title: Attitude change during medical school: a cohort study.
abstract: BACKGROUND
  Attitudes influence behaviour. Developing and maintaining proper attitudes by medical students can impact on the quality of health care delivered to their patients as they assume the role of doctors. There is a paucity of longitudinal research reports on the extent to which students' attitude scores shift as they progress through medical school.
  
  
  OBJECTIVE
  This study examined the change in attitude scores of a large student cohort as they progressed through medical school. Whether student gender is related to attitude change was also investigated.
  
  
  METHODS
  Medical students from 3 consecutive classes (1999-2001) participated in this study. Students completed 2 instruments that included the Attitudes Toward Social Issues in Medicine and an in-house tool referred to as the Medical Skills Questionnaire. The instruments were administered at 3 milestones during the course of medical school training (entry, end of preclinical training and end of clerkship).
  
  
  RESULTS
  Reliability estimates for total (0.82-0.91) and subscale (0.41-0.81) attitudinal scores were in the acceptable range. Multivariate analyses of variance of mean attitudinal scores indicated a persistent decline in several attitude scores as students progressed through the medical educational programme. Females demonstrated higher attitude scores than males.
  
  
  CONCLUSIONS
  As students progress through medical school their attitude scores decline. The reasons for the shift in attitude scores are not clear but they may relate to a ceiling of high attitude scores at entry, loss of idealism and the impact of the unintended curriculum. Further study of the impact of medical education on student attitudes is warranted.
authors.affiliation: Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. woloschu@ucalgary.ca
authors.forename: Wayne
authors.initials: W
authors.lastname: Woloschuk
authors.forename: Peter H
authors.initials: PH
authors.lastname: Harasym
authors.forename: Walley
authors.initials: W
authors.lastname: Temple
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D015331:Cohort Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012737:Sex Factors; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires