title: Resident trainees do not affect patient satisfaction in an outpatient gastroenterology clinic: a prospective study conducted in a Canadian gastroenterology clinic.
abstract: BACKGROUND
  There is little literature regarding how a gastroenterology trainee affects a patient's interpretation of care during outpatient clinic visits. Improving patient satisfaction is desirable and benefits may include enhanced patient compliance as well as providing trainees with areas for improvement.
  
  
  OBJECTIVE
  To evaluate patient satisfaction in an outpatient gastroenterology clinic when seen by a trainee and attending physician versus an attending physician alone. The secondary objective was to evaluate physician characteristics that play a role in creating a positive clinical experience.
  
  
  METHODS
  A randomized prospective survey study was conducted over an 11-month period (July 2012 to June 2013) at St Boniface Hospital (Winnipeg, Manitoba). Two gastroenterology fellows (postgraduate year 4 and 5) and nine internal medicine residents (postgraduate year 1 to 3) comprised the 'trainee' role, while three academic clinicians comprised the 'attending' role. Patients included individuals seen for an initial consultation and were >18 years of age.
  
  
  RESULTS
  A total of 211 patients comprised the final study group, with 118 in the attending group and 93 in the trainee group. In univariate analysis, patients more often had a very good experience when seen by an attending physician alone versus a trainee and attending physician (73% versus 56%; P=0.016); however, on multivariate analysis, there was no significant difference in patient satisfaction (OR 0.89; P=0.931). Physician factors found to be associated with high patient satisfaction on multivariate analysis included: addressing all patient concerns (OR 27.56; P=0.021); giving the patient a preliminary diagnosis (OR 78.02; P=0.006); and feeling the physician was thorough (OR 72.53; P=0.029).
  
  
  CONCLUSIONS
  The present study did not reveal a difference in patient satisfaction if a patient sees an attending physician alone or with a trainee. Moreover, to improve patient satisfaction in a gastroenterology clinic, physicians should address all patient concerns, provide a preliminary diagnosis and appear to be thorough in their assessment. Further work to increase patient awareness on the role of residents in teaching hospitals is warranted to further promote careers in gastroenterology.
authors.forename: Mayur
authors.initials: M
authors.lastname: Brahmania
authors.forename: Madison
authors.initials: M
authors.lastname: Young
authors.forename: Chetty
authors.initials: C
authors.lastname: Muthiah
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ilnyckyj
authors.forename: Donald
authors.initials: D
authors.lastname: Duerksen
authors.forename: Dana C
authors.initials: DC
authors.lastname: Moffatt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000523:psychology*; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D005260:Female; D005762:Gastroenterology / Q000193:education; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008297:Male; D008350:Manitoba; D008505:Medical Staff, Hospital / Q000523:psychology; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D017060:Patient Satisfaction; D011446:Prospective Studies; D055815:Young Adult