Medical Students’ View on Troublesome Aspects of Bedside Manner in a Multilingual Area

Abstract

Bedside manner is currently not separately taught in the University of Medicine and Pharmacy of Tîrgu Mureş. Students have to figure it out for themselves by observing physicians and learning from their own experience – methods that are fundamentally linked to the students’ attitude towards this important aspect of their future career as doctors. Obtaining relevant information from the patient and creating a proper physician-patient relationship depends on the physician's willingness and capacity to interact with and adapt to patients of varying cultural, educational and social background. The unique multicultural and multilingual features of our area can further challenge medical students in developing their bedside manner. We conducted a questionnaire-based survey amongst 4th year medical students to identify the problematic aspects of learning and practicing bedside skills. Our questionnaire was filled out by 125 students from the Romanian-language series and 121 from the Hungarian-language series. Statistical analysis (MedCalc software) was based on the chi square test, with a cut-off point set at p=0.05. The majority of students consider that bedside manner is not sufficiently explained, but only a few reported to having searched for answers in the literature or asking for help from teachers. A quarter of students (24.8% Romanian-language, 26.44% Hungarian-language students) try to inform themselves about the patients’ education level before questioning them, and the majority feel that it is harder to get anamnestic information from rural patients. There was no statistically significant difference between problems related to language barriers and difficulties conversing with patients of a different native language reported by the two series. More Hungarian-language students consider that the usual 20minutes allocated for anamnesis during their exams are insufficient (p=0.001). Overall, students would opt for 30 to 40minutes for examining a patient. Although mastering bedside manner could be more difficult in a multilingual setting, it might better prepare students for the future requirements of a clinical career, challenging them to look for solutions and be open-minded. We feel that a good head start would be the inclusion of these skills in the student's curricula.