Medical students’ perceptions of the patient-centredness of the learning environment

Abstract

BackgroundPatient-centred care is an important aspect of quality health care. The learning environment may impact medical students’ adoption of patient-centred behaviours.MethodsAll medical students at a single institution received an anonymous, modified version of the Communication, Curriculum, and Culture instrument that measures patient-centredness in the training environment along three domains: role modelling, students’ experience, and support for patient-centred behaviours. We compared domain scores and individual items by class year and gender, and qualitatively analyzed responses to two additional items that asked students to describe experiences that demonstrated varying degrees of patient-centredness.ResultsYear 1 and 2 students reported greater patient-centredness than year 3 and 4 students in each domain: role modelling (p = 0.03), students’ experience (p = <0.001), and support for patient-centred behaviours (p < 0.001). Female students reported less support for patient-centred behaviours compared with male students (p = 0.03). Qualitative analysis revealed that explicit patient-centred curricula and positive role modelling fostered patient-centredness. Themes relating to low degrees of patient-centredness included negative role modelling and students being discouraged from being patient-centred.ConclusionsStudents’ perceptions of the patient-centredness of the learning environment decreased as students progressed through medical school, despite increasing exposure to patients. Qualitative analysis found that explicit patient-centred curricula cultivated patient-centred attitudes. Role modelling impacted student perceptions of patient-centredness within the learning environment.

How video cases in preparatory teaching influence students’ approaches to patients in psychiatric clerkship. A qualitative study.

“…being aware of own emotional responses) and taking into account support from family (52), when describing how they used insight gained from discussing the video cases. This finding is in accordance to recent research which indicates that medical students' adoption of patient-centeredness depends on their perception of the encouragement in clinical learning environments for applying patient-centered behaviors (53). Independency and clinical responsibility are considered important to develop students' competency during practice training (54,55).…”

“…It is well documented that students having negative experiences related to professional socialisation processes in clerkship may experience a major gap between preclinical and clinical training, regardless of the quality of the preclinical training (72). Their professional development may thus be prolonged, as these students get 'stuck' in the transition from theory to practice (68,73,74).The present study is in line with these findings, demonstrating how passive roles in clerkship compromises medical students' learning and development of a patient-centred approach (53,75). However, we did not specifically study how the psychiatric clerkships were organized or to what extent there were designated clinical supervisors with the role of guiding students' learning experiences.…”

The Graduating European Dentist: Contemporaneous Methods of Teaching, Learning and Assessment in Dental Undergraduate Education

“…Within dentistry, the real-time clinical environment and episodes of live patient care mean that clinical teachers are uniquely placed to role model for their students (Kenny et al 2003, Oandsan & Reeves 2005 or clinical teachers has been shown to impact on the ability of students to appreciate the importance of patient-centred care (Wilcox et al 2017).…”

“…Ultimately, role modelling by fellow students or clinical teachers has been shown to impact on the ability of students to appreciate the importance of patient‐centred care (Wilcox et al. ).…”

The evaluation of students of medicine of a college of Belo Horizonte, in relation to the process of teaching-learning of the medical-patient relationship

“…Por isso, para alcançar mudança, as escolas precisam incorporar em seus currículos conhecimentos de ciências humanas e sociais. 13,18,19 cONclUsÃO Ao longo da pesquisa, percebeu-se que os estudantes se julgam preparados para estabelecer uma relação médico--paciente efetiva num modelo biologicista que considera a anamnese biológica mais relevante. Este preparo advém das disciplinas práticas e muitas vezes os aspectos técnicos da consulta são priorizados em detrimento da atenção integral do paciente.…”