Early longitudinal experiences increase medical student self-efficacy.

Kanwarabijit Thind,Patrick Bauer,Hilary Titus,Meredith Niess,Reem Hasan

doi:10.15694/mep.2021.000142.1

Kanwarabijit Thind, Patrick Bauer + Show 3 more

Open Access

https://doi.org/10.15694/mep.2021.000142.1

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Journal: MedEdPublish (2016)	Publication Date: Jan 1, 2021
Citations: 1	License type: cc-by

Affiliation: Oregon Health & Science University

Abstract

This article was migrated. The article was marked as recommended. Background: The purpose of this study was to investigate the impact of early longitudinal preceptorship experiences on the evolution of general self-efficacy and patient-centeredness self-efficacy through medical school. Methods:Validated surveys for general self-efficacy and patient-centeredness self-efficacy were administered in an allopathic medical school at three timepoints. These data were stratified by traditional and longitudinal preceptorship groups and analyzed using Generalized Estimating Equations. Qualitative analysis of narrative medicine essays by the same cohort during their preceptorship experiences was also performed. Results: While general self-efficacy remained largely unchanged over time, patient-centeredness self-efficacy measures increased throughout medical school in the whole cohort (N=157). The longitudinal preceptorship group had higher gains in patient-centeredness self-efficacy, especially in the domain of exploring patient perspectives (p<0.05). The qualitative analysis of narrative medicine essays showed those in longitudinal preceptorships were more likely to discuss health care systems issues, consider psychosocial factors, and perceive themselves as active members of the care team. Discussion:Our study indicates greater patient-centeredness attitudes over time among students who have early longitudinal experiences, perhaps due to the self-efficacy building nature of these experiences. Our research suggest that medical school programs should consider incorporating opportunities for early longitudinal clinical experiences for their students.

Highlights

General self-efficacy is a concept long studied in psychology that represents one’s judgement of their own ability to complete the actions necessary to deal with a variety of prospective situations (Artino, 2012; Bandura, 1977)
We report on the evolution of general self-efficacy and patient-centeredness self-efficacy in a single institution’s medical school class from three cross-sectional surveys set throughout their undergraduate medical education
We found that while general self-efficacy remained largely stable, patient-centeredness self-efficacy measures increased significantly throughout medical school

Summary

Introduction

General self-efficacy is a concept long studied in psychology that represents one’s judgement of their own ability to complete the actions necessary to deal with a variety of prospective situations (Artino, 2012; Bandura, 1977) This concept has expanded to many fields, including extensive use in medical education (Artino, 2012; Mavis, 2001). Through self-efficacy theory, students with increased perceived "general self-efficacy" and "patient-centeredness self-efficacy" are hypothesized to have higher academic and career performance (Bandura, 1977) It is unclear how either general or patient-centeredness self-efficacy changes throughout medical school and residency training, how competing pressures (i.e. high-stakes tests like USMLE Step tests, family obligations, etc.) impacts these trends, or if increased clinical exposure leads to more accurate self-efficacy assessment. Our research suggest that medical school programs should consider incorporating opportunities for early longitudinal clinical experiences for their students

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