Beyond the classroom: a qualitative study of voluntary home visits to older adults as a tool for empathy and professional growth in medical students

Global populations are rapidly aging, posing significant challenges. Yet, ageism among clinicians and medical students persists, undermining empathy and care quality. Traditional short-term educational efforts have limited effect; sustained, relationship-based programs hold promise but remain understudied. To address this, we implemented a year-long service-learning project, where first-year medical students visit elderly individuals at their homes to engage in light physical activities and discuss life challenges. This qualitative study examines the project's impact on first, second, and third-year medical students.From August to October 2020, we recruited, via convenience sampling, first-year medical students of three consecutive cohorts (<i>n</i> = 313) that completed ten home visits with older adults; of these sixty (19%) students participated in focus groups/interviews and 128 (41%) submitted reflective assignments. Data was manually analyzed using Braun and Clarke's six-phase reflexive thematic approach until saturation. We adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist.Three major themes and seven sub-themes emerged. First, building trusting patient-physician relationships, characterized by empathy, trust, and effective communication, alongside a balance between physician responsibility and patient autonomy. Second, embracing uncertainty and holistic care, which involved navigating medical ambiguity and integrating psychosocial dimensions into clinical reasoning. Third, reflecting on vulnerability, aging, and mortality, encompassing the emotional impact of disability and decline; reframing aging positively; and processing experiences of death and loss. Participants described profound shifts in their perspectives on aging, care relationships, and their professional identities; changes that persisted throughout their pre-clinical training. To conclude, early and sustained engagement with older adults in their home environment through a structured service-learning project enhanced medical students' professional development, empathy, and attitudes toward aging. Incorporating similar programs into medical education curricula may provide substantial pedagogical benefits. Future research should assess long-term impacts on career choices and care quality.