Unclear if future physicians are learning about patient-centred care: Content analysis of curriculum at 16 medical schools

Abstract

Purpose

Given barriers of patient-centred care (PCC) among physicians and trainees, this study assessed how medical schools addressed PCC in curriculum.

Method

The authors used content analysis to describe PCC in publicly-available curriculum documents of Canadian medical schools guided by McCormack’s PCC Framework, and reported results using summary statistics and text examples.

Results

The authors retrieved 1459 documents from 16 medical schools (median 49.5, range 16–301). Few mentioned PCC (301, 21.2%), and even fewer thoroughly or accurately described PCC. Significantly more clerkship versus pre-clerkship (24.0% vs 12.6%, p < 0.00001), and elective compared with core course descriptions (24.7% vs 14.9%, p < 0.00001) mentioned PCC. The domain of foster a healing relationship was common (79.0%) compared with other domains: address concerns (16.5%), exchange information (14.9%), enable self-care (10.4%), share decisions (4.5%), and manage uncertainty (1.3%).

Conclusions

Overall, few documents mentioned or described PCC or related concepts. This varied by school, and was more frequent in clerkship and elective courses, suggesting that student exposure may be brief and variable. Thus, it remains unclear if medical students are fully exposed to what PCC means and how to implement it. Future research is needed to confirm if PCC content in medical curriculum is lacking.

Keywords:

• Patient-centred care
• medical curriculum
• content analysis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data are included in the manuscript and its Supplemental files.

Glossary

Patient-centred care: Partnership among clinicians, patients and their families or care partners to ensure that patients receive care that is attentive to their clinical needs, life circumstances, and personal preferences. PCC is multi-dimensional, entrenched in effective communication, and achieved when patients and clinicians jointly foster a healing relationship, exchange information, address concerns, manage uncertainty about prognosis or treatment risks and benefits, share decision-making, and enable self-management.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Notes on contributors

Natalie N. Anderson

Natalie N. Anderson, MPH is a Research Associate, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.

Anna R. Gagliardi

Anna R. Gagliardi, PhD is a Senior Scientist, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada and Professor, University of Toronto.