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Erosion in medical students’ attitudes about telling patients they are students

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Abstract

OBJECTIVE: To study the attitudes of preclinical and clinical medical students toward the importance of telling patients they are students, and to compare their attitudes with those of patients.

METHODS: We conducted a cross-sectional survey of medical students from five Philadelphia medical schools, and a longitudinal follow-up in one medical school, to assess the importance students place on telling patients they are medical students before interacting with them. We asked similar questions of 100 general medical outpatients from two academically affiliated hospitals.

MAIN RESULTS: In total, 2,603 students (58%) responded to the cross-sectional survey, 74 (50%) responded to the longitudinal survey, and 100 patients responded to our interview survey (94% response rate). In the cross-sectional survey, there were negligible differences in the importance that patients and medical students placed on informing alert patients that they are interacting with students in nonsurgical settings. In surgical settings involving anesthetized patients, patients placed significantly more importance on being informed of students’ roles in their surgery than did students, and preclinical students placed more importance on this than did clinical students. Results from the cross-sectional survey were supported by the longitudinal survey, in which fourth-year medical students placed significantly less importance on informing patients of their student status than the same cohort had done 2 years previously.

CONCLUSIONS: Medical students place less importance on informing patients about their student status than patients desire, especially in surgical settings in which the patient is to be anesthetized. Medical students already having completed a clinical rotation stray further from patient ideals than preclinical medical students. These findings suggest that, as medical students advance in their training, they suffer an erosion in their attitudes about telling patients they are students.

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Author information

Authors and Affiliations

  1. the Department of Pediatrics, University of Maryland, Baltimore, Md

    Ari Silver-Isenstadt MD, MEd

  2. Veterans Affairs Medical Center, Division of General Internal Medicine and Center for Bioethics, University of Pennsylvania School of Medicine, Philadelphia, Pa

    Peter A. Ubel MD

Authors
  1. Ari Silver-Isenstadt MD, MEd
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  2. Peter A. Ubel MD
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Additional information

Dr. Ubel is a Robert Wood Johnson Generalist Physician Faculty Scholar and a recipient of a career development award in health services research from the Department of Veterans Affairs.

This research was funded by the Annenberg Public Policy Foundation through its support of the Center for Bioethics’ Project on Informed Consent.

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Silver-Isenstadt, A., Ubel, P.A. Erosion in medical students’ attitudes about telling patients they are students. J GEN INTERN MED 14, 481–487 (1999). https://doi.org/10.1046/j.1525-1497.1999.09298.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.1999.09298.x

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