[The influence of the presence of students on the consultation--attitudes of tutors in family medicine clinics].
BACKGROUND
The consultation is the pivot of clinical teaching in ambulatory care. It is therefore essential that students observe the consultation. The students' presence itself influences the consultation and also requires the patients' consent. Moreover the introduction in Israel of the "Patients' Rights Act" in 1996 has made us more acutely aware of the place of the patient in teaching especially with regard to the consent to be part of the teaching process.


OBJECTIVE
This study was undertaken in order to investigate how tutors in family medicine perceive changes in the consultation caused by the presence of students.


METHODS
An anonymous physician questionnaire was distributed on the first day of the 6th year clinical clerkship in family medicine. The questions pertained to perceived influence on length and content of the consultation. In addition physician and patient background information was gathered; and the physicians were asked to estimate the patients' willingness to be part of the teaching process.


RESULTS
46 tutors in family medicine participated, 70% of whom were female. Sixty four percent of the doctors thought that the student's presence had an influence on the consultation. Ninety one percent thought that it increased consultation length, especially of the physical part (93%). More than half thought that the student's presence might interfere with asking intimate questions. The majority held the opinion that the patient's gender and socioeconomic background were inconsequential. Ninety two percent of physicians estimated that 5% or less of the patients would refuse the presence of a student.


CONCLUSIONS
Tutors in family medicine think that the presence of a student affects the consultation. Those involved in and responsible for teaching should take this into account. Further research of these changes with objective measurements is needed.
Vinker
S
S
Dept of Family Medicine, Sackler School of Medicine, University of Tel Aviv, Tel Aviv.
Monnickendam
S
S
Cohen
O
O
Zalewski
S
S
Kitai
E
E
D000328:Adult; D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D010821:Physicians, Family; D013337:Students, Medical; D011795:Surveys and Questionnaires