Maintaining patient-centredness in Australian medical students: Culture, curriculum and selection criteria (original) (raw)
Related papers
Help, I’m losing patient-centredness! Experiences of medical students and their teachers
Medical Education, 2010
OBJECTIVES Despite all educational efforts, the literature shows an ongoing decline in patientcentredness during medical education. This study explores the experiences of medical students and their teachers and supervisors in relation to patient-centredness in order to gain a better understanding of the factors that determine its development.
Medical students' attitudes toward patient-centred care: a longitudinal survey
Medical Education, 2007
Purpose 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.
BMC Medical Education
Background A patient-centred approach to care is increasingly the mandate for healthcare delivery. There is a need to explore how health professional students develop patient-centred attributes. This study aims to understand the extent of patient-centred orientations of health professional students, their perceptions and factors influencing their adoption of the approach. Methods The study used a cross-sectional, parallel mixed methods design combining a survey using the Patient-Practitioner Orientation Scale (PPOS) followed by focus groups with medical, nursing, physiotherapy and speech and language therapy students. Data included students’ age, gender, programme, and placements experienced. Pearson’s chi squared and the non-parametric equivalent Kruskal-Wallis H test were done to test for differences in demographics for appropriate variables. One-way ANOVA or Welch test was done to explore differences in PPOS scores. Regression analysis was done to test the influence of the demogr...
Changing on Patient-Centred Attitudes on Same Students Group: A Qualitative Study
Objective: Study aimed to clarify the effect of educational activities on same students in their pre-med students and medical students standing point about patient centred care. Methods: The PPOS questionnaire used to examine patient-centredness and has been used in pre-med student and medical student samples. We surveyed students in their first month in undergraduate medical education following their enrolment in 2010. Three years later in 2013-2014 educational year same group included to same questionnaire, when they are 4th year students. Same 128 students filled questionnaire forms in two different years. The survey utilized the patients practitioners orientation scale (PPOS) to measure students' changing attitudes. Results: 59% of respondents were female and mean age was 18.52 in their 1st year. In total PPOS scores were 55.58 for Year 4 students and 62.41 for Year 1 students. We found that sharing and caring domains scores lowered when students finished their basic medical science education including empathy, communication and ethics lectures. Conclusion: Despite encouraging patient-centred attitudes of undergraduate medical students by curricular models, our findings showed that in their further level, students became less patient centred. Depending on respondents' score, curriculum organisers should recheck their curricular aim and educational program or activities. Feedback in medical education can be accepted as " specific information about the students' perception and attitudes ". These findings give great information concerning effectiveness of program on specific areas with the clues to improve the program' performance " .
BMC Medical Education, 2016
Background: Medical student clinical confidence and positive attitudes to patient centredness are important outcomes of medical education. The clinical placement setting is regarded as a critical support to these outcomes, so understanding how the setting is influential is important. The aim of this study was to compare students' attitudes towards patient-centredness and clinical confidence as they progressed through their medical course, and understand the influence of diverse clinical placement zones. Methods: Students at one Australian medical school completed a questionnaire at the beginning of second year and at the end of their third year of medical training. The questionnaire measured attitudes to patient centred care, clinical confidence, role modelling experiences and clinical learning experiences. Descriptive analyses investigated change in these attitudes over time. Repeated measures analysis of variance was used to assess the influence of placement location on each variable of interest. Responses to two open-ended questions were also coded by two researchers and themes were identified. Results: Student confidence increased over the course of two years of clinical training (p < 0.001), but attitudes to patient centredness (p = 0.933) did not change. The location of clinical placements (urban, outer urban and rural) was unrelated to levels of confidence or patient centredness. Students had positive attitudes towards patient-centredness throughout, and noted its importance in contributing to quality care. Patient-centred care was encouraged within the clinical placements, and was influenced by positive and negative role modelling, direct teaching, and opportunities to practise patient-centred care. Conclusions: A new generation of doctors with a strong patient-centred focus is emerging. Medical schools have a responsibility to facilitate clinical placements that will support the acquisition and maintenance of skills in patient centred care through positive role modelling.
Does clinical training period support patient-centeredness perceptions of medical students?
Medical Education Online
Background: Learning environment influences students' professional formation and patientcentered attitudes and behaviors. Objective: The purpose of this study is to investigate how hidden curriculum of learning environment and the previous experience with chronically ill patients affect patient-centeredness perceptions of medical students. Design: We followed 144 students and determined their opinions on 'ideal patient-centered practice and learning environment' via patient-centeredness questionnaire (PCQ) just before (third year) and at the end (sixth year) of clinical training years of medical school. At the end of each clinical training year (fourth, fifth, and sixth years), we determined experiences of the students about 'patient-centeredness of the learning environment' using a relevant survey called communication, curriculum, and culture (C3) instrument. We also compared PCQ and C3 instrument scores of the participants who had chronically ill patient in their families/ friends and who do not. Results: C3 scores worsened over the years, namely, students faced increasing number of examples against patient centeredness. Final PCQ scores were worse than initial ones. C3 and PCQ scores of the students who had previous experience with chronically ill patients were not different from the scores of the remaining students. Conclusion: Medical students, even those who have a chronically ill patient in their families or friends, lose their idealism about patient centeredness to some degree possibly due to hidden curriculum of the medical school.
Patient-centred education: What do students think?
2014
CONTEXT Medical educators endeavour to foster patient-centred learning. Although studies of patient-educators report general increases in patient-centredness, no formal review of students' reflections on the role of patients in their education has yet been undertaken. Our research questions were: (i) What themes might be identified through a qualitative analysis of students' reflective writing on patient-centred education? (ii) What are common students' perceptions regarding patients as educators?
Medical Education Online, 2019
Background: Learning environment influences students' professional formation and patient-centered attitudes and behaviors. Objective: The purpose of this study is to investigate how hidden curriculum of learning environment and the previous experience with chronically ill patients affect patient-centered-ness perceptions of medical students. Design: We followed 144 students and determined their opinions on 'ideal patient-centered practice and learning environment' via patient-centeredness questionnaire (PCQ) just before (third year) and at the end (sixth year) of clinical training years of medical school. At the end of each clinical training year (fourth, fifth, and sixth years), we determined experiences of the students about 'patient-centeredness of the learning environment' using a relevant survey called communication, curriculum, and culture (C3) instrument. We also compared PCQ and C3 instrument scores of the participants who had chronically ill patient in their families/ friends and who do not. Results: C3 scores worsened over the years, namely, students faced increasing number of examples against patient centeredness. Final PCQ scores were worse than initial ones. C3 and PCQ scores of the students who had previous experience with chronically ill patients were not different from the scores of the remaining students. Conclusion: Medical students, even those who have a chronically ill patient in their families or friends, lose their idealism about patient centeredness to some degree possibly due to hidden curriculum of the medical school.
Medical student attitudes toward the doctor-patient relationship
Medical Education, 2002
Background: The desire to help others is stated as a primary motivation for pursuing a career in the medical professions. Patient-centered care refers to the focus of the practitioner on the condition from the patient's perspective and seeing the patient as a whole person, independent of the condition. The concept of patient-centered care provides an organizing framework for helping others during real-world interactions between practitioner and patient. Medical educators have emphasized the importance of teaching patient-centred care. Objectives To describe and quantify the attitudes of medical students towards patient-centred communication 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.