title: Educational implications of nurse practitioner students and medical residents' attitudes toward managed care.
abstract: The increasing number of individuals enrolled in managed care organizations is a key consideration when planning effective models of education for future health care professionals. This study compares attitudes toward managed care between medical residents (MRs) (n = 431) and advanced practice nursing students (APNSs) (n = 153) in a Midwestern U.S. state, and it reports the results of a factor analysis of the attitude survey. MRs and APNSs completed a 34-item questionnaire. Results show that MRs were more likely than APNSs to believe that cost has priority over quality of care in a managed care setting and that managed care threatens the autonomy of health care providers. APNS were more likely than MRs to believe that managed care encourages preventive health care. Other comparisons related to Medicaid, capitation, practice guidelines, and success factors are discussed. Findings indicate that MRs were more inclined to see managed care as an economic threat to quality of care than APNSs. At the same time, MRs were somewhat less enthusiastic about practice guidelines and patient outcomes as measures of success in managed care settings than APNSs. Educational implications of findings are discussed.
authors.affiliation: Center for Collaborative Research in Health Outcomes and Policy, Michigan Public Health Institute, Okemos, USA.
authors.forename: M Lynn
authors.initials: ML
authors.lastname: Breer
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Pohl
authors.forename: Manfred
authors.initials: M
authors.lastname: Stommel
authors.forename: Violet H
authors.initials: VH
authors.lastname: Barkauskas
authors.forename: Barbara
authors.initials: B
authors.lastname: Schillo
authors.forename: Deborah
authors.initials: D
authors.lastname: Oakley
mesh_terms: D001291:Attitude of Health Personnel; D003362:Cost-Benefit Analysis; D003625:Data Collection; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000592:standards; D008484:Medicaid; D008824:Michigan; D009722:Nurse Practitioners / Q000193:education* / Q000523:psychology*; D017410:Practice Guidelines as Topic; D011315:Preventive Medicine; D017009:Professional Autonomy; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States