Teaching medical students the effects of values and stereotyping on the doctor/patient relationship.

As part of an introductory course on the doctor/patient relationship, a teaching unit was designed which emphasized to students that values, biases and prejudices may affect their behaviors when interacting with patients. The unit included lectures on values, specific readings and a survey component which challenged students' value systems and provided them with the opportunity for exploration of hidden biases and prejudices. The survey component involved a series of trigger vignettes depicting five patients interacting with the same (actor) physician. On a rating instrument, students were asked to rate each patient on ten positive and ten negative characteristics, identify the characteristic which best described each patient and select the patient they would most like to treat. The survey was administered to an incoming class of medical students at the orientation session to a course on the doctor/patient relationship. Students were asked to keep a copy of their ratings and bring it to the small group discussion session on physician values. The data were collected, and a class composite developed and submitted to the course instructors prior to the discussion and processing sessions on values. Specific instructions on how to utilize the materials were provided. The class composite, which revealed that students have biases, served as a focus for discussion and facilitated students awareness that unconscious stereotypes exist in their value systems. This teaching approach provided students with a beginning insight that biases and prejudices affect the doctor/patient relationship and the quality of care patients receive.

KIE: As part of an introductory course on the physician patient relationship, a teaching unit was developed that emphasized to medical students that their unconscious biases could affect their interactions with patients. The unit included lectures and readings on physician values and behaviors, videotaped trigger vignettes with an associated survey, and follow-up discussion sessions. In the survey component, students were asked to rate five similarly presenting patients--a young attractive black woman, a young attractive white woman, a middle-aged professional male, a middle-aged housewife, and an elderly male--on each of ten positive and ten negative characteristics. Discussion of the composite class responses revealed to the students the extent to which they shared many commonly encountered social prejudices.

The lecture: increasing student learning.

This study involved a single lecture given to second-year medical students. Its purpose was to detemine whether significant learning of the lecture content could occur during the lecture. The author's criteria for "significant" learning was mastery of 75 percent of what he predetermined to be the important of "required" content plus T-test analysis of pretest-posttest learning. The class divided into Groups A and B. At the commencement of the lecture Group A took Test 1 as its pretest and Group B took Test 2. Immediately following the lecture Group A took Test 2 as its posttest and Group B took Test 1. Comparing Test 1 with Test 2 as pretests and again as posttest, they were not significantly different at the .05 level. However, Group A's posttest scores were significantly higher than its pretest scores (p less than .005). The same was found for Group B, with both groups' averaging over 90 percent mastery of the required content and demonstrating that significant learning occurred during the lecture.