Genesis of the professional-patient relationship in early practical experience: qualitative and quantitative study.
BACKGROUND
As a rule, undergraduate medical students experience everyday work in health care as spectators. They are not allowed to participate in real-life interaction between professionals and patients. We report on an exception to this rule.


OBJECTIVE
The aim of this study was to examine undergraduate students' experiences in developing their first professional-patient relationships on the basis of being responsible for the care of patients.


METHODS
The study involved 2 cohorts (2002 and 2003) of medical students, amounting to 503 students. They had all worked in hospitals and/or nursing homes for 4 weeks at the end of their first year of study. Subsequent to this, they produced a case presentation of experiences in this work they perceived as important. These important experiences were the focus of our analysis.


RESULTS
Five categories of important experiences were identified. Four of the 5 categories are logically interrelated in that they collectively cover the range of players involved in a caring situation and provide student insights into the interaction between these players. The fifth category is a heterogeneous residue category. Analysis and quantification of these 5 categories reveals a general similarity: students, to an overwhelming degree, are concerned with developing patient-centred care.


CONCLUSIONS
If they are given real responsibility for patient care, undergraduate medical students, of their own accord, tend to develop patient-centred relationships in accordance with the principles of the new professionalism, sometimes in opposition to institutional and/or collegial constraints.
Scavenius
Michael
M
Department of Social Medicine, University of Amsterdam Academic Medical Centre, Amsterdam, The Netherlands. m.p.scavenius@amc.uva.nl
Schmidt
Sonja
S
Klazinga
Niek
N
D001291:Attitude of Health Personnel; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D012941:Social Responsibility; D013337:Students, Medical / Q000523:psychology*