A gender-specific evaluation of a care-oriented curricular change in a Dutch medical school

Abstract

Background: Patients with chronic diseases need doctors who have the appropriate skills to maintain a long-term doctor–patient relationship with an orientation towards care rather than cure and focused on the patient's role in managing their condition. As the number of chronically ill patients is rising, medical education has to develop and evaluate instructional formats to prepare future doctors to provide care tailored to these patients.Aim: To examine the possibly gender-specific effects on students’ orientations of a patient-oriented programme.Methods: Three consecutive cohorts of third-year medical students at least twice completed the Ideal Physician questionnaire, which measures care versus cure orientation. Two cohorts participated in a care-oriented curriculum intervention, the third cohort did not. Analysis of variance was used to examine trends in the students’ orientation.Results: Starting from a rather neutral care-cure orientation, a small but consistent trend towards increased cure orientation was found, which was unaffected by the educational intervention. Female students were more patient centred (p = 0.00) but became increasingly cure oriented.Conclusion: Our programme was unable to curb the increased cure orientation in students. In addition to appropriate health-care innovations, other or more intensive curricular interventions are probably needed to serve the current and the future influx of chronically ill patients.