Council on Medical Student Education in Pediatrics

COMSEP Logo

Search This Site

COMSEP 2011 San Diego Meeting with AMSPDC

Poster Presentation:


QUALITATIVE ANALYSIS OF STUDENT ATTITUDES TOWARDS TEACHING AND COUNSELING: THREE STUDENT PROFILES EMERGE

Authors:
Judith A. Turow, MD, Thomas Jefferson University, Philadelphia, PA; Lindsey Lane, MD, University of Colorado School of Medicine, Aurora, CO

 

Background: Physicians often avoid teaching and counseling on awkward topics. Purpose: To analyze variation in medical student responses to performing a challenging patient-counseling task. Methods: Twenty-one medical students on the pediatric clerkship taught first-time mothers with public insurance, one-on-one on the postpartum floor about shaken baby syndrome. Using grounded theory, we interviewed each student, recorded, transcribed, coded, and thematically categorized their responses. After qualitative analysis and identification of major themes and subthemes, the students were categorized according to the thematic content of their responses. Results: Five major themes emerged that characterized students’ responses to performing the counseling task: orientation to task, beneficiary of task, value of teaching/counseling, engagement with task, student role in the medical team. These themes were used to develop a profile of each student on a continuum from self/doctor-centered, through learning-centered, to patient-centered.

Table 1. Summary of Student Profile by Theme
 
 
Student Profiles
 
Theme in Student Responses
Self/Doctor-Centered
Learning-Centered
Patient-Centered
Orientation to task
Disease oriented
Learning oriented
Psychosocially oriented
Beneficiary of task
Self
Student/self as learner
Patient
 
Value of teaching/counseling
Not valued
Valued as learning opportunity but unprepared/hesitant to teach
Valued
 
Engagement with task
Minimal
Moderate
Maximal
Role and status as part of the team
Negative/low
Mixed
High
These student profiles were consistently associated with the thematic content of their responses. An additional sub theme of awkwardness was not considered a defining factor as it was seen in all three profiles.

Table 2. Role of Awkwardness in the Student Response to a Challenging Counseling Task
Theme in Student Responses
Self/Doctor-Centered
Learning-Centered
Patient-Centered
Percentage of students who specified awkwardness
100
67
56

Conclusions: Based on their response to performing the challenging counseling task, students’ responses were categorized into characteristic profiles that fit the previously recognized model of a doctor-centered to patient-centered continuum. Given that some students need help to develop a more patient-centered style of care, this challenging counseling task may have use as a diagnostic method to identify students who could benefit from interventions to increase their sensitivity to patient needs.