Abstract: Incoming Medical Students’ Attitudes Toward Family-Centered Care

◆ Anna M. Kerr, Ohio University
◆ Amy Zidron, Ohio University

Patient-centered care is a core competency required of medical students. Students with positive attitudes toward patient-centered care ask fewer biomedical questions and engage in more rapport-building tasks. [1] Patient-centered communication also decreases patient anxiety and increases patient satisfaction. [2,3] Accordingly, medical schools have integrated more patient-centered care curriculum. [4] However, the needs of family caregivers are often overlooked, [5] despite the fact that developing a therapeutic relationship with patients and families is a core competency defined by the Accreditation Council for Graduate Medical Education. [6]
Previous research suggests that students’ patient-centered attitudes decline during medical school. [7-9] One explanation for this is the presence of a hidden curriculum that models, and even rewards, behaviors that are not patient-centered. [10] To our knowledge, medical students’ family-centered attitudes during medical school and the potential influence of a hidden curriculum on those attitudes have not been explored. Therefore, the goal of the current study is to explore medical students’ attitudes toward patient and family-centered care. This investigation part of a larger longitudinal study exploring potential changes in students’ attitudes toward family-centered care during medical school.
We administered an online survey to the incoming class of medical students at a Midwestern medical school. The survey included multiple validated measures of attitudes toward patient-centered care [11,12] and family-centered care. [13,14] All scales included a 7-point Likert-type response scale. Students were offered a $10 Amazon gift card for completing the survey.
A total of 166 students (52.4% female; 80.1% White; Mean age = 23.1 years ± 1.8) completed the survey. Students reported very positive attitudes toward patient-centered medical communication (M = 6.50 ± .40) and a patient-centered orientation toward the doctor-patient relationship (M = 5.26 ± .49). Students reported positive, albeit lower, attitudes toward family-centered care (M = 5.07 ± .59). Students value families as a resource (M = 5.31 ± .75) and do not consider them to be a significant burden in patient care (M = 2.98 ± .95). All patient- and family-centered subscales were significantly correlated at the p < .001 level.
We explored factors affecting patient- and family-centered attitudes. Contrary to previous research [15], no significant differences emerged based on gender and intended specialty nor under-represented minority status or rural/urban origin. Age was also not significantly correlated with scores on any of the subscales. A significant difference did emerge by student race, but only for attitudes toward family-centered care [F(3,161) = 2.78, p < .05]. Students who identified as two or more races reported higher family-centered attitudes (M = 5.58 ± .21) than their White peers (M = 5.03 ± .58; p < .05).
Our results suggest that incoming medical students’ possess favorable attitudes toward family-centered care. However, their family-centered attitudes are lower than those they report for patient-centered care. Moreover, their family-centered attitudes are correlated with patient-centered attitudes, suggesting that they may be susceptible to the detrimental influence of the hidden curriculum. More research is needed to explore this potential influence, but our results confirm the need to promote family-centered care in medical education.