But cheer up, nursing home residents. Things will change. Medical necessity is the mother of public policy. Many medical schools are striving to meet the growing demand for physicians trained and willing to devote themselves to primary care practice. In providing such education, a crucial issue is how the presence of medical students during the ambulatory medical encounter affects patient satisfaction and the use of clinical time.
Opinions vary widely, but reliable data are hard to obtain.
Investigators at Case Western Reserve University in Cleveland, Ohio have now utilized an elaborate protocol involving direct observation and review of medical records by research-trained nurses. An exit questionnaire was also administered to the patients. All data were coded to ensure confidentiality. The presence of the students made no difference either in patient satisfaction or the amount of time spent in physical examination, treatment planning, health education, or social chatting. Furthermore, there was no change in the rank order of the five most commonly observed physician behaviors, namely history taking, treatment planning, physical examination, health education, and providing feedback.