Medical student attitudes toward the doctor-patient relationship.
BACKGROUND
Medical educators have emphasized the importance of teaching patient-centred care.


OBJECTIVE
To describe and quantify the attitudes of medical students towards patient-centred care and to examine: (a) the differences in these attitudes between students in early and later years of medical school; and (b) factors associated with patient-centred attitudes.


METHODS
We surveyed 673 students in the first, third, and fourth years of medical school. Our survey utilized the Patient-Practitioner Orientation Scale (PPOS), a validated instrument designed to measure individual preferences towards various aspects of the doctor-patient relationship. Total PPOS scores can range from patient-centred (egalitarian, whole person oriented) to disease- or doctor-centred (paternalistic, less attuned to psychosocial issues). Additional demographic data including gender, age, ethnicity, undergraduate coursework, family medical background and specialty choice were collected from the fourth year class.


RESULTS
A total of 510 students (76%) completed data collection. Female gender (P < 0.001) and earlier year of medical school (P = 0.03) were significantly associated with patient-centred attitudes. Among fourth year students (n = 89), characteristics associated with more patient-centred attitudes included female gender, European-American ethnicity, and primary-care career choice (P < 0.05 for each comparison).


CONCLUSIONS
Despite emphasis on the need for curricula that foster patient-centred attitudes among medical students, our data suggest that students in later years of medical school have attitudes that are more doctor-centred or paternalistic compared to students in earlier years. Given the emphasis placed on patient satisfaction and patient-centred care in the current medical environment, our results warrant further research and dialogue to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centred care.
Haidet
Paul
P
Houston Veterans Affairs Medical Centre, Texas 77030, USA. phaidet@bcm.tmc.edu
Dains
Joyce E
JE
Paterniti
Debora A
DA
Hechtel
Laura
L
Chang
Tai
T
Tseng
Ellen
E
Rogers
John C
JC
D001294:Attitude to Health; D003479:Curriculum; D003695:Delivery of Health Care / Q000592:standards*; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D012723:Sex; D013337:Students, Medical / Q000523:psychology*