The Decline in Attitudes Toward Physician–Nurse Collaboration From Medical School to Residency

Abstract

BACKGROUND: Interprofessional education is often part of early medical school curricula; however, as learners progress through their training, there is often less instruction in this important area. Little is known of the impact of clinical exposure on medical students' and residents' attitudes toward physician–nurse collaboration. METHODS: Third-year medical students and residents completed the validated Jefferson Survey of Attitudes Toward Physician–Nurse Collaboration. This instrument has 20 questions in which trainees indicate their level of agreement with statements regarding physician–nurse collaboration. All items were scored on a 4-point Likert scale (1=strongly disagree to 4=strongly agree). Student and resident scores were compared using Student's t tests. RESULTS: The survey was completed by 129 medical students and 260 residents. The response rate for medical students was 75% and for residents was 16.5%. Resident respondents agreed more strongly with the notion of physician as dominant authority, “the primary function of the nurse is to carry out the physician's orders” (students: 2.02±0.72 versus residents: 2.45±0.82; P=.0001) and “doctors should be the dominant authority in all health care matters” (students: 2.36±0.84 versus residents: 2.67±0.89; P=.0011). DISCUSSION: Resident physicians' perceptions of the physician–nurse relationship are significantly less favorable than the views of 3rd-year medical students, particularly in the area of authority. There may be some aspects of the hidden curriculum which contribute to the development of these interprofessional attitudes.