Gender differences on medical students’ attitudes toward patient-centred care: a cross-sectional survey conducted in Heilongjiang, China

Abstract

ObjectivesAssessing medical students’ attitudes toward patient-centred care is essential to bettering medical education. Based on doctor-patient relationships and the medical system in China, it is important to explore the impact of gender differences and other background factors on patient-centred attitudes and to provide references for medical education reform.MethodsA cross-sectional study was conducted on fourth-year medical undergraduate students from November 2017 to March 2018 in Heilongjiang Province, Northeast China. The Chinese-revised Patient-Practitioner Orientation Scale (CR-PPOS), which has been validated in previous research, was used to measure the medical students’ attitudes. The medical students’ demographic data was collected, including their gender, age, information on whether they have siblings, family residence location, doctor(s) for parents, year in which the student first experienced clinical practice, and student category.ResultsA total of 513 students (91.12%) completed the survey. The Chinese medical students scored considerably higher for ‘Caring’ (including patients’ preferences into the decision-making process) than for ‘Sharing’ (sharing information/responsibility with patients). These students tended to have patient-centred attitudes, as measured by an average overall CR-PPOS score of 3.63 (scores higher than 3.5 indicate patient-centred attitudes), which is higher than Malian (3.38) and Pakistani (3.40) medical students but lower than American (4.57) and Brazilian (4.66) students. Female students (P < 0.05) were significantly associated with more patient-centred attitudes and with higher ‘Sharing’ and ‘Caring’ subscale scores. Student category (P < 0.05) was associated with ‘Sharing’ and ‘Caring’ scores. Clinical hospital students (P < 0.05) were associated with more patient-centred attitudes and with higher ‘Sharing’ and ‘Caring’ subscale scores, Students without siblings (p < 0.07) were associated with the higher ‘Sharing’ subscale scores.ConclusionsIn China, gender has a significant impact on medical students’ patient-centred attitudes, which is similar to findings from other countries. If medical schools want to raise patient-centred attitudes across the board and bridge the gap between male and female patient-centred attitudes, gender, student category, and other factors should be incorporated into medical education.

Do Physicians’ Attitudes towards Patient-Centered Communication Promote Physicians’ Intention and Behavior of Involving Patients in Medical Decisions?

“…The observed lower score of sharing subscale among Chinese physicians in primary care may contribute to environmental factors, such as Chinese cultural values, local health system [ 27 ].…”

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

“…In line with the practice of a more autonomist style, a study that assessed psychiatrists' sharing-based decision behaviours reported higher scores for women [65]. Likewise, in more recent studies, female physicians [23,66] and medical students [66,67] had signi cantly more patient-centred attitudes (understood as share of power, control, and information; respect for patients' feelings, expectations, and preferences taking these factors into account in medical decision-making [68]), suggesting that gender-stereotyped communication is established through the attitudes of medical students and seems to persist among practicing physicians [66]. These differences are even more important in that they lead to corresponding differences in patients' behaviour towards physicians.…”

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

“…In line with the practice of a more autonomist style, a study that assessed psychiatrists' sharing-based decision behaviours reported higher scores for women [62]. Likewise, in more recent studies, female physicians [23,63] and medical students [63,64] had signi cantly more patient-centred attitudes (understood as share of power, control, and information; respect for patients' feelings, expectations, and preferences taking these factors into account in medical decision-making [65]), suggesting that gender-stereotyped communication is established through the attitudes of medical students and seems to persist among practicing physicians [63]. These differences are even more important in that they lead to corresponding differences in patients' behaviour towards physicians.…”