Promoting Patient Care Ownership in Medical Students through Standardized Simulations

Abstract

Background:Professional identity formation (PIF) has been demonstrated to play an important role in medical students' transition from a peripheral role into becoming a physician that bears primary responsibility for the care of their patients1,2. Multiple factors influence this development, including clinical experiences as well as sociocultural, familial, academic, moral, religious, and gender-based roles, values, beliefs, and obligations. Many of these factors can be emulated in simulations to encourage this merging of identities; the most critical of which is patient care ownership (PCO)6. This study was conducted on the 4th year medical students at the Medical College of Georgia (MCG) and compares a self-reported PCO index score amongst the various subsets. These include main vs regional campus assignment for clinical years, gender identity, ethnicity, and prior healthcare experience before medical school. Methods:For this study, we distributed a questionnaire developed by Avey et al. (2009) and adapted by Wyatt et al.11 (2023) to evaluate the feelings and opinions of medical students regarding their level of patient care ownership11,16,17. To evaluate the effects of the longitudinal simulation curriculum on PCO as measured with the survey instrument index scores, independent sample t-tests and ANOVA between different groups with a Tukey HSD multiple-comparison post-hoc were done. Groups analyzed for differences included campus, gender identity, race, ethnicity, and prior experience in the healthcare field. Results: A total of 201 students were invited to participate in this study. There was no statistically significant difference between students from main and regional campuses in PCO index scores. When comparing between gender identities of male, female, and nonbinary, there was no significant difference (p = 0.248). Comparing ethnicities did not show any significant differences (p = 0.936). Finally, there was no significant difference in PCO index scores between students in regard to their prior healthcare experiences (p = 0.155). Conclusion:This study highlights the importance of a comprehensive and intentionally-designed simulation curriculum to prompt PCO in order to facilitate PIF prior to residency, for the purpose of producing more confident and competent intern physicians2. Conflict of interest: none Treatment of human and animal subjects: not applicable

Keywords

• simulation
• patient care ownership
• professional identity formation
• medical education
• regional campus
• Clerkship site choice