Article

Do patients' comfort levels and attitudes regarding medical student involvement vary across specialties?

Schulich School of Medicine & Dentistry, University of Western Ontario, Canada.
Medical Teacher (Impact Factor: 1.68). 03/2008; 30(1):48-54. DOI: 10.1080/01421590701753443
Source: PubMed

ABSTRACT

Studies on patient comfort with medical student involvement have been conducted within several specialties and have consistently reported positive results. However, it is unknown whether the intrinsic differences between specialties may influence the degree to which patients are comfortable with student involvement in their care.
This is the first study to investigate whether patient comfort varies across specialties.
A total of 625 patients were surveyed in teaching clinics in Family Medicine, Obstetrics/Gynaecology, Urology, General Surgery, and Paediatrics. Seven patient attitudes and patients' comfort levels based on student gender, level of training, and type of clinical involvement were assessed.
Patients in all specialties shared similar comfort levels and attitudes regarding medical student involvement for the majority of parameters assessed, suggesting that findings in this area may be generalised between specialties. Most of the inter-specialty variation found pertained to patient preference for student gender and the genitourinary specialties.
As there are numerous specialties that have never undergone a similar investigation of their patients, this study has important implications for medical educators in those specialties by supporting their ability to apply the results and recommendations of studies conducted in other specialties to their own.

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    • "Female patients admitted to surgical ward were more likely to prefer female students to care for them. The finding of this study on gender preference is in line with the findings of a several studies done (Adams et al. 1999, Passaperuma et al. 2008, Carmody et al. 2011, Siwe et al. 2012). This implies that female students have more chance to be accepted in gynecology and obstetrics wards than male students. "
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    ABSTRACT: Background: The cooperation of patients and their acceptance to involve medical students in their care is vital to clinical education. Objective: To explore the attitudes of patients towards medical students at University charity teaching hospital, and to explore the determinants of those attitudes. Methods: This cross-sectional study was conducted at University charity teaching hospital affiliated to University of Medical Sciences and Technology (UMST). Four hundred and thirty-two patients were interviewed between January and December 2013 using a structured questionnaire. Results: Four hundred and thirty-two patients had responded to all questions they were asked. Of the patients interviewed, 95.2% approved the presence of medical students during the medical consultation. 79.8% of the patients agreed to be examined by students in the presence of a doctor, while 33.5% gave agreement even in the absence of a doctor. More than half of the patients think that it is important that students examine patients as part of their training and 18 % of them were not sure about the importance of clinical examination. Conclusion: The study concluded overall positive attitudes to the medical students’ involvement by patients. Patients preferred lower number of students to be involved; however, few were aware of their rights.
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    • "It particularly affects GP-teachers, their patients and their relationship [2]. However, there is a lack of knowledge regarding their attitudes towards this teaching activity during the consultation [3]. A German study showed that student teaching in primary care practices is well accepted by patients but that it can disturb the relationship between patients and doctors especially if it lacks an informed consent [4]. "
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    ABSTRACT: Curricula in most western medical universities include teaching in the primary care setting as core elements. This affects GP-teachers, their patients and their interaction. Therefore, it was the aim of this study to assess the influence of the presence of medical students in the teaching practice on the attitudes of both GPs and patients. Seventy-four GP-preceptors were invited to answer an online survey. Patients attending consultations with a medical student present completed questionnaires either before the consultation (WR group) or immediately after consultation (AC group). Fifty- nine preceptors completed the online survey. Physicians showed positive attitudes towards their activities as preceptors: 95% expressed a positive attitude predominantly towards being a role model and to represent the discipline and for 64% remuneration was not important. In 28 practices 508 questionnaires were completed by patients in the WR-group and 346 by the AC-group. Only 12% (WR) and 7.2% (AC) of patients expressed a preference for being seen by the doctor alone. While 16% of doctors rated that confidentiality of the doctor-patient relationship is compromised, only 4.1% (WR) and 1.7% (AC) of patients felt so. The motivation to be a preceptor is primarily driven by personal and professional values and not by economic incentives. Further, patients have even more positive attitudes than the preceptors towards the presence of students during their consultation. Reservations to teaching students in GP-practices are, therefore, unwarranted.
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    • "While feedback from patients is largely and generally positive regarding medical student participation as being shown in the comprehensive review of Mol and colleagues [16] and this is regardless of the nature of specialty with little intrinsic differences between specialties [17,18], Simons and co-authors showed that 55.8% of the patients had no preference regarding medical student participation, while a third preferred to see the attending physician alone [19]. Generally, studies showed that there is little reluctance to students' presence for emotional or intimate problems; expectedly, in Obstetrics and Gynecology as well as in Genito-Urinary clinics approval of students' involvement is reported to be lower [20-23]. "
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    ABSTRACT: The cooperation of patients and their consent to involve medical students in their care is vital to clinical education, but large numbers of students and lack of experience as well as loss of privacy may evoke negative attitudes of patients, which may sometimes adversely affect the clinical teaching environment. This study aimed to explore the attitudes of patients towards medical students at Damascus University hospitals, and to explore the determinants of those attitudes thus discussing possible implications applicable to clinical teaching. This cross-sectional study was conducted at three teaching hospitals affiliated to the Faculty of Medicine at Damascus University. Four hundred patients were interviewed between March and April 2011 by a trained sociologist using a structured questionnaire. Of the patients interviewed, 67.8% approved the presence of medical students during the medical consultation and 58.2% of them felt comfortable with the presence of students, especially among patients with better socio-economic characteristics. 81.5% of the patients agreed to be examined by students in the presence of the supervisor, while 40.2% gave agreement even in the absence of the supervisor. Privacy was the most important factor in the patients' reticence towards examination by the students, whilst the relative safety and comfort if a supervisor was available determined patients' agreement. The study concluded overall positive attitudes to the medical students' involvement in medical education. However, it is essential that students and clinical supervisors understand and adhere to professional and ethical conduct when involving patients in medical education.
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