Patient-Centeredness and its Correlates among First Year Medical Students

Krupat, Edward; Hiam, C. Michael; Fleming, Michael; Freeman, Phyllis

doi:10.2190/dvcq-4lc8-nt7h-ke0l

Cited by 121 publications

(157 citation statements)

References 24 publications

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“…A physician's style of communicating with patients may have evolved from repeated experiences with certain kinds of patients, his or her philosophy of care (Krupat, Rosenkranz, Yeager, Barnard, Putnam & Inui, 2000;Levinson & Roter, 1995), or socialization related to gender (Bertakis, Helms, Callahan, Azari & Robbins, 1995;Hall & Roter, 1998), culture (Waitzkin, 1985), and medical training (Bertakis, Callahan, Helms, Azari, Robbins & Miller, 1998;Bertakis, Helms, Azari, Callahan, Robbins & Miller, 1999;Paasche-Orlow & Roter, 2003). In this investigation, we were particularly interested in whether physicians' communication and perceptions were related to their orientations to the provider-patient relationship (Haidet, Dains, Paterniti, Hechtel, Chang, Tseng et al 2002;Krupat, Bell, Kravitz, Thom & Azari, 2001;Krupat, Hiam, Fleming & Freeman, 1999). That is, do physicians who report a stronger belief in sharing control and understanding the patient's perspective (i.e., a more patient-centered orientation) use more forms of patient-centered communication (e.g., clear explanations, partnershipbuilding, support) and view their patients more favorably than do physicians oriented more toward biomedical issues and doctor control?…”

Section: Conceptual Framework: An Ecological Approachmentioning

confidence: 99%

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Street

Gordon

Haidet

2007

Social Science & Medicine

451

359

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Although physicians' communication style and perceptions affect outcomes, few studies have examined how these perceptions relate to the way physicians communicate with patients. Moreover, while any number of factors may affect the communication process, few studies have analyzed these effects collectively in order to identify the most powerful influences on physician communication and perceptions. Adopting an ecological approach, this investigation examined: (a) the relationships of physicians' patient-centered communication (informative, supportive, partnership-building) and affect (positive, contentious) on their perceptions of the patient, and (b) the degree to which communication and perceptions were affected by the physicians' characteristics, patients' demographic characteristics, physician-patient concordance, and the patient's communication. Physicians (N = 29) and patients (N = 207) from 10 outpatient settings in the United States participated in the study. From audio-recordings of these visits, coders rated the physicians' communication and affect as well as the patients' participation and affect. Doctors were more patientcentered with patients they perceived as better communicators, more satisfied, and more likely to adhere. Physicians displayed more patient-centered communication and more favorably perceived patients who expressed positive affect, were more involved, and who were less contentious. Physicians were more contentious with black patients, whom they also perceived as less effective communicators and less satisfied. Finally, physicians who reported a patient-centered orientation to the doctor-patient relationship also were more patient-centered in their communication. The results suggest that reciprocity and mutual influence have a strong effect on these interactions in that more positive (or negative) communication from one participant leads to similar responses from the other. Physicians' encounters with black patients revealed communicative difficulties that may lower quality of care for these patients.

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Section: Conceptual Framework: An Ecological Approachmentioning

confidence: 99%

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Street

Gordon

Haidet

2007

Social Science & Medicine

451

359

View full text Add to dashboard Cite

show abstract

“…As previously described, the core elements of PPOS, an instrument that has been used to measure student's patient--centred beliefs, are based largely on two dimensions 'caring' and 'sharing' 2,3,15,16 . The last dimension might be defined as sharing the power, the control and the information about the patient's clinical condition.…”

Section: Discussionmentioning

confidence: 99%

“…'Caring' domain measures beliefs about attending to patient's emotions and lifestyle [2][3][4] . Similar findings were also observed in other two studies conducted in medical schools located in the same state 21,23 .…”

Section: Discussionmentioning

confidence: 99%

“…These students were enrolled via internet after providing consent for participation through a web-based survey. Student attitudes regarding the relationship between physicians and patients were measured using a previously validated instrument 2,3,15,16 . The Patient-Practitioner Orientation scale (PPOS) is an 18-item instrument originally designed to be administered to either doctor or patients.…”

Section: Participantsmentioning

confidence: 99%

“…In 1969, the pioneer, Enid Balint 1 , who devoted much of her career to the study of the doctor-patient relationship, introduced the term "patient-centred medicine", which was related to the understanding of the patient as a unique human being 2,4 . Since then, various educational strategies have been adopted in the teaching-learning process aiming at the improvement of the doctor-patient relationship [5][6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

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Impacto da “Disciplina Relação Médico-Paciente” sobre Atitudes Centradas no Paciente

Silva

Ribeiro

Nogueira

et al. 2017

Rev. bras. educ. med.

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“A sorely neglected field”: A multisite study of self‐reported humanities exposure among emergency medicine residents

Balhara

Irvin

Zink

et al. 2022

AEM Education and Training

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BackgroundThe Association of American Medical Colleges has identified the humanities as fundamental to medical education across all specialties. Evidence from undergraduate medical education (UME) demonstrates the humanities' positive impacts on outcomes that could be relevant to patient care and trainee well‐being in emergency medicine (EM) residency training. However, less is known about the humanities' role in graduate medical education (GME).ObjectivesThe objectives were to describe EM residents' self‐reported exposure to the humanities and its relationship with their empathy, tolerance of ambiguity, and patient‐centeredness, and to assess their attitudes toward the humanities in GME.MethodsThis cross‐sectional survey‐based study was conducted at six U.S. EM residency programs in 2018–2019. Quantitative analyses included linear regressions testing for trends between humanities exposures and outcomes, adjusted for sex, year in training, and clustering within programs; adjunct analysis of free‐text responses was performed using an exploratory constructivist approach to identify themes about views on the humanities' role in medicine.ResultsResponse rate was 54.8% (153/279). A total of 65% of respondents were male and 28.1% of respondents had a preceding humanities degree. Preceding humanities degree and current self‐reported humanities exposure were positively associated with performance on empathy subscales (p = 0.02). Seventy‐five percent (n = 114) of respondents agreed humanities are important in GME; free‐text responses revealed perceived positive impacts of humanities on generating well‐rounded clinicians and enhancing patient care.ConclusionsEngagement with the humanities may be associated with empathy among EM residents. Although the magnitude of associations was smaller than that seen in UME, this study demonstrates resident interest in humanities and suggests that extracurricular engagement with the humanities may be insufficient to prolong positive impacts seen in UME. Further research is needed to explore how to sustain these benefits through integration or addition of the humanities in existing GME curricula.

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Patient-Centeredness and its Correlates among First Year Medical Students

Cited by 121 publications

References 24 publications

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Impacto da “Disciplina Relação Médico-Paciente” sobre Atitudes Centradas no Paciente

“A sorely neglected field”: A multisite study of self‐reported humanities exposure among emergency medicine residents

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