Medical student attitudes toward the doctor–patient relationship

Abstract

Context Medical educators have emphasized the importance of teaching patient‐centred care. Objectives To describe and quantify the attitudes of medical students towards patient‐centred care and to examine: (a) the differences in these attitudes between students in early and later years of medical school; and (b) factors associated with patient‐centred attitudes. Methods We surveyed 673 students in the first, third, and fourth years of medical school. Our survey utilized the Patient–Practitioner Orientation Scale (PPOS), a validated instrument designed to measure individual preferences towards various aspects of the doctor–patient relationship. Total PPOS scores can range from patient‐centred (egalitarian, whole person oriented) to disease‐ or doctor‐centred (paternalistic, less attuned to psychosocial issues). Additional demographic data including gender, age, ethnicity, undergraduate coursework, family medical background and specialty choice were collected from the fourth year class. Results A total of 510 students (76%) completed data collection. Female gender ( P < 0·001) and earlier year of medical school ( P = 0·03) were significantly associated with patient‐centred attitudes. Among fourth year students ( n = 89), characteristics associated with more patient‐centred attitudes included female gender, European‐American ethnicity, and primary‐care career choice ( P < 0·05 for each comparison). Conclusion Despite emphasis on the need for curricula that foster patient‐centred attitudes among medical students, our data suggest that students in later years of medical school have attitudes that are more doctor‐centred or paternalistic compared to students in earlier years. Given the emphasis placed on patient satisfaction and patient‐centred care in the current medical environment, our results warrant further research and dialogue to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient‐centred care.