Medical student attitudes toward the doctor–patient relationship

Medical student attitudes toward the doctor–patientrelationship

Paul Haidet,1,2 Joyce E Dains,3 Debora A Paterniti,4 Laura Hechtel,5 Tai Chang,3 Ellen Tseng3 & John CRogers3

Context Medical educators have emphasized the im-

portance of teaching patient-centred care.

Objectives To describe and quantify the attitudes of

medical students towards patient-centred care and to

examine: (a) the differences in these attitudes between

students in early and later years of medical school; and

(b) factors associated with patient-centred attitudes.

Methods We surveyed 673 students in the first, third,

and fourth years of medical school. Our survey utilized

the Patient–Practitioner Orientation Scale (PPOS), a

validated instrument designed to measure individual

preferences towards various aspects of the doctor–

patient relationship. Total PPOS scores can range from

patient-centred (egalitarian, whole person oriented)

to disease- or doctor-centred (paternalistic, less attuned

to psychosocial issues). Additional demographic data

including gender, age, ethnicity, undergraduate course-

work, family medical background and specialty choice

were collected from the fourth year class.

Results A total of 510 students (76%) completed data

collection. Female gender (P < 0Æ001) and earlier year

of medical school (P ¼ 0Æ03) were significantly

associated with patient-centred attitudes. Among

fourth year students (n ¼ 89), characteristics associ-

ated with more patient-centred attitudes included

female gender, European-American ethnicity, and pri-

mary-care career choice (P < 0Æ05 for each compar-

ison).

Conclusion Despite emphasis on the need for curricula

that foster patient-centred attitudes among medical

students, our data suggest that students in later years of

medical school have attitudes that are more doctor-

centred or paternalistic compared to students in earlier

years. Given the emphasis placed on patient satisfaction

and patient-centred care in the current medical envi-

ronment, our results warrant further research and

dialogue to explore the dynamics in medical education

that may foster or inhibit student attitudes toward

patient-centred care.

Keywords Attitude; curriculum; delivery of health care;

*doctor–patient relations; education, medical,

undergraduates, *methods; patient-centred care;

patient-centred satisfaction.

Medical Education 2002;36:568–574

Introduction

The doctor–patient relationship is central to the deliv-

ery of high quality medical care, and has been shown to

affect patient satisfaction and a variety of other biologi-

cal, psychological, and social outcomes.1 Patient-

centred care is one aspect of the doctor–patient

relationship that takes into account patients’ preferenc-

es, concerns, and emotions; it has been proposed as a

mechanism through which favourable patient outcomes

are achieved.2,3 In recent years, medical educators have

recognized the importance of patient-centred care by

instituting a variety of curricula to teach communica-

tion skills, professional values, and humanistic attitudes

and behaviours to medical students.4 However, a large

body of qualitative and ethnographic data exists to

suggest that the culture of medical education focuses

more on the biomedical mechanisms of disease than on

the issues central to patients’ preferences, concerns,

and emotions.5 Such a dynamic between school curri-

1Houston Veterans Affairs Medical Centre, Houston, Texas, USA,2Department of Medicine, Baylor College of Medicine, Houston,

Texas, USA, 3Department of Family and Community Medicine,

Baylor College of Medicine, Houston, Texas, USA, 4Department of

Medicine, University of California Davis School of Medicine,

Sacramento, California, USA, 5Department of Biology, Augustana

College, Rock Island, Illinois, USA

Correspondence: Paul Haidet MD MPH, Houston Veterans Affairs

Medical Centre, 2002 Holcombe Boulevard (152), Houston, Texas

77030, USA. Tel.: 00 1 713 794 8601; Fax: 00 1 713 748 7359;

E-mail: [email protected]

Learning to care

568 � Blackwell Science Ltd MEDICAL EDUCATION 2002;36:568–574

culum and culture may act as a barrier to educators’

attempts to promote patient-centred care. We conduc-

ted this study to describe and quantify student attitudes

towards the doctor–patient relationship and differences

in attitudes between students in early and later years of

medical school.

Methods

Study sample

We assessed student attitudes towards the doctor–

patient relationship among students in 2 consecutive

first-year classes (academic years 1997–98 and 1998–

99) and in the third- and fourth-year medical classes

(academic year 1998–99) at a large US medical school

(> 150 students per class). Our study institution has a

4-year curriculum divided into pre-clinical (first

18 months, mostly classroom-based) and clinical (fol-

lowing 30 months, mostly patient care- or ward-based)

curricula. Since no major curricular changes were made

at this institution during the tenure of each of these

student classes, all experienced essentially identical

curricula. We collected data on gender from all

students and additional demographic data from stu-

dents in the fourth-year class.

Gender and attitude data among first-year students

were collected as part of a first-year history and physical

examination course. Students completed an optional

survey during this course at the mid-point of the first

year. Data on attitudes and gender in third-year

students were collected throughout the 1998–99

academic year during a 4-week family medicine clerk-

ship. All students in our sample began clinical clerk-

ships in the 18th month of medical school (January of

the second year), so the third-year students in our study

had been exposed to a variety and number of clinical

rotations for at least 6 months before data collection.

Each third-year student completed a survey at the

beginning of their family medicine rotation.

In addition to data collected from first and third-year

students as part of pre-clinical or clinical coursework,

we administered an anonymous survey to fourth-year

students during a school-wide gathering in the autumn

of the 1998–99 academic year. This survey collected

information on student attitudes, gender, ethnicity, age,

medical specialty of interest, major field of undergra-

duate degree, type of undergraduate degree (BA versus

BS), extracurricular coursework during medical school

(such as music or language lessons), and first degree

family members in the medical professions. The med-

ical specialty of interest was classified as ‘primary care’

if students responded with internal medicine, paediat-

rics, or family and community medicine as their

specialty choice. The major field of undergraduate

degree was classified as science and technology-

oriented for undergraduate majors in science, engin-

eering, and other technology-oriented fields such as

computer science.

Measurement of student attitudes

Student attitudes toward the doctor–patient relation-

ship were measured using a previously validated

instrument.6 The Patient–Practitioner Orientation

Scale (PPOS) is an 18-item instrument originally

designed to be administered to either doctors or

patients. It measures an individual’s attitudes toward

the doctor–patient relationship along two dimensions

termed ‘sharing’ and ‘caring’, respectively. The sharing

dimension consists of 9 items that measure the degree

to which the respondent believes that power and

control should be shared between doctor and patient,

and the degree to which doctors should share informa-

tion with the patient. Examples of sharing items

include: ‘the doctor’s agenda is the one that should

direct the course of the medical interview’ and ‘often it

is in the patient’s best interests if he⁄she does not have a

full explanation of his⁄her medical condition’. The

caring dimension consists of nine items that measure

the extent to which the respondent cares about the

value of warmth and support in the relationship, and

the degree to which the respondent thinks the doctor

should inquire about psychosocial issues and employ a

holistic approach to medical care. Examples of caring

items include: ‘a good bedside manner is the most

important thing a doctor can bring to a sick patient’ and

‘to understand their patients, doctors must explore

relevant sources of stress in their patients’ lives’.

Key learning points

Despite calls for patient-centred care curricula, we

found attitudes among later-year students to be

significantly less patient-centred than attitudes

among students in earlier years of medical school.

Ethnic and gender differences in patient-centred

attitudes exist among medical students.

Ongoing dialogue in medical education should

focus on innovative strategies that challenge

students and teachers alike to critically examine

their own views toward the provision of patient

care.

Medical student attitudes • P Haidet et al. 569

� Blackwell Science Ltd MEDICAL EDUCATION 2002;36:568–574

Respondents were asked to rate their agreement or

disagreement with individual items on a 6-point scale.

The overall PPOS score was computed as the mean of

the scores for the 18 items. Sharing and caring scores

were computed as the mean of the scores for the nine

items in each dimension, respectively. For this study,

we calculated mean scores to range from a value of 1

( ¼ doctor-centred or paternalistic) to 6 ( ¼ patient-

centred or egalitarian).

Statistical analysis

We used factorial analysis of variance to examine the

effect of gender, year of medical school, and their

interaction on mean PPOS scores (overall PPOS, caring

subscore, sharing subscore). Since mean PPOS values

did not differ significantly between the two first-year

classes (academic years 1997–98 and 1998–99,

P ¼ 0Æ3, Student’s t-test) and since the addition of

the 1997–98 data did not alter the findings of our

analyses, we combined all first-year students’ data in

our reported results. We used linear regression to

examine associations between mean PPOS score and

month of data collection among third-year students.

For fourth-year students, we examined the relation-

ships between PPOS scores (overall PPOS, caring

subscore, sharing subscore) and demographic variables

using linear regression for age and Student’s t-test for

dichotomous variables.

Results

We identified 673 eligible students, of whom 510

(76%) completed the PPOS instrument. Distribution

of students by year and gender is shown in Table 1.

The average total PPOS score for the entire cohort was

4Æ57 (± 0Æ48 SD). Total PPOS scores ranged from 2Æ50

to 5Æ94. Distributions of overall PPOS scores by

medical school year and gender are shown in Fig. 1.

Similar results were obtained on analysis of sharing and

caring subscores (not shown). Higher PPOS values

correspond to more patient-centred and egalitarian

attitudes in regard to the doctor–patient relationship.

Female students had a significantly higher overall

PPOS score (4Æ65 ± 0Æ04, least square mean ± SE)

than did male students (4Æ47 ± 0Æ03, P < 0Æ001). There

was a significant association of medical school year with

Figure 1 Distribution of PPOS scores by

medical school year and gender

Table 1 Distribution of students by gender and year of school

Year of medical school

Number of students

completing PPOS (number

of students eligible)

Female

(%)

First year students 263 (352) 118 (45)

Third year students 158 (159) 65 (41)

Fourth year students 89 (162) 36 (41)

Medical student attitudes • P Haidet et al.570


PPOS score (P ¼ 0Æ03). The pattern of change in

PPOS scores across classes differed between females

and males. The average class scores for females

decreased with increasing years of school, while the

male classes demonstrated an increase followed by a

decrease in PPOS scores from the first- to the fourth-

year class. This interaction between gender and year of

medical school was statistically significant (P < 0Æ001).

Since the PPOS instrument was administered to

third-year students throughout the year during rotation

through a family medicine core clerkship, we analysed

the association between the month of the year in which

students completed the instrument and overall PPOS

score. The month of the year in this analysis reflects

that amount of experience in other clinical rotations

prior to the family medicine clerkship. While this

analysis did not show a statistically significant associ-

ation of the month of the year with PPOS scores, there

was a trend toward PPOS scores being progressively

more doctor-centred among students who completed

data collection later in their third year (P ¼ 0Æ07).

We collected additional demographic data in the

survey that we administered to fourth-year students.

These data are detailed in Table 2. Among the non-

European-American students, 63% identified their

ethnicity as Asian, 23% identified their ethnicity as

Hispanic, and 9% identified their ethnicity as African.

Three demographic variables had significant associ-

ations with overall PPOS scores in fourth-year students.

These data are shown in Table 3. Female students,

students who reported their ethnicity as European-

American, and students who reported a primary care

specialty choice demonstrated significantly more

patient-centred scores than students who were male,

of non-European-American ethnicity, or reported non-

primary care specialty career choices (P < 0Æ05 for each

comparison). Age, educational background, extracurri-

cular coursework, and family background did not show

significant associations with PPOS scores. Slight trends

were seen toward higher (more patient-centred) scores

in students who reported non-science and technology

majors and students who reported extracurricular

activities, but they were not statistically significant

(P ¼ 0Æ16, P ¼ 0Æ11, respectively). Analysis of shar-

ing subscale scores revealed additional associations with

demographic variables. Higher sharing scores indicate a

greater belief in shared power between doctor and

patient and in the doctor’s sharing of information with

the patient. Females, European-American students,

students choosing primary care specialties, students

who reported non-science and technology majors and

students who reported extracurricular activities had

higher sharing scores (P < 0Æ05 for each comparison).

The type of undergraduate degree, advanced degrees,

age, and family background were not significantly

associated with sharing scores.

Discussion

Despite the emphasis placed by medical educators,

health care administrators, and practising doctors on

the importance of curricula that foster patient-centred

attitudes among medical students,7 our data suggest

that the attitudes of students in the later years of

medical school are more doctor-centred or paternalis-

tic than those of students in earlier years. Doctor-

centred attitudes have been shown to be associated

Table 2 Demographic characteristics of fourth-year students

(n ¼ 89)

Characteristic n (%)

Primary care specialty choice 44 (49)

European-American ethnicity 45 (51)

BS undergraduate degree 46 (52)

Science and technology undergraduate major 55 (62)

Advanced degrees (Masters, PhD or equivalent) 10 (11)

Extracurricular activities 28 (31)

Family members in the medical professions 45 (44)

Mean age (SD) 25 (2Æ3)

Table 3 Total and subscale PPOS scores via demographic in

fourth-year students*

Demographic

variable Total PPOS Caring Sharing

Gender: female

(male)

4Æ57 (4Æ37)� 4Æ51 (4Æ43) 4Æ62 (4Æ31)�

Ethnicity: European-

American

(non-Euro-American)

4Æ57 (4Æ32)� 4Æ55 (4Æ38)� 4Æ59 (4Æ28)�

Specialty choice:

primary care

(non-primary care)

4Æ56 (4Æ34)� 4Æ55 (4Æ39)� 4Æ56 (4Æ30)�

College major:

non-science (science)

4Æ53 (4Æ40)� 4Æ47 (4Æ46) 4Æ59 (4Æ33)�

Extracurricular

activity: yes (no)

4Æ56 (4Æ40)§ 4Æ49 (4Æ45) 4Æ63 (4Æ34)�

College degree:

BA (BS)

4Æ42 (4Æ47) 4Æ44 (4Æ49) 4Æ40 (4Æ46)

Family in the

medical profession:

yes (no)

4Æ44 (4Æ45) 4Æ45 (4Æ48) 4Æ43 (4Æ42)

* All scores are mean scores, n ¼ 89.

� P < 0Æ05, Student’s t-test. � P ¼ 0Æ16, Student’s t-test.

§ P ¼ 0Æ11, Student’s t-test.



with lower patient satisfaction8 and may contribute to

decreased trust in the doctor–patient relationship. The

doctor-centred attitudes among senior students that

this study demonstrates may be associated with a

decline in senior students’ patient-centred behaviours

that others have observed.9 Medical sociologists and

anthropologists suggest that methods for managing

work, mistakes and emotions, in addition to the

language and manner of presentation that students

acquire during their training, direct students away

from patient-centred patterns of interactions in both

peer groups and with patients.5,10–12 These data sug-

gest that the culture of medicine and the structure of

medical education erode patient-centred attitudes in

spite of the international movement toward patient

satisfaction and patient-centred care. Unfortunately,

the influence of socialization on the practice of

medicine is difficult to mediate with curricular inter-

ventions alone. Medical educators have noted that

interventions timed during the pre-clinical years and

intended to foster patient-centred attitudes and behav-

iours are often overshadowed by the powerful experi-

ences of the clinical years as embodied in the informal,

or ‘hidden’ curriculum.5 Our data would support this

observation, since third-year students demonstrated a

progressive trend toward doctor-centred attitudes as

successive cohorts completed the PPOS during the

course of this initial clinical year. In order to be

maximally effective, we believe that educational inter-

ventions intended to foster patient-centred attitudes

and behaviours must occur during the clinical years

and must counter-balance the experiences embodied in

the ‘hidden’ curriculum that foster the opposite.

Ideally, patient-centred attitudes should be nurtured

in the setting of patient care through active learning

approaches and strong patient-centred role-modelling

by respected attending doctors.13

The differences we observed in student attitudes

between the first-, third-, and fourth-year classes

demonstrated different patterns according to gender.

While the average class scores for female students

were less patient-centred in later years of school, the

scores among males were most patient-centred

during the third year. Early ethnographic research

on medical students shows that students enter

medical school with a high degree of idealism, which

declines during the first 2 years of their education

and increases at the start of their clinical years when

students begin to see more patients.14 To the extent

that the construct of ‘patient-centredness’ as meas-

ured by the PPOS aligns with ‘idealism’ as observed

in this early research, our quantitative results among

males (the gender about which early ethnographic

accounts were written) seem to corroborate this

qualitative finding.

In a previous study, freshman female medical stu-

dents were shown to have more patient-centred atti-

tudes than male students.15 Our present study shows

that this difference between female and male students

exists in the fourth year of medical school as well. This

difference in attitudes may be linked to demonstrated

differences in gendered patterns of communication

among male and female doctors.16 It has been sugges-

ted that the patient-centred communication pattern

employed by women doctors may account for demon-

strated differences according to gender of doctor in a

diverse array of patient outcomes, including satisfaction

and provision of preventive services such as hormone

replacement therapy.17 Further study and understand-

ing of the nature and development of this gender

difference in attitudes toward the doctor–patient rela-

tionship may significantly inform efforts to eliminate

disparities by gender in the provision of high quality

medical care.

In this study, we demonstrated a strong association

between student ethnicity and patient-centred atti-

tudes. We hypothesize that this observation can be

explained by cultural differences in students’ views of

the ‘ideal’ doctor–patient relationship. For example, the

majority of non-European-American students in our

sample identified themselves to be of Asian ancestry.

Others have noted that the fundamental nature of the

doctor–patient relationship in terms of power-sharing

and holistic care tends to vary among cultures, and that

social norms in certain Asian cultures tend to favour a

more doctor-centred relationship.18 We hypothesize

that students enter medical school with their own

specific views of the ‘ideal’ doctor–patient relationship,

views that are shaped by diverse factors, including

social and cultural norms, gender, past experience as

patients, and portrayals of doctors in various mass

media. These ‘baseline’ impressions of the doctor–

patient relationship may be especially important in

determining students’ attitudes toward patient-centred

care upon graduation from medical school. We argue

that a critical developmental task for student doctors is

to develop awareness and understanding of the back-

ground of their own views toward patient-centred care.

Since ethnic differences between doctors and patients

are often barriers to partnership and communication in

the doctor–patient relationship, such an awareness may

help students to manage the relational dynamics

between themselves and patients of different ethnicity

more effectively. In addition, awareness of personal

views and biases has been proposed as an essential

ingredient for high quality patient care and teaching.19



The PPOS instrument may be useful towards this end

in that it provides information that individual students

can use as a first step toward examining and developing

personal awareness of their own views.

It is important to note that our study measured

attitudes toward patient-centred care rather than actual

patient-centred behaviours. While it is difficult for us to

predict the clinical significance of relatively patient-

centred or doctor-centred scores without additional

outcome data, previous work with the PPOS has

demonstrated important links between doctor or stu-

dent attitudes and patient outcomes. Krupat and

colleagues previously demonstrated that patient-

centred attitudes among doctors are associated with

high degrees of patient satisfaction.8 In addition, we

previously demonstrated that patient-centred attitudes

among third-year medical students are associated with

higher standardized patients’ ratings of those students’

humanism.20 We assume that the mechanism through

which these favourable outcomes are achieved concerns

patient-centred behaviours exhibited by the doctor,

although this assumption remains to be tested. In our

ongoing work, we will be examining associations

between students’ attitudes and their communicative

behaviours with both standardized patients and ward

patients.

Our study has several limitations. Since we used a

cross-sectional design, the comparisons we made

between classes of medical students may not be indic-

ative of attitude changes that occur in individual students

as they progress through medical school. Another

limitation is the relatively small sample size for examining

the association of personal attributes to PPOS scores, as

well as the absence of second-year medical students in

our study. A larger sample may have statistical power to

show differences in overall PPOS scores that were

suggested by the sharing subscale analysis. In our

ongoing investigation, we are collecting demographic

and PPOS information from all medical students with

the statistical power to determine more accurately the

relative impacts of various demographic factors on

student attitudes and changes in attitudes over time.

The generalizability of our results is limited by our

collection of data at only one institution. However, the

curriculum at our study institution is relatively similar

to that at many other medical schools. At this

institution, all students receive formal instruction in

doctor–patient communication and ethics during the

pre-clinical years and they all participate in a weekly

longitudinal ambulatory care experience during the

clinical years. In addition, all students in the first-year

cohort receive feedback on communication skills

through the use of an objective structured clinical

examination (OSCE) with standardized patients. Given

the similarity between these types of patient-centred

curricula and those of other schools, we believe our

results to be indicative of general trends in attitudes of

medical students.

In conclusion, we have assessed the attitudes of

medical students toward the doctor–patient relation-

ship and shown these attitudes to be less patient-

centred among later-year classes of medical students.

Our hope is that these results will stimulate an ongoing

dialogue among educators, deans, and administrators

that will lead to innovative strategies in medical

education that challenge students and teachers at all

levels to critically examine their own views toward the

provision of patient care.

Contributors

PH conceptualized the research question. All contrib-

utors were involved in planning the research. PH, JED,

DAP, TC, ET and JCR worked on the design of the

study. PH, JED, TC, ET and JCR were involved in its

implementation. LH and TC contributed to design of

data analysis. PH, JED, DAP, LH and TC analysed the

data. PH and DAP drafted and revised the manuscript.

JED, LH, TC, ET and JCR carried out critical revision

of the manuscript.

The opinions and findings contained herein are those

of the authors and do not necessarily represent the

views of the US Department of Veterans Affairs, Baylor

College of Medicine, the University of California Davis

School of Medicine, or Augustana College.

Acknowledgements

The authors would like to acknowledge Harlan Nelson

MS for assistance in data management, Claire Huckins

PhD for assistance in data collection, and Nelda P

Wray MD MPH and Edward Krupat PhD for com-

ments and suggestions on earlier versions of the

manuscript. Data contained in this report were presen-

ted in part at the 22nd Annual Meeting of the Society of

General Internal Medicine, April 1999, San Francisco,

California, USA, and at the 110th Annual Meeting of

the Association of American Medical Colleges, October

1999, Washington DC, USA.

Funding

Dr Haidet is supported by a career development award

from the Office of Research and Development, Health

Services R&D Service, US Department of Veterans

Affairs.



References

1 Simpson M, Buckman R, Stewart M et al. Doctor–patient

communication: the Toronto consensus statement. BMJ

1991;303:1385–7.

2 Stewart M, McWhinney IR, Buck CW. The doctor–patient

relationship and its effect upon outcome. J Royal College

General Practitioners 1979;29:77–82.

3 Stewart M. What is a successful doctor–patient interview? A

study of interactions and outcomes. Social Sci Med

1984;19:167–75.

4 Schmidt H. Integrating the teaching of basic sciences, clinical

sciences, and biopsychosocial issues. Academic Med

1998;73:S24–31.

5 Hafferty FW. Beyond curriculum reform: confronting medi-

cine’ hidden curriculum. Academic Med 1998;73:403–7.

6 Krupat E, Putnam SM, Yeager C. The fit between doctors

and patients: can it be measured? J General Intern Med

1996;11 (Suppl.):134.

7 The Medical School Objectives Writing Group. Learning

objectives for medical student education – guidelines for

medical schools. Report 1 of the Medical School Objectives

Project. Academic Med 1999;74:13–8.

8 Krupat E. The practice orientations of doctors and patients.

The effect of doctor–patient congruence on satisfaction.

Patient Education and Counselling 1999;39:49–59.

9 Pfeiffer C, Madray H, Ardolino A, Willms J. The rise and fall

of students’ skill in obtaining a medical history. Med Educ

1998;32:283–8.

10 Atkinson P. Training for certainty. Social Sci Med

1984;19:949–56.

11 Good BJ. Medicine, Rationality, and Experience: an Anthropo-

logical Perspective. Cambridge: Cambridge University Press; 1994.

12 Haas J, Shaffir W. Becoming Doctors: the Adoption of a Cloak of

Competence. Greenwich, Connecticut: JAI Press; 1991.

13 Branch WT Jr, Kern D, Maidet P, Weissmann P, Gracey CF,

Mitchell G, Inui T. The patient–physician relationship.

Teaching the human dimensions of care in clinical settings.

JAMA 2001;286:1067–74.

14 Becker HS, Geer B, Hughes EC, Strauss AM. Boys in White:

Student Culture in Medical School. Chicago: Chicago University

Press; 1961.

15 Krupat E, Hiam CM, Fleming MZ, Freeman P. Patient-

centredness and its correlates among first year medical stu-

dents. Int J Psychiatry 1999;29:347–56.

16 West C. Routine Complications. Bloomington, Indiana: U Press;

1984.

17 Seto TB, Taira DA, Davis RB, Safran C, Phillips RS. Effect of

doctor gender on the prescription of oestrogen replacement

therapy. J General Intern Med 1996;11:197–203.

18 Kleinman AM, Eisenberg L, Good B. Culture, illness and

care. Clinical lessons from anthropological and cross-cultural

research. Ann Intern Med 1978;88:251–8.

19 Novack DH, Epstein RM, Paulsen RH. Toward creating

doctor-healers. fostering medical students’ self-awareness,

personal growth, and well-being. Academic Med 1999;74:516–

20.

20 Haidet P, Dains JE, Paterniti DA, Chang T, Tseng E, Rogers

JC. Medical students’ attitudes toward patient-centred care

and standardized patients’ perceptions of humanism: a link

between attitudes and outcomes. Academic Med 2001;76

(Suppl.):S42–S44.

Received 28 February 2001; editorial comments to authors 21 June

2001, 2 November 2002; accepted for publication 13 December 2001



Documents

Medical student attitudes toward the doctor–patient relationship