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Doctor-patient interaction in Finnish primary health care as perceived by first year medical students

机译：一年级医学生认为芬兰初级卫生保健中的医患互动

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Background In Finland, public health care is the responsibility of primary health care centres, which render a wide range of community level preventive, curative and rehabilitative medical care. Since 1990's, medical studies have involved early familiarization of medical students with general practice from the beginning of the studies, as this pre-clinical familiarisation helps medical students understand patients as human beings, recognise the importance of the doctor-patient relationship and identify practicing general practitioners (GPs) as role models for their professional development. Focused on doctor-patient relationship, we analysed the reports of 2002 first year medical students in the University of Kuopio. The students observed GPs' work during their 2-day visit to primary health care centres. Methods We analysed systematically the texts of 127 written reports of 2002, which represents 95.5% of the 133 first year pre-clinical medical students reports. The reports of 2003 (N = 118) and 2004 (N = 130) were used as reference material. Results Majority of the students reported GPs as positive role models. Some students reported GPs' poor attitudes, which they, however, regarded as a learning opportunity. Students generally observed a great variety of responsibilities in general practice, and expressed admiration for the skills and abilities required. They appreciated the GPs' interest in patients concerns. GPs' communication styles were found to vary considerably. Students reported some factors disturbing the consultation session, such as the GP staring at the computer screen and other team members entering the room. Working with marginalized groups, the chronically and terminally ill, and dying patients was seen as an area for development in the busy Finnish primary health care centres. Conclusion During the analysis, we discovered that medical students' perceptions in this study are in line with the previous findings about the importance of role model (good or bad) in making good doctors. Therefore, medical students' pre-clinical primary health care centre visits may influence their attitudes towards primary health care work and the doctor-patient relationship. We welcome more European studies on the role of early pre-clinical general practice exposure on medical students' primary care specialty choice.
机译：背景技术在芬兰，公共卫生保健是初级卫生保健中心的责任，初级卫生保健中心提供广泛的社区级预防，治疗和康复医疗服务。自1990年代以来，医学研究涉及从医学研究开始就对医学生进行早期熟悉，因为这种临床前的熟悉性有助于医学生将患者理解为人类，认识到医患关系的重要性并确定一般的执业医师。从业者（GPs）作为他们职业发展的榜样。我们着重于医患关系，分析了库奥皮奥大学2002年第一年医学生的报告。在为期2天的初级保健中心访问期间，学生观察了全科医生的工作。方法我们对2002年的127份书面报告进行了系统的分析，占133名第一年临床前医学生报告的95.5％。 2003年（N = 118）和2004年（N = 130）的报告用作参考材料。结果多数学生认为全科医生是积极的榜样。一些学生报告了全科医生的不良态度，但是他们认为这是学习的机会。学生通常在一般实践中承担着各种各样的责任，并对所需的技能和能力表示钦佩。他们感谢全科医生对患者的关注。发现全科医生的沟通方式差异很大。学生报告了一些会影响咨询会议的因素，例如GP盯着计算机屏幕和其他团队成员进入教室。在繁忙的芬兰初级卫生保健中心，与边缘化群体一起工作的慢性病和绝症以及垂死的患者被视为发展的领域。结论在分析过程中，我们发现医学生对这项研究的看法与先前关于榜样（好的或坏的）对培养好医生的重要性的发现是一致的。因此，医学生对临床前初级保健中心的访问可能会影响他们对初级保健工作和医患关系的态度。我们欢迎更多有关早期临床前常规实践暴露对医学生初级保健专业选择的作用的欧洲研究。

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