Can Medical Students Acquire Patient Centered Attitudes at Medical Schools?

Abstract

Progress in psychosomatic medicine will largely depend on the kind of attitudinal learning that takes place at medical schools. What can be achieved by a patient-centered training programme emphasizing attitudinal learning? In a research programme 350 students were introduced to principles of patient-centered medicine in so-called peer groups on history taking (‘Anamnesegruppen’). By the end of group work, students exhibited more realistic and less defensive expectations towards the patients and felt more confident about their peers’ support. The interviewing skills had improved. The training scheme appeals to approximately 20 % of the students. It has been adopted by various other places in the Federal Republic of Germany and Switzerland. Basic institutional aids became apparent: access to patients, supervision, regional meetings. It is assumed that students learn how to link role performance with personal self-awareness, how to trust and be accepted, how to face the faculty. Four overlapping stages basic to the learning process (exposing, reflecting, acting, progressing) are discussed. It is concluded that in medical schools patient-oriented attitudinal learning is possible. Peer learning seems to be decisive. Interdisciplinary research into peer learning is recommended.

Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills

“…Beyond improving interview management, history-taking groups also support medical students’ development as professional physicians. During this process, students may acquire and refine fundamental professional values as well as ethical and social attitudes [ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ], [ 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ], [ 23 ].…”

“…Peer tutors in history-taking groups facilitate feedback, moderate discussion, and manage group processes, which support students’ reflection upon themselves and upon student–patient relationship and interaction [ 19 ], [ 20 ], [ 21 ]. Peer tutors not only impart knowledge and skills regarding communicative competence and interview techniques, but moreover give structured feedback to participants.…”

Evaluation of a 'breaking bad news' course at the Charite, Berlin

“…Two tutors facilitate the discussion in a small group setting. All participants received practical and theoretical training during their years as tutors of ‘Anamnesegruppen’ (history taking groups) 1 . Halfway through the course, students had the opportunity to discuss their observations and questions with two experienced doctors or psychologists.…”