Genesis of the professional-patient relationship in early practical experience: qualitative and quantitative study

CONTEXT: As a rule, undergraduate medical students experience everyday work in health care as spectators. They are not allowed to participate in real-life interaction between professionals and patients. We report on an exception to this rule. OBJECTIVES: The aim of this study was to examine undergraduate students' experiences in developing their first professional-patient relationships on the basis of being responsible for the care of patients. METHODS: The study involved 2 cohorts (2002 and 2003) of medical students, amounting to 503 students. They had all worked in hospitals and/or nursing homes for 4 weeks at the end of their first year of study. Subsequent to this, they produced a case presentation of experiences in this work they perceived as important. These important experiences were the focus of our analysis. RESULTS: Five categories of important experiences were identified. Four of the 5 categories are logically interrelated in that they collectively cover the range of players involved in a caring situation and provide student insights into the interaction between these players. The fifth category is a heterogeneous residue category. Analysis and quantification of these 5 categories reveals a general similarity: students, to an overwhelming degree, are concerned with developing patient-centred care. DISCUSSION: If they are given real responsibility for patient care, undergraduate medical students, of their own accord, tend to develop patient-centred relationships in accordance with the principles of the new professionalism, sometimes in opposition to institutional and/or collegial constraints.