What Makes Challenging Patients Challenging for Medical Students?

• In Event: 68.030 - Qualitative Studies: Experiences and Practices of Health Professionals

Abstract

To prepare medical students to care for patients who evoke negative reactions we must understand their experiences with these challenging patients. Using constructivist grounded theory we conducted an interview study of 26 graduating students, and in this analysis we present themes related to their roles as learners. Students experienced negative feelings about patients when 1)they thought the patients decreased their chances of positive evaluation and 2)the students lacked authority or skills to directly meet the patients’ needs. These findings evoke two theoretical frameworks about motivation: Goal Orientation and Self-Determination Theory. To shift students’ focus from evaluation to learning we should consider promoting mastery orientation, de-emphasize performance orientation, and give students roles in which they have autonomy and feel competent.

Authors

• Jody Steinauer, University of California - San Francisco

• Patricia S. O'Sullivan, University of California - San Francisco

• Felisa Preskill, University of California - San Francisco

• Olle ten Cate, University Medical Center Utrecht

• Arianne Teherani, University of California - San Francisco