MEDICINE AND SOCIETY<strong>Family</strong> Medical Centre Patients’ Attitudes Toward Senior MedicalStudents’ Participation in the ExaminationsGanime Sadikoglu MD,Assistant Pr<strong>of</strong>essor, Department <strong>of</strong> <strong>Family</strong> <strong>Medicine</strong>, Uludag University School <strong>of</strong> <strong>Medicine</strong>Correspondence:Dr. Ganime Sadikoglu, MD, Assistant Pr<strong>of</strong>essorDepartment <strong>of</strong> <strong>Family</strong> <strong>Medicine</strong>, Uludag University School <strong>of</strong> <strong>Medicine</strong>, Gorukle 16059, Bursa TurkeyTel: +90.224.4428929; Fax : +90.224.4428929; Email: ganime_s@hotmail.com or ganimes@uludag.edu.trABSTRACTIntroduction: Examination <strong>of</strong> polyclinic patients is an invaluable part in student medical education. The aim <strong>of</strong>this study is to determine the variables that affect patient satisfaction in students’ visits.Methods: 185 patients who attended the <strong>Family</strong> <strong>Medicine</strong> Clinic <strong>of</strong> Uludag University participated in this studyand were asked to answer the questionnaire consisting <strong>of</strong> 13 questions. Variables differed in the observed demographicdata.Results: Among the patients, 92.1% pointed out that students’ examinations were helpful. 84.1% <strong>of</strong> the patientsfelt confidence in the examination.Discussion: From this study, according to the collected data, we can say that communication between the patients<strong>of</strong> our clinic and the students, is satisfactory and therefore, we can also say that most <strong>of</strong> our patients have positivethoughts about the participation <strong>of</strong> the students in their examinations. Satisfaction from student participation ishigh, especially in the group <strong>of</strong> elderly, married, women, and patients with less education.Key words: <strong>Family</strong> <strong>Medicine</strong>, Patients’ Attitudes, Senior Medical Students.INTRODUCTIONSupporting clinical medical education with primarycare experience is an invaluable component in medicalstudents’ education. Attitudes <strong>of</strong> the patient toward beinga part <strong>of</strong> medical education are a very important factor ineducation quality. In recent years, services have changedfrom focus on care <strong>of</strong> hospital inpatients to ambulatorypatients. This caused changes in the format <strong>of</strong> medicaleducation. Patients’ attitudes were very positive withparticipation <strong>of</strong> medical students in the visits at internalmedicine, surgery, and dermatology clinics (1,2,3) .<strong>Family</strong> <strong>Medicine</strong>, which forms a big part <strong>of</strong> medicaleducation, and which has a great role in giving thephilosophy <strong>of</strong> general medicine to the students, is one <strong>of</strong>the areas where the patient-doctor communication is mostput into practice (4,5,6,7) . Observations showed that medicalstudents are accepted generally by the patients (3,8,9,10) .However, advantages and disadvantages <strong>of</strong> participation<strong>of</strong> students to the examinations were not clear.Positive communications between the patients andstudents have important effects on determining theexpectations <strong>of</strong> the patients (11) . At the same time, trainingwell-educated primary care doctors also has a bigimportance on constructing the organisation <strong>of</strong> changinghealth services and providing good quality healthcare(2,12,13). This study is designed to observe the attitudes <strong>of</strong>patients toward participation <strong>of</strong> senior medical studentsin their examinations.METHODSUludag University Faculty <strong>of</strong> <strong>Medicine</strong> is a universityhospital that serves the Marmara Region <strong>of</strong> Turkey. Thisstudy was done at Fethiye <strong>Family</strong> Medical Centre, wheresenior medical students do the patient examinations, andit is located in the main building <strong>of</strong> Uludag UniversityDepartment <strong>of</strong> <strong>Family</strong> <strong>Medicine</strong>.The patients who applied to Uludag University Faculty <strong>of</strong><strong>Medicine</strong> Department <strong>of</strong> <strong>Family</strong> <strong>Medicine</strong> and who wereseen by students’ were included in this study. The patients48MEJFM - Volume 5 Issue 1 - January 2007
MEDICINE AND SOCIETYwhose examinations were completed were asked tovoluntarily fill out the questionnaire forms anonymously.Students examined all the patients during their practice.The questionnaire forms consist <strong>of</strong> 13 questions thatcontain demographic information, education status, andtheir opinions about participation <strong>of</strong> medical students inthe examination period.Senior medical students do a 4-week family medicinerotation, examining the patients before the responsiblelecturer. First, medical students introduce themselvesto the patient, take the medical history and before theresponsible doctor arrives, they finish the examination<strong>of</strong> the patient. Then, students collect all findings, presentthem to the responsible lecturer and finally they end thevisit together by evaluating the patients.Statistical analyses, double frequency charts, comparison<strong>of</strong> the distribution <strong>of</strong> categorized answers were observedwith ki-square. Five pointed Likert scale was used inthe questionnaire form and the highest point was givento the most accepted (1 being strongly disagree, 5 beingstrongly agree). Variation analyses were made to comparethe average <strong>of</strong> the answers to the demographic variablesand one-way ANNOVA statistics were made to show theharmony in variables. SPSS 9.0 program was used at allanalyses.RESULTSA hundred and eighty five people were included inthis study. Demographic data are presented on Table 1.98.2% <strong>of</strong> the patients stated that the patient examinationis a necessity, 1.7% <strong>of</strong> the patients were undecided,only 0.1% <strong>of</strong> the patients did not answer this question.Opinions <strong>of</strong> the patients about student participation intheir examinations are summarized in Table 2.92.1% <strong>of</strong> the patients stated that participation <strong>of</strong> thestudents in their examination was helpful for them, 5.6%<strong>of</strong> the patients were undecided, and 2.3% <strong>of</strong> the patientsresponded that this practice was not useful.84.1% <strong>of</strong> the patients felt confident about the participation<strong>of</strong> the students in the examinations, 9.1% <strong>of</strong> the patientsexpressed that they had no idea, and 6.8% <strong>of</strong> thepatients expressed that they did not feel confident in theexaminations.76.6% <strong>of</strong> our patients expressed that they were notdisturbed by the participation <strong>of</strong> the students, 78.4% <strong>of</strong>the patients expressed that participation <strong>of</strong> the students tothe examinations did not cause waste <strong>of</strong> time, and 72.6%<strong>of</strong> them expressed that this participation did not preventthem from explaining their illnesses; they also expressedthat they could easily explain their illnesses.For the internal reliability <strong>of</strong> analysed data, CronbachAlpha index was calculated. Cronbach Alpha, which isa reliability coefficient, was found approximately 80.0%(0.7972). At the same time, it can be said that internalconsistency <strong>of</strong> data is very good because there was notany negative relationship between total correlations andany variables, or total correlation between variables wasnot very low.According to the results <strong>of</strong> ANOVA, there was ameaningful difference between the answers <strong>of</strong> young andold patients about the idea <strong>of</strong> patient examination beingnecessary or unnecessary in medical education. Whenthe ages <strong>of</strong> the patients increase, response to this subjectbecame more positive (p=.014). Older patients receivedthe highest score (4.857). <strong>Middle</strong>-aged (30-60) patients(4.796), young (