening and consistent presence
• communicate with sensitivity and respect, especially around autonomy
• cope with uncertainty and complexity, rather than rushing to “fix” problems
• understand health in a broader context that includes loneliness, disability, and social support
• confront difficult topics such as vulnerability, mortality, and end-of-life care

Many students noted that these encounters helped them reflect on what kind of physicians they hope to become.

Voices from the field

Students described the experience as eye-opening:

“When I was able to create a real connection with an older person, I understood that treatment has meaning far beyond providing medicine — it is about seeing the whole person.”

“I learned that sometimes the most important thing is simply to listen. Our mere presence in the room made an impact and gave the patient a sense of value.”

Study overview
The study included three consecutive cohorts of medical students. Of 555 students in the pre-clinical years, 313 volunteered to take part in the year-long program.

Researchers collected data from 60 students through interviews and focus groups, and analyzed 128 reflective assignments using reflexive thematic analysis.

Why it matters
As populations age worldwide, medical education continues to grapple with age-related stereotypes and discomfort around aging. The researchers conclude that relationship-based service learning early in training may help medical students develop stronger empathy, reduce ageist attitudes, and approach patients with a more human, patient-centered mindset.