Medical students’ and teachers’ attitude: physician or patient-centered?

Abstract: Introduction: Patient-centered care has been associated with positive results in medical practice. Objective: The aim of this study was to evaluate the attitudes of students and teachers from a Brazilian medical school regarding the physician-patient relationship and verify associated factors. Methods: This was an analytical cross-sectional study carried out in a public university, using the PPOS “Patient-Practitioner Orientation Scale” as well as a sociodemographic questionnaire. The subjects were regularly enrolled students attending the second semester of 2015 and their teachers. Mann-Whitney and Kruskal-Wallis tests were used to examine the effect of sociodemographic variables and the interaction with the scores found for students and teachers. Results: A total of 212 students were surveyed, corresponding to 57.1% of the enrolled students in the medical course. The value of the total PPOS score found for the students was 4.35 (± 0.5 SD), and the mean total score of PPOS among female students (4.43) was significantly higher than that in males (4.23) (p < 0.001), indicating more patient-centered attitudes in that group. Regarding medical teachers, 77 (56%) participated. The total score of PPOS was 4.52 (± 0.5 SD), with a more patient-centered attitude among teachers in comparison to students (4.35) (p = 0.001). However, there is a clear need for progress in both groups. Conclusion: The analysis of the students’ and teachers’ attitudes about the physician-patient relationship disclosed an unknown scenario, with more patient-centered attitudes verified among teachers despite the need for improvements by both. Further research is needed to evaluate not only the attitude but the behavior of these subjects.

摘要：
引言：以患者为中心的医疗照护（patient-centered care）已被证实与临床实践中的积极结局密切相关。
目的：本研究旨在评估某巴西医学院校学生与教师对医患关系的态度，并验证相关影响因素。
方法：本研究为一项在公立高校开展的分析性横断面研究，采用医患沟通取向量表（Patient-Practitioner Orientation Scale，PPOS）以及社会人口学问卷开展调查。研究对象为2015年第二学期在册就读的医学生及其授课教师。采用曼-惠特尼U检验（Mann-Whitney test）与克鲁斯卡尔-沃利斯H检验（Kruskal-Wallis test）分析社会人口学变量对学生与教师得分的影响及其交互作用。
结果：本次共调查212名医学生，占该医学专业在册学生总数的57.1%。学生的PPOS总均分为4.35（±0.5 标准差），其中女性学生的PPOS总均分（4.43）显著高于男性学生（4.23）（p < 0.001），表明该群体展现出更强的以患者为中心的医疗态度。针对医学教师群体，共有77人参与调查，占比56%；教师的PPOS总均分为4.52（±0.5 标准差），相较学生的4.35分，教师群体展现出更显著的以患者为中心的医疗态度（p = 0.001）。但两类群体均存在明显的改进空间。
结论：对学生与教师医患关系态度的分析揭示了此前未被充分认知的现状：尽管两类群体均有待改进，但教师群体展现出更强的以患者为中心的医疗态度。未来仍需开展进一步研究，不仅评估研究对象的态度，同时考察其实际行为表现。