Making use of an existing questionnaire to measure patient-centred attitudes in undergraduate medical students: A case study

Background. Patient-centred care is widely acknowledged as important to achieve improved patient outcomes in healthcare. Therefore, it is vital that medical schools should foster this attitude in their students. Studies report that students are becoming less patient-centred in the period between entry to medical school and graduation.Objective. To determine the shift in attitude towards patient-centredness in a group of South African undergraduate medical students. Simultaneously, the reliability and validity of the Patient-Practitioner Orientation Scale (PPOS) in our context were measured.Methods. A cross-sectional survey was undertaken by asking all the medical students from year 1 to year 6 to complete the PPOS. The mean PPOS score for each cohort was calculated using SPSS for Windows. Reliability and validity testing was conducted using Cronbach’s alpha and confirmatory and exploratory factor analysis.Results. The average return rate across the 6 years of study was 81%. The results indicated low initial scores on the PPOS and a decrease in scores over the years of study, with the most dramatic drop being from year 1 to year 2. The PPOS showed poor validity and reliability in our context.Conclusion. The study appears to indicate the same decrease in patient-centredness in our students as has been shown in other studies using this tool. However, the low reliability and validity of the PPOS in our environment means that the result should be interpreted with caution. Factors such as our medical students’ not having had first-hand experience of the doctor-patient relationship and second-language issues may play a role. It is recommended that the PPOS not be used in our context without further exploration of the factors contributing to this loss of reliability and validity