Ageism toward older adults among healthcare workers and students: A scoping review.

Introduction: Ageism, particularly against older adults, is widespread in different settings, including public policies, healthcare institutions, workplaces and media. Its pervasive presence, especially in healthcare settings, has caused a significant impact on the economics and healthcare expenses and has become a growing concern. Older adults' health outcomes are impacted by both positive and negative ageism displayed by healthcare workers and students. Although multiple reviews have studied ageism in healthcare, literature mapping the presence of both positive and negative ageism among healthcare workers and students while synthesizing current interventions remains lacking. Objective: This scoping review aims to map the presence of both positive and negative ageism among healthcare workers and students as well as synthesise the current types of interventions that address ageism among HCWs and students and its outcome. Methods: This scoping review followed Arksey and O'Malley's five-step methodology. A total of 156 studies were included. Results: The included studies comprise 134 quantitative, 14 qualitative and 8 mixed-method studies. Most studies are conducted in high-income countries, while none of them are conducted in low-income countries. The majority are mainly focusing on the nursing profession and nursing students. Furthermore, almost two-thirds of the included studies are particularly looking at healthcare students. The findings show that almost half of the healthcare workers and students have positive ageism toward older adults. Surprisingly, only about 10 % reported negative ageism. Mixed, neutral and inconclusive presence of ageism are also reported. Various interventions have been adopted to tackle ageism, such as courses and curriculum interventions, clinical experience, intergenerational interaction, mentoring, simulation and psychological training. In addition, this scoping review highlights the need to develop a comprehensive scale to measure ageism accurately and evaluate existing interventions. Implication: Future studies should focus more on underrepresented regions such as low-income countries, Southeast Asia, and Africa. At the same time, to improve comparability across different studies, a widely accepted tool for evaluating both positive and negative ageism needs to be developed.