Student reflections on a Patient-Centred Primary Care Attachment

Abstract

BACKGROUND: In Asia, many doctors are reluctant to provide, and remain skeptical towards, psychological counselling. One reason may be an inadequate undergraduate exposure, and subsequent low priority to develop further skills. In response to this, a curriculum was introduced to expose students to common psychological presentations, with the hope of changing attitudes towards the care of emotionally distressed patients. SUMMARY OF WORK: Our final year Family medicine students attended a half-day, small-group (4 students) attachment to a primary care clinic with family doctors trained in counseling. Students were given the opportunity to observe and perform supervised patient-centred consultations. Skills coaching, feedback and debriefing were provided. Students were asked to write reflections on the learning achieved. Student reflections were transcribed and analyzed qualitatively. SUMMARY OF RESULTS: Analysis was undertaken on 60 reflections. Students’ main learning outcomes were an enhanced awareness and ability to detect patient distress, and recognition of the importance of establishing a therapeutic relationship. Students expressed a wish to explore further psycho-therapeutic techniques, and felt that the attachment had made an impact on their future practice as a doctor. CONCLUSIONS: A single, small-group, primary care attachment, focused on providing patient-centered care, was effective in raising awareness and producing positive attitudinal change towards the provision of psycho-social care.