The Effect of a Structured, Home-based Interview With a Patient on First-year Medical Students' Patient-centredness.

NCT03722810 | Completed Results

• 1 other identifier: 1
• Study Type: interventional
• Target: 317
• Locations: 1 country
• Sites: 1

Brief Summary

Background Doctors are regarded as professionals, and specific teaching on professional behaviour is considered important in many countries. For medical students, early patient contact experiences were found to be an important way of learning about professionalism, and learning activities promoting critical reflection were particularly effective. Medical students consider that patient-centredness is one of the most important aspects of medical professionalism, and the PPOS questionnaire has been used extensively in measuring the attitudes of medical students towards patient-centredness. The PPOS-D12 questionnaire is a validated German version of that questionnaire. The study aim is to assess how a structured, in-depth, home-based interview with a patient with a chronic illness affects first-year medical students' patient-centredness. Methods In this randomised controlled trial, medical students who are in the first year of their studies at the University of Bern will be randomised to either seeing a patient with a chronic illness for a structured, in-depth interview in their own home (the intervention), or to reading an educational document that gives information about consultation skills (the sham comparator). Students will complete the PPOS-D12 survey before and after the interventions, so that changes in their scores can be calculated, and the mean scores of the two groups compared. Secondary outcomes will be the effect of students' gender and prior exposure to chronic illness in the participant or her/his close relatives and friends on their PPOS-D12 scores. A nested study will measure the strength of association between the GP teachers' own levels of patient/doctor-centredness and changes in their students' levels over the year. Discussion This research will consider the effect of an in-depth, structured interview with a patient with a chronic illness on changes in first-year medical students' levels of patient-centredness. There is existing evidence that medical students' levels of patient-centredness reduce over their student years, and this study will contribute to an understanding of how this reduction can be minimised or reversed.

Conditions

Educational Techniques

Keywords

Medical Professionalism; Professionalism Education

Outcome Measures

Primary Outcomes (1)

• Changes in Medical Students' Patient-centredness as Assessed by the PPOS-D12 Questionnaire

  Change in students' PPOS-D12 scores from base-line (at the start of the academic year) to the end of their year-long primary care attachment. The PPOS-D12 is the validated German-language version of the Patient-Provider Orientation Scale (Kiessling C, Fabry G, Rudolf Fischer M, et al., 2014), a self-completed questionnaire to assess patient-centredness among medical students. PPOS-D12 scale scores can vary from a mean score per question of 1 (most doctor-centred) to 6 (most patient-centred). For the primary outcome measure, to adjust for a difference in baseline PPOS-D12 scores between the two intervention groups, and after exploration of the data suggested that the effect of the baseline scores was linear, we compared the mean difference in the study start and end PPOS-D12 scores for the active and sham intervention groups using analysis of covariance (ANCOVA).

  Between study start, 28th September 2018 and study completion, June 20, 2019, approximately 9 months.

Secondary Outcomes (3)

• The Effect of Students' Gender on Their Levels of Patient-centredness as Assessed by the PPOS-D12 Questionnaire

  At baseline (start of academic year).

• The Effect of Students Having Previously Studied Another Subject as an Undergraduate.

  At baseline (start of academic year).

• The Effect of Students' Prior Exposure to Chronic Illness on Their Levels of Patient-centredness as Assessed by the PPOS-D12 Questionnaire.

  At baseline (start of academic year).

Other Outcomes (1)

• Correlation Between GP Teachers' Patient-centredness and Changes in Levels of Their Students Levels of Patient-centredness, as Assessed by the PPOS-D12 Questionnaire.

  GP teachers: end of primary care attachment. Students: Between study start, 28th September 2018 and study completion, June 20, 2019, approximately 9 months.

Study Arms (2)

Active comparator: patient interview

ACTIVE COMPARATOR

This intervention will be a structured in-depth interview with a patient with a chronic illness that has been chosen by the student's allocated GP teacher. The interview will be followed by a structured interview with the practice nurse and then a structured debriefing interview with the GP teacher.

Other: Intervention

Sham comparator: document

SHAM COMPARATOR

In this intervention, the student's allocated GP teacher will give the student time to read a document that gives information about consultation skills, and asks questions that the student will need to discuss with the GP teacher.

Other: Sham comparator

Interventions

Intervention OTHER

The intervention will be a structured in-depth interview with a patient with a chronic illness that has been chosen by the student's allocated GP teacher. These chronic diseases are the four conditions at the top of a list of diseases with high disability-adjusted life years (DALY) scores in Switzerland: ischaemic heart disease, low back pain, major depressive disorder and COPD. GP teachers and students will be told that the students' intervention interviews need to be unaccompanied and at patients' own homes. The interview will be followed by a structured interview with the practice nurse and then a structured debriefing interview with the GP teacher.

Also known as: Active intervention

Active comparator: patient interview

Sham comparator OTHER

In the sham comparator, the student's allocated GP teacher will be give the student time to read a document that gives information about consultation skills, and asks questions that the student will need to discuss with the GP teacher. The document is designed to have real educational value, and to complement BIHAM's department-based consultation skills teaching.

Sham comparator: document

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Medical students who are in the first year of their studies (their first Bachelor year) at the University of Bern, Switzerland.

You may not qualify if:

• None

Sponsors & Collaborators

• University of Bern: lead

Study Sites (1)

Berner Institut für Hausarztmedizin (BIHAM)

Bern, Canton of Bern, 3012, Switzerland

Location

Related Publications (23)

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• Harris M, Camenzind AL, Fankhauser R, Streit S, Hari R. Does a home-based interview with a chronically ill patient help medical students become more patient-centred? A randomised controlled trial. BMC Med Educ. 2020 Jul 11;20(1):217. doi: 10.1186/s12909-020-02136-y.

  PMID: 32652987 DERIVED

MeSH Terms

Interventions

Methods

Intervention Hierarchy (Ancestors)

Investigative Techniques

Results Point of Contact

• Title: Prof. Michael Harris
• Organization: BIHAM, University of Bern

michael.harris@biham.unibe.ch

+44 1761 241366

Study Officials

• Michael F Harris, MB BS MMEd

  Employee

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Randomised controlled trial, with sham control.

Study Record Dates

• First Submitted: October 20, 2018
• First Posted: October 29, 2018
• Study Start: September 28, 2018
• Primary Completion: June 20, 2019
• Study Completion: June 20, 2019
• Last Updated: September 16, 2020
• Results First Posted: September 16, 2020

Record last verified: 2020-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: Starting 6 months after publication
• Access Criteria: Emailed request to study lead (MH).

Locations

CH (1)