Journal of General Internal Medicine

, Volume 17, Issue 6, pp 420–427 | Cite as

Effect of student involvement on patient perceptions of ambulatory care visits

A randomized controlled trial
  • Todd W. Gress
  • John A. Flynn
  • Haya R. Rubin
  • Lisa Simonson
  • Stephen Sisson
  • Traci Thompson
  • Frederick L. Brancati
Original Articles

Abstract

OBJECTIVE: To determine if patient satisfaction with ambulatory care visits differs when medical students participate in the visit.

DESIGN: Randomized controlled trial.

SETTING: Academic general internal medicine practice.

PARTICIPANTS: Outpatients randomly assigned to see an attending physician only (N=66) or an attending physician plus medical student (N=68).

MEASUREMENTS AND MAIN RESULTS: Patient perceptions of the office visit were determined by telephone survey. Overall office visit satisfaction was higher for the “attending physician only” group (61% vs 48% excellent), although this was not statistically significant (P=.16). There was no difference between the study groups for patient ratings of their physician overall (80% vs 85% excellent; P=.44). In subsidiary analyses, patients who rated their attending physician as “excellent” rated the overall office visit significantly higher in the “attending physician only” group (74% vs 55%; P=.04). Among patients in the “attending physician plus medical student” group, 40% indicated that medical student involvement “probably” or “definitely” did not improve their care, and 30% responded that they “probably” or “definitely” did not want to see a student at subsequent office visits.

CONCLUSIONS: Although our sample size was small, we found no significant decrement in patient ratings of office visit satisfaction from medical student involvement in a global satisfaction survey. However, a significant number of patients expressed discontent with student involvement in the visit when asked directly. Global assessment of patient satisfaction may lack sensitivity for detection of dissatisfaction. Future research in this area should employ more sensitive measures of patient satisfaction.

Key Words

medical education medical student patient satisfaction randomized controlled trial 
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Copyright information

© Society of General Internal Medicine 2002

Authors and Affiliations

  • Todd W. Gress
    • 1
  • John A. Flynn
    • 1
    • 2
  • Haya R. Rubin
    • 1
    • 3
  • Lisa Simonson
    • 1
    • 2
  • Stephen Sisson
    • 1
    • 2
  • Traci Thompson
    • 1
  • Frederick L. Brancati
    • 1
    • 4
    • 5
  1. 1.Division of General Internal MedicineThe Johns Hopkins Medical InstitutionsBaltimore
  2. 2.the Program for Outpatient Education in MedicineThe Johns Hopkins UniversityUSA
  3. 3.the Program for Medical Technology and Practice AssessmentThe Johns Hopkins UniversityUSA
  4. 4.the Welch Center for Prevention, Epidemiology, and Clinical ResearchThe Johns Hopkins UniversityUSA
  5. 5.the Department of EpidemiologyThe Johns Hopkins University School of Hygiene and Public HealthBaltimore

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