Medical Students' Attitudes toward Patient-Centered Care

Patient-centered care has a positive impact on clinical outcomes in terms of the patient-physician relationship. Cultivating patient-centered care is considered to be one of the most important objectives of a medical student liberal education and the evaluation for medical humanistic education. The purpose of this study is to explore medical students' attitudes toward patient-centered care in medical practice and to examine the relationship between the direction of patient-centered care and the multiple channel university admission system. The subjects of the survey research were first-year medical students from seven medical schools entering in the 2003 academic year. This longitudinal study was conducted over the first three years of their training and then in their fifth-year at medical school in 2007. The Patient-Practitioner Orientation Scale ( PPOS), a validated instrument designed to measure individual preferences toward various aspects of the patient-physician relationship, was administered to these students. The PPOS is composed of Sharing (sharing information, take part in decision making) and Caring (respect for a person's feelings , interpersonal relationships) subscales. The total PPOS score can range from patient-centered (egalitarian, whole person oriented) to disease- or physician-centered ( paternalistic, less attuned to psychosocial issues). The impact of the multiple channel university admission system on medical students' attitudes toward patient-centered care was also analyzed. There was a significant decline in the PPOS score across the four measured years as well as a gender difference. Female students tended to be more patient -centered than the male students. A different pattern was found among those who had entered the medial school via the universities' diversified entrance system. Those who had become medical students by recommendation and application of an entrance system retained a more positive attitude toward patient-centered care. Although the declines in medical students' attitudes toward patient-centered care were not all statistically significant, the downward trend suggests that patient-centered care needs to be reemphasized at medical schools.