How Does the First Clerkship Affect Medical Students' Views of the Relationship Between Physicians and Nurses?

Abstract

BACKGROUND: Preparing future physicians to work collaboratively with nurses is a must for today's educators. Effective physician-nurse collaboration improves patient care and health outcomes. Medical students' views of the physician-nurse relationship and how these views may evolve during their clerkships have not been well examined. METHODS: Medical students on their first clinical clerkship completed the Jefferson Survey of Attitudes Towards Physician-Nurse Collaboration on the first and last day of their 6-week obstetrics and gynecology clerkship. This 20-question instrument addresses areas of responsibility and collaboration between physicians and nurses and has construct validity and reliability. All questions used a 4-point Likert scale (1=strongly disagree, 4=strongly agree). Pre- and post-clerkship scores were compared using paired t tests. RESULTS: Twenty-five students completed the pre- and post-surveys with a 100% response rate. Students overall had positive views of the physician-nurse relationship. At the completion of the clerkship, medical students felt more strongly that “during their education; medical and nursing students should be involved in teamwork in order to understand their respective roles” (pre: 3.82, post: 3.95, P=.042), and that “there are many overlapping areas of responsibility between physicians and nurses” (pre: 3.26, post: 3.57, P=.008). DISCUSSION: Our work reveals promising data that medical students begin their clinical clerkships with positive views of the physician-nurse relationship. Furthermore after the completion of their first clerkship, the students had significantly higher views of the importance of collaboration and shared responsibility.