Does clinical training period support patient-centeredness perceptions of medical students?

Background: Learning environment influences students’ professional formation and patient-centered attitudes and behaviors. Objective: The purpose of this study is to investigate how hidden curriculum of learning environment and the previous experience with chronically ill patients affect patient-centeredness perceptions of medical students. Design: We followed 144 students and determined their opinions on ‘ideal patient-centered practice and learning environment’ via patient-centeredness questionnaire (PCQ) just before (third year) and at the end (sixth year) of clinical training years of medical school. At the end of each clinical training year (fourth, fifth, and sixth years), we determined experiences of the students about ‘patient-centeredness of the learning environment’ using a relevant survey called communication, curriculum, and culture (C3) instrument. We also compared PCQ and C3 instrument scores of the participants who had chronically ill patient in their families/friends and who do not. Results: C3 scores worsened over the years, namely, students faced increasing number of examples against patient centeredness. Final PCQ scores were worse than initial ones. C3 and PCQ scores of the students who had previous experience with chronically ill patients were not different from the scores of the remaining students. Conclusion: Medical students, even those who have a chronically ill patient in their families or friends, lose their idealism about patient centeredness to some degree possibly due to hidden curriculum of the medical school

A Multicenter Study: How Do Medical Students Perceive Clinical Learning Climate?

Background The relationship between students and instructors is of crucial importance for the development of a positive learning climate. Learning climate is a multifaceted concept, and its measurement is a complicated process. The aim of this cross-sectional study was to determine medical students’ perceptions about the clinical learning climate and to investigate differences in their perceptions in terms of various variables. Methods Medical students studying at six medical schools in Turkey were recruited for the study. All students who completed clinical rotations, which lasted for 3 or more weeks, were included in the study (n=3,097). Data were collected using the Clinical Learning Climate Scale (CLCS). The CLCS (36 items) includes three subscales: clinical environment, emotion, and motivation. Each item is scored using a 5-point Likert scale (1: strongly disagree to 5: strongly agree). Results The response rate for the trainees was 69.67% (n=1,519), and for the interns it was 51.47% (n=917). The mean total CLCS score was 117.20±17.19. The rotation during which the clinical learning climate was perceived most favorably was the Physical Therapy and Rehabilitation rotation (mean score: 137.77). The most negatively perceived rotation was the General Internal Medicine rotation (mean score: 104.31). There were significant differences between mean total scores in terms of trainee/intern characteristics, internal medicine/surgical medicine rotations, and perception of success. Conclusion The results of this study drew attention to certain aspects of the clinical learning climate in medical schools. Clinical teacher/instructor/supervisor, clinical training programs, students’ interactions in clinical settings, self-realization, mood, students’ intrinsic motivation, and institutional commitment are important components of the clinical learning climate. For this reason, the aforementioned components should be taken into consideration in studies aiming to improve clinical learning climate.PubMedWoSScopu