Characteristics of patient encounters that challenge medical students' provision of patient-centered care.

BACKGROUND

Medical educators need to effectively engage and teach medical students to provide patient-centered care (PCC). There is limited appreciation for the issues that clinical students identify as challenges in providing PCC.

METHOD

As part of a required half-day PCC workshop in 2007, medical students authored critical incident scenarios on patient encounters where PCC was difficult. The authors analyzed 131 scenarios using qualitative memo technique to identify features associated with these encounters. Categories and themes were identified using constant comparative methodology.

RESULTS

Commonly cited PCC challenges were student's/patient's emotional responses (63%/44%), patient's/family's perception of the care plan (54%), conflicting expectations (35%), communication barriers (30%) and patient's social circumstances (29%). Sixty-three percent of incidents identified PCC-appropriate responses to these challenges.

CONCLUSIONS

Student-authored critical incidents regarding difficult patient encounters can be analyzed to identify key features that students perceive as challenges to providing PCC and can inform curriculum development.