Students' attitudes toward the patient-doctor relationship in a graduate-entry, problem-based medical program - a qualitative study

Context and objectives:Doctors and student doctors develop attitudes to the patient-doctor relationship that range from patient-centred to doctor-centred. Patient-centred attitudes and approaches lead to increased patient satisfaction and improved health outcomes. In some circumstances the proportion of students with patient-centred attitudes may decline as students progress through their medical program.Method:We conducted qualitative research on the determinants of attitudes to the patient-doctor relationship in students from Years 1 to 4 of a graduate-entry, problem-based medical program.Results:Themes identified for the determinants of students’ attitudes to the patient-doctor relationship included personal values, experiences as patients, personal experiences with patients and experiences of doctors interacting with patients in the clinical setting during the medical program. Students’ attitudes are both positively and negatively influenced by experiences with patients and experiences with doctors’ interactions with patients, and negatively influenced by perceived time constraints.Conclusion:Students attitudes to the patient-doctor relationship are determined by a variety of influences throughout their medical program. To counter negative influences, medical schools may need to focus on improving the quality of practising doctors’ patient-centred role-modelling through selection and teacher training.