Menezes Colin Nigel, Dhai Ames, Tshabalala Nonzwakazi, Mpanya Dineo, Dickens Caroline
Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Med Sci Educ. 2020 May 7;30(2):933-942. doi: 10.1007/s40670-020-00976-3. eCollection 2020 Jun.
South Africa urgently needs more doctors. We examined perceptions of patients and students to provide evidence for optimum student-patient ratios and substantiate solutions for this dilemma.
We interviewed 118 patients and invited 120 students to complete a self-administered questionnaire from four specialities in an academic hospital in Johannesburg.
The total sample size was 238 participants. A total of 91/118 (77%) patients and 78/120 (65%) students were female. Almost all the patients had some level of education, with most patients having received at least a secondary education (71/120). More than half of the students (69/120) were final year students. A third (41/118) of the patients were unaware they were admitted to a teaching hospital. Half of the patients (60/118) thought they had the right to refuse interaction with students. Patients and students preferred smaller groups of between 1-3 and 4-8 students at a bedside tutorial ( < 0.001), although patients preferred smaller groups (1-3) compared with the students (4-8). Majority of patients said they never refused consent to students, while a third of students reported at least up to three patients refusing consent to be examined. The most frequent reason cited by students for refusal of consent by patients was the exposure to excessive numbers of students and healthcare professionals.
Medical schools should consider patient safeguards while responding to the country's need for more doctors. The Medical Council and medical schools need to draw up professional guidelines on patient-student interactions, including the role of patients in this setting.
南非迫切需要更多医生。我们研究了患者和学生的看法，以提供最佳师生比例的证据，并为这一困境提出切实可行的解决方案。
我们采访了118名患者，并邀请120名学生在约翰内斯堡一家学术医院完成了一份来自四个专业的自填式问卷。
总样本量为238名参与者。118名患者中有91名（77%）为女性，120名学生中有78名（65%）为女性。几乎所有患者都有一定程度的教育背景，大多数患者至少接受过中等教育（71/120）。超过一半的学生（69/120）是最后一年的学生。三分之一（41/118）的患者不知道自己被收治到了教学医院。一半的患者（60/118）认为他们有权拒绝与学生互动。在床边辅导时，患者和学生都更喜欢1 - 3人和4 - 8人的较小群体（<0.001），不过与学生（4 - 8人）相比，患者更喜欢更小的群体（1 - 3人）。大多数患者表示他们从未拒绝学生的同意，而三分之一的学生报告至少有三名患者拒绝同意接受检查。学生提到患者拒绝同意的最常见原因是接触过多的学生和医护人员。
医学院在应对该国对更多医生的需求时应考虑患者保障措施。医学委员会和医学院需要制定关于医患互动的专业指南，包括患者在这种情况下的角色。
