Patients' views on student participation in general practice consultations: A comprehensive review

Background: Recruiting general practitioners (GPs) to host students for their clerkship is difficult. GPs often assume patients dislike consulting a student-doctor. Aim: To systematically review the evidence on patient satisfaction regarding the presence/participation of a student during a consultation in general practice. Method: Medline search (January 1990 to July 2010). One reviewer extracted data from the articles fulfilling the criteria which were set, and a second reviewer checked these for accuracy. Due to heterogeneity a quantitative synthesis could not be performed. Results: Sixteen studies fulfilled the criteria. The majority of patients gave permission for the presence or participation of a student-doctor. Emotional problems and the need for an intimate examination were the main reasons for refusal. Satisfaction was high. Benefits the patients mentioned were: more time, a more thorough physical examination, better patient education and getting a second opinion. Altruism also played a role. Conclusion: In general, the attitude of patients towards student-doctors is positive. There is a general reluctance to see a student-doctor for emotional or intimate problems. Future research should focus on the effect of the preceptor's presence in the latter case. Another interesting topic would be the effect on consent and appreciation of the student-doctor when there are differences in cultural background between patient and student.