title: Medical students' attitudes toward patient-centred care: a longitudinal survey.
abstract: OBJECTIVE
  Patient-centredness should be at the heart of medical education. This longitudinal study aimed to assess possible attitude changes towards patient-centredness in a medical students' cohort as they progressed through the clinical curriculum. It also investigated the possible impact of socio-demographic factors on students' attitudes.
  
  
  METHODS
  The same student cohort was tested on 2 occasions: during their initial exposure to clinical curricula (year 4) and after 2 years, at the end of the clerkship (year 6). Students completed a questionnaire including demographics and the 18-item Patient-Practitioner Orientation Scale (PPOS). PPOS differentiates between patient-centred versus doctor-centred or disease-centred orientation, measuring attitudes along 2 dimensions: 'sharing' and 'caring'.
  
  
  RESULTS
  A total of 483 fully completed questionnaires was returned (response rate 83%). The cohort's attitudes were significantly more doctor-centred at the end of their studies compared to the beginning of their clinical curricula (P < 0.001). However, regarding the caring part of their relationship with patients, they maintained a satisfactory level of patient-centredness. Concerning sharing information, female students were significantly more patient-centred at year 4, with their mean score decreasing at the end of their clerkship. Furthermore, among only female students, having a looser relationship with religion was associated with more patient-centred attitudes.
  
  
  CONCLUSIONS
  Increased authoritarianism in graduating students' attitudes emphasises clearly the need for future research and redesigning communication curricula. Furthermore, the influence of gender and relationship with religion on attitudes towards the doctor-patient relationship should be explored further, in order to eliminate disparities in the provision of patient-centred medical care.
authors.affiliation: Research Center for Health Promotion, Institute for the Study of Urologic Diseases, Aristotle University of Thessaloniki, Greece. zoitsimtsiou@yahoo.gr
authors.forename: Zoi
authors.initials: Z
authors.lastname: Tsimtsiou
authors.forename: Olga
authors.initials: O
authors.lastname: Kerasidou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Efstathiou
authors.forename: Stamatis
authors.initials: S
authors.lastname: Papaharitou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Hatzimouratidis
authors.forename: Dimitris
authors.initials: D
authors.lastname: Hatzichristou
mesh_terms: D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D004504:Education, Medical, Undergraduate; D005260:Female; D006115:Greece; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018802:Patient-Centered Care; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires