Does the presence of medical students affect quality in general practice consultations?

CONTEXT Previous studies have suggested that the patient's experience of a consultation with a doctor is not affected by the presence of medical students. However, no study has looked at the effect of student presence on conventional UK general practice consultations. OBJECTIVES This study aimed to measure the quality of the consultation as experienced by patients when students are present, to explore patients' attitudes to the presence of medical students, and to look at the relationships between these factors. METHODS We conducted a cross-sectional questionnaire study in general practices in north-east England. General practitioners (GPs) from practices teaching fourth and final year students administered questionnaires to patients who were seen in either teaching or non-teaching consultations. The questionnaire comprised previously validated measures of empathy and enablement as measures of quality, attitudinal statements regarding the presence of students, a scale rating pertaining to the patient's degree of acquaintance with the doctor, and items on demographic data. RESULTS Results showed no significant differences in enablement scores between the 2 groups. Consultations with student presence last longer. Empathy scores were significantly lower in the 'student present' group, but the size of the difference was small. Attitudinal statements regarding the presence of students showed a high proportion of positive responses, and some groupings of negative ones. Further analysis demonstrated some significant links between attitudinal statements and enablement and empathy scores. CONCLUSIONS The quality of general practice consultations was not adversely affected by medical student presence. However, significant numbers of patients who agreed to be seen with a student present were resistant to the student's presence.