Embedding effective dementia education into undergraduate medical curricula—a realist review

BACKGROUND: Despite the growing global population of people with dementia, education about dementia is not systematically integrated across undergraduate healthcare curricula. This study set out to explore the reasons behind this inconsistency. METHODS: An earlier realist review identified barriers and facilitators to integrating effective dementia education in medical schools through the development of an initial programme theory (IPT). This study examined further supporting literature and undertook interviews with a wide range of stakeholders, including people with dementia and carers, to refine the IPT, synthesising the contexts and mechanisms that influence dementia education. RESULTS: Twenty-nine educational interventions about dementia were included in the data synthesis and supported the domains of the IPT. Twenty-three stakeholders, including clinical educators, people with dementia and their carers, and medical students, were interviewed to interrogate the IPT. Stakeholders agreed that the IPT appropriately represented the challenges of embedding effective dementia education. All stakeholders highlighted the failure to mandate education about dementia in medical curricula as a sign of a lack of institutional commitment. In contrast to the literature, stakeholders did not think that negative student attitudes were a significant barrier, rather a lack of confidence due to limited contact with people with dementia. CONCLUSIONS: Embedding effective dementia education in medical curricula is possible if contextual barriers are identified and facilitatory mechanisms are developed. Our programme theory offers a roadmap for educators to embed undergraduate dementia education in their own medical school.