title: Teaching appropriate interactions with pharmaceutical company representatives: the impact of an innovative workshop on student attitudes.
abstract: BACKGROUND
  Pharmaceutical company representatives (PCRs) influence the prescribing habits and professional behaviour of physicians. However, the skills for interacting with PCRs are not taught in the traditional medical school curriculum. We examined whether an innovative, mandatory workshop for third year medical students had immediate effects on knowledge and attitudes regarding interactions with PCRs.
  
  
  METHODS
  Surveys issued before and after the workshop intervention solicited opinions (five point Likert scales) from third year students (n = 75) about the degree of bias in PCR information, the influence of PCRs on prescribing habits, the acceptability of specific gifts, and the educational value of PCR information for both practicing physicians and students. Two faculty members and one PCR led the workshop, which highlighted typical physician-PCR interactions, the use of samples and gifts, the validity and legal boundaries of PCR information, and associated ethical issues. Role plays with the PCR demonstrated appropriate and inappropriate strategies for interacting with PCRs.
  
  
  RESULTS
  The majority of third year students (56%, 42/75) had experienced more than three personal conversations with a PCR about a drug product since starting medical school. Five percent (4/75) claimed no previous personal experience with PCRs. Most students (57.3%, 43/75) were not aware of available guidelines regarding PCR interactions. Twenty-eight percent of students (21/75) thought that none of the named activities/gifts (lunch access, free stethoscope, textbooks, educational CD-ROMS, sporting events) should be restricted, while 24.0% (8/75) thought that students should be restricted only from sporting events. The perceived educational value of PCR information to both practicing physicians and students increased after the workshop intervention from 17.7% to 43.2% (chi square, p = .0001), and 22.1% to 40.5% (p = .0007), respectively. Student perceptions of the degree of bias of PCR information decreased from 84.1% to 72.9% (p = .065), but the perceived degree of influence on prescribing increased (44.2% to 62.1% (p = .02)).
  
  
  CONCLUSIONS
  Students have exposure to PCRs early in their medical training. A single workshop intervention may influence student attitudes toward interactions with PCRs. Students were more likely to acknowledge the educational value of PCR interactions and their impact on prescribing after the workshop intervention.
authors.affiliation: Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA. jwofford@wfubmc.edu
authors.forename: James L
authors.initials: JL
authors.lastname: Wofford
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Ohl
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003132:Commerce; D016265:Conflict of Interest; D004345:Drug Industry; D011307:Drug Prescriptions; D004363:Drug Utilization; D004504:Education, Medical, Undergraduate; D005260:Female; D037921:Gift Giving / Q000941:ethics*; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000941:ethics; D007400:Interprofessional Relations / Q000941:ethics*; D008297:Male; D040541:Marketing / Q000941:ethics*; D009657:North Carolina; D010565:Persuasive Communication; D012938:Social Perception; D013337:Students, Medical / Q000523:psychology*; D014146:Training Support