title: Effect of educational interventions and medical school policies on medical students' attitudes toward pharmaceutical marketing practices: a multi-institutional study.
abstract: OBJECTIVE
  To determine the effect of educational interventions on medical students' attitudes toward pharmaceutical industry marketing practices and whether restrictive medical school policies governing medicine-industry interactions are associated with student support for banning such interactions.
  
  
  METHODS
  Prospective cohort study involving the graduating classes of 2009 (intervention, n=474) and 2010 (control, n=459) at four U.S. medical schools. Intervention students experienced a former pharmaceutical representative's presentation, faculty debate, and a Web-based course. Both groups completed baseline and follow-up attitude surveys about pharmaceutical marketing.
  
  
  RESULTS
  A total of 482 students (51.6%) completed both surveys. In regression analyses, intervention students were more likely than control students to think that physicians are strongly or moderately influenced by pharmaceutical marketing (OR, 2.29; 95% CI, 1.46-3.59) and believed they would be more likely to prescribe a company's drug if they accepted that company's gifts and food (OR, 1.68; 95% CI, 1.12-2.52). Intervention students were more likely to support banning interactions between pharmaceutical representatives and students (OR, 4.82; 95% CI, 3.02-7.68) and with physicians (OR, 6.88; 95% CI, 4.04-11.70). Students from schools with more restrictive policies were more likely to support banning interactions between pharmaceutical representatives and students (OR, 1.99; 95% CI, 1.26-3.16) and with physicians (OR, 3.44; 95% CI, 2.05-5.79).
  
  
  CONCLUSIONS
  Education about pharmaceutical marketing practices and more restrictive policies governing medicine-industry interactions seem to increase medical students' skepticism about the appropriateness of such marketing practices and disapproval of pharmaceutical representatives in the learning environment.
authors.affiliation: Ethics Group, American Medical Association, Chicago, Illinois 60654, USA.
authors.forename: Audiey C
authors.initials: AC
authors.lastname: Kao
authors.forename: Clarence
authors.initials: C
authors.lastname: Braddock
authors.forename: Maria
authors.initials: M
authors.lastname: Clay
authors.forename: Donna
authors.initials: D
authors.lastname: Elliott
authors.forename: Scott K
authors.initials: SK
authors.lastname: Epstein
authors.forename: William
authors.initials: W
authors.lastname: Filstead
authors.forename: Tim
authors.initials: T
authors.lastname: Hotze
authors.forename: Win
authors.initials: W
authors.lastname: May
authors.forename: Jennifer
authors.initials: J
authors.lastname: Reenan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016022:Case-Control Studies; D003479:Curriculum; D004345:Drug Industry; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000639:trends; D005260:Female; D037921:Gift Giving; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D040541:Marketing; D011050:Policy Making; D011446:Prospective Studies; D012016:Reference Values; D012044:Regression Analysis; D012577:Schools, Medical / Q000592:standards / Q000639:trends; D013337:Students, Medical / Q000523:psychology*; D014481:United States; D055815:Young Adult