Council on Medical Student Education in Pediatrics

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COMSEP 2011 San Diego Meeting with AMSPDC

Poster Presentation:


QUANTITATIVE ANALYSES OF STUDENTS' ATTITUDES AND PERFORMANCE IN TEACHING AND COUNSELING: ATTITUDES AFFECT PERFORMANCE

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

Background: Three distinct profiles (patient-centered (PC), learning-centered (LC) and self/doctor-centered (S/DC)) were identified during a 2008 qualitative analysis of student responses to teaching and counseling (T&C) first time mothers about Shaken Baby Syndrome. The Jefferson Scale for Teaching and Counseling a Challenging Topic (JTCCT) was developed and administered to the same students.  Four subscores were identified.  A scoring system to classify students into the three profiles was developed using factor analysis. Purpose: To assess the relationship between medical students’ attitudes toward T&C patients and performance on a simulation of a challenging T&C task. Methods: In 2009, one hundred and eighty students counseled Standardized Patients (SP) within a third-year Objective Structured Clinical Exam. Eighty four completed the JTCCT. They were classified into one of the three profiles based on the four subscores of the JTCCT. Mean SP ratings of student performance were calculated for the three profiles. Results: The JTCCT quantifies students’ attitudes toward T&C, revealing significant differences among PC, LC and S/DC student profiles.

Table 1. Mean  JTCCT Factor Scores within Student Profile Toward T&C

 
 
Profile
JTCCT Factor
 
Self/Doctor-Centered
(n=4)
Learning-Centered (n= 44)
Patient-Centered (n=36)
 Overall Attitudes Toward Communication
 
40.0*
45.1*
54.4*
Enjoyment of Task
 
2.3*
3.1*
3.5*
Value of Teaching
 
2.1*
3.2*
3.5*
Maturation
 
2.1*
3.0*
3.5*
* p<.001
SPs assigned significantly higher T&C ratings to the students classified as PC, lower to those classified as LC and the lowest to those classified as S/DC. There were no differences in content scores.

Table 2. Mean SP Ratings of Students' Performance on
Three Aspects of a Challenging T&C Task within Student Profile
 
Profile
SP Rating Categories
Self/Doctor-Centered
 
Learning-Centered
Patient-Centered
T&C
75.00*
84.11*
87.72*
Communication
72.25
77.98
82.31
Content
94.75
96.05
97.36
* p<.05

Conclusions:  Our findings indicate 1) use of the JTCCT to quantify students' attitudes toward T&C is supported; 2) Students' attitudes toward T&C affect performance in T&C, even though each group transmits the same content, 3) the JTCCT could be used to identify students who might benefit from curricular support in order to move them along the continuum toward patient-centeredness.