טכניון מכון טכנולוגי לישראל
הטכניון מכון טכנולוגי לישראל - בית הספר ללימודי מוסמכים  
Ph.D Thesis
Ph.D StudentMeirovich Adaya
SubjectMedical Student-Centered Tutoring as a Model for Patient-
Centered Medicine
DepartmentDepartment of Education in Science and Technology
Supervisors Professor Michael Moore
Clinical Professor Avi Rotshild
Professor Rosalie Ber


Abstract

There is a marked difference between the explicit and implicit messages that medical students receive regarding patient-physician relationship at medical faculties worldwide. In order to bridge this gap patient-centered teaching and the use of student-centered pedagogical approach have been recommended.


The research objectives were:
 1) Testing the effect of a student-centred pedagogical approach on the development of patient-centred relationship;
 2) understanding the professional development of medical students during the preclinical stage of their  studies. The targets of this pedagogical approach were  groups of medical  students  in the 3-year course “Being a Doctor: Exposure to The Medical Profession" at the Technion Faculty of Medicine.

The study involved repeated measurements of the students' attitudes and empathy; and assessing student behavior in simulated medical interviews, comparing an experimental group, tutored by tutors undergoing student-centered pedagogical mentoring, and a control group, whose tutors were not coached in a student-centered pedagogical manner.


The results show that tutoring in the experimental group was more student-centered than in the control group.   This difference was prominent when comparing the discussions of the course and the communication workshop:  In the experimental group, the course's discussions were more student-centered compared to those in the communication workshop. In the control group, the situation was reversed. Despite these differences in tutoring style, no differences in empathy and attitudes were found between the two groups.   However, the behavior of the experimental group in the simulated medical interview tended to be more patient-centered than that of the control group.  The lack of statistical significance of this trend may be due to the small size of the sample participating in the simulation.   Our findings show stability in the professional development of the students throughout the pre-clinical years. The attitudes and behavior of Arab students were more doctor-centered than those of Jewish students.

The study is unique in its contribution to longitudinal pedagogy. It opens up future research projects in both medical and general education.

    Our recommendations for developing more patient-centeredness in medical students are:
  1. Explicitly stress the parallel process of tutoring and medical interviewing;
  2. explicitly develop role-modeling as a central element in the tutoring process;
  3. develop a culture of good interpersonal relationships in the faculty;
  4. develop tutor training and student support programs.