NCT03722810

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

Completed NA Results posted Last updated 16 September 2020

What this trial tests

NA trial testing Intervention in Educational Techniques in 317 participants. Completed in 20 June 2019.

Timeline

28 September 2018

Primary endpoint
20 June 2019

20 June 2019

Quick facts

Lead sponsor	University of Bern
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	single
Primary purpose	other
Enrollment	317
Start date	28 September 2018
Primary completion	20 June 2019
Estimated completion	20 June 2019
Sites	1 location across Switzerland

Drugs / interventions tested

• Intervention
• Sham comparator

Conditions studied

• Educational Techniques — all drugs for Educational Techniques →

Sponsor

University of Bern

Who can join

Eligibility, any sex, with Educational Techniques. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Changes in Medical Students' Patient-centredness as Assessed by the PPOS-D12 Questionnaire Primary · Between study start, 28th September 2018 and study completion, June 20, 2019, approximately 9 months.

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

Group	Value	95% CI
Active Comparator: Patient Interview	0.23	± 0.41
Sham Comparator: Document	0.32	± 0.47

The Effect of Students' Gender on Their Levels of Patient-centredness as Assessed by the PPOS-D12 Questionnaire Secondary · At baseline (start of academic year).

The effect of students' gender (female/male) on their levels of patient-centredness, as measured by their PPOS-D12 questionnaire administered before the intervention (at start of academic year). PPOS-D12 scale scores can vary from a mean score per question of 1 (most doctor-centred) to 6 (most patient-centred). To measure secondary outcomes, we used linear regression to determine the effect of students' baseline characteristics on PPOS-D12 scores before the intervention (at start of academic year).

Group	Value	95% CI
Female	4.25	± 0.43
Male	4.08	± 0.51

The Effect of Students Having Previously Studied Another Subject as an Undergraduate. Secondary · At baseline (start of academic year).

The effect of students' previous experience (presence or absence of previous university degrees) on their levels of patient-centredness, as measured by their PPOS-D12 questionnaire administered before the intervention (at start of academic year). PPOS-D12 scale scores can vary from a mean score per question of 1 (most doctor-centred) to 6 (most patient-centred). To measure secondary outcomes, we used linear regression to determine the effect of students' baseline characteristics on PPOS-D12 scores before the intervention (at start of academic year).

Group	Value	95% CI
Studied Another Subject as an Undergraduate	4.37	± 0.54
Not Previously Studied Another Subject	4.17	± 0.46

The Effect of Students' Prior Exposure to Chronic Illness on Their Levels of Patient-centredness as Assessed by the PPOS-D12 Questionnaire. Secondary · At baseline (start of academic year).

The effect of students' prior exposure to chronic illness (presence or absence of experience of serious chronic illness in the participant, a relative or a close friend) on their levels of patient-centredness, as measured by their PPOS-D12 questionnaire administered before the intervention (at start of academic year). PPOS-D12 scale scores can vary from a mean score per question of 1 (most doctor-centred) to 6 (most patient-centred). To measure secondary outcomes, we used linear regression to determine the effect of students' baseline characteristics on PPOS-D12 scores before the interventio

Group	Value	95% CI
Experience of a Chronic Illness	4.22	± 0.48
No Experience of a Chronic Illness	4.18	± 0.47

Correlation Between GP Teachers' Patient-centredness and Changes in Levels of Their Students Levels of Patient-centredness, as Assessed by the PPOS-D12 Questionnaire. Secondary · GP teachers: end of primary care attachment. Students: Between study start, 28th September 2018 and study completion, June 20, 2019, approximately 9 months.

A nested study measured the strength of association between the GP teachers' own levels of patient-centredness (at end of students' primary care attachment) and changes in their own students' levels over the year (from baseline, i.e. start of academic year, to end of primary care attachment, up to 12 months), as measured by their respective PPOS-D12 scores (PPOS-D12 change for the students, PPOS-D12 score for their GP teachers). PPOS-D12 scale scores can vary from a mean score per question of 1 (most doctor-centred) to 6 (most patient-centred). We used the Pearson correlation coefficient to

Group	Value	95% CI
Correlation Between Students' and Teachers' PPOS-D12 Scores	0.088

Sponsor's own description

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.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

1. Does a home-based interview with a chronically ill patient help medical students become more patient-centred? A randomised controlled trial.
   Harris M, Camenzind AL, Fankhauser R, Streit S, et al · · 2020 · cited 3× · PMID 32652987 · DOI 10.1186/s12909-020-02136-y