Effect of student involvement on patient perceptions of ambulatory care visits: a randomized controlled trial.
OBJECTIVE
To determine if patient satisfaction with ambulatory care visits differs when medical students participate in the visit.


METHODS
Randomized controlled trial.


METHODS
Academic general internal medicine practice.


METHODS
Outpatients randomly assigned to see an attending physician only (N = 66) or an attending physician plus medical student (N = 68).


RESULTS
Patient perceptions of the office visit were determined by telephone survey. Overall office visit satisfaction was higher for the "attending physician only" group (61% vs 48% excellent), although this was not statistically significant (P =.16). There was no difference between the study groups for patient ratings of their physician overall (80% vs 85% excellent; P =.44). In subsidiary analyses, patients who rated their attending physician as "excellent" rated the overall office visit significantly higher in the "attending physician only" group (74% vs 55%; P =.04). Among patients in the "attending physician plus medical student" group, 40% indicated that medical student involvement "probably" or "definitely" did not improve their care, and 30% responded that they "probably" or "definitely" did not want to see a student at subsequent office visits.


CONCLUSIONS
Although our sample size was small, we found no significant decrement in patient ratings of office visit satisfaction from medical student involvement in a global satisfaction survey. However, a significant number of patients expressed discontent with student involvement in the visit when asked directly. Global assessment of patient satisfaction may lack sensitivity for detection of dissatisfaction. Future research in this area should employ more sensitive measures of patient satisfaction.
Gress
Todd W
TW
Department of Medicine, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205-2223, USA.
Flynn
John A
JA
Rubin
Haya R
HR
Simonson
Lisa
L
Sisson
Stephen
S
Thompson
Traci
T
Brancati
Frederick L
FL
D000328:Adult; D000553:Ambulatory Care; D002983:Clinical Competence; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010465:Perception; D010817:Physician-Patient Relations; D013337:Students, Medical; D013997:Time Factors