Through patient eyes: Can third-year medical students deliver the care patients expect?

Abstract

Introduction: Patient-centered approaches have a positive impact on adherence to treatment, self-management of chronic disease, and patient satisfaction. We seek to graduate physicians who provide effective Patient-Centered Care (PCC). The aims of this research were to (a) include the patients’ perspectives in describing behaviors essential to effective PCC, (b) create an authentic, credible tool to assess these behaviors in third-year medical students, and (c) validate the assessment tool through the eyes of our patients.

Methods: To develop and validate PCC behaviors we (a) developed PCC descriptors that included patient perspectives, (b) developed scenarios for students to demonstrate PCC, (c) administered the PCC-Objective Structured Clinical Exam, and (d) used the patient perspective to validate results.

Results: Faculty and students found the PCC-OSCE to be an authentic experience. Students received abundant individualized feedback and demonstrated strong performance in communicating effectively, avoiding medical jargon, listening actively, demonstrating empathy, and leading critical conversations. Patient critiques of exemplary performances confirmed that the PCC-OSCE assesses elements the patients viewed as essential to PCC.

Conclusion: Incorporating the patients’ perspective aids in better understanding professional competencies and legitimizes the assessment.

Acknowledgements

Karen Gordy-Panhorst M.A. made substantial contributions to the acquisition of Phases 2 and 3 data and analysis of Phase 3 data. She provided editorial assistance in the preparation of the manuscript.

Kyungbin Kwon Ph.D. made substantial contributions to the acquisition and analysis of Phase 3 data. He provided assistance in the preparation of the manuscript.

The authors would like to thank Linda Headrick, M.D., M.S., FACP, for helpful critique during the development of this manuscript. We also wish to thank the many faculty and staff who contributed to the development of the PCC-OSCE.

Declaration of interest: Phase one work was support by a grant from The Edward J. Stemmler, M.D., Medical Education Research Fund of the National Board of Medical Examiners, Kimberly Hoffman, P.I.