The majority of patients (n = 25, 78.1%) did not think the college student affected the visit in either a positive or negative way, whereas 21.9% thought the college student had a positive effect. No patient felt that having the college student present affected their ability to maintain a trusting relationship with their physician. The majority of patients (n = 28, 87.5%) had no concerns about confidentiality, whereas 12.5% had concerns (n = 3) or did not answer the question (n = 1). The three patients with concerns about confidentiality did not elaborate further.
Although all of the patients were informed that a college student would be shadowing their doctor today, only twenty-two of the twenty-eight patients (78.5%) who responded to the query whether they understood why the college student was there indicated they recognized the individual was a college student or some type of premedical student. A small number of patients (4/28, 14.3%) thought the individual shadowing was already in medical training (i.e., either medical student or intern). One patient thought the college student was a “student doctor” and only one patient indicated no remembrance of the background of the individual shadowing.
When the patients were asked if they would have a college student shadow their physician should the opportunity again present itself, the overwhelming majority (n = 31, 96.9%) stated they would (“Yes. I think patients will benefit in the long run by allowing students to increase their knowledge this way." "Course! Yeah, sure. It was nice.”). Only one patient answered “maybe” and no further explanation was given.
From the qualitative analysis of the interviews, three themes emerged: (1) benefits to students; (2) willing participation; and (3) sensitive issues.
Benefits to students. Many patients thought that the college students benefited from having the opportunity to observe and learn. They noted the “hands-on” experience outside of a classroom, even though just observing, was valuable.
“I think they benefit greatly. They get to see real things going on and get themselves out of the classroom into the doctor’s office. Obviously, I’m a real person with real issues and she gets to see that. It all gets filed away collectively, I think, to bring back up some day when you need it. That’s all. It’s all experience”.
“One, she needs to learn. Two, I’m not against learning. And three, you know, I don’t think there are any secrets that I would have that she shouldn’t know about”.
“…people need to learn. And you need on-site training for certain professions. I think they absolutely should be able to come in and observe and learn”.
“I think it definitely benefits them because they can see things hands-on how they’re happening instead of reading about it or hearing about it”.
“I think there’s nothing like hands-on learning to me, but that’s the way I learned, so…I think it can only benefit them because textbooks are never going to put you in a situation like real life”.
Several patients thought that shadowing helped the college students decide about going into a career in medicine (“If he wants to think about possibly going into medicine, it helps him see more what the daily routine is like. It can help him decide.”) and that the patients themselves were helping the profession recruit future physicians (“Doctors are here to do whatever doctors are here to do and whatever I can do to help that process is good. We probably need more doctors down the road. So, hey, good for a young person looking to get into medicine.” “I have no problems helping the medical community continue on to get new volunteers or new recruits. I work in a business that is always looking to recruit as well.”).
Even though these were only college students, patients felt that this experience would help the college students be a better physician someday.
“I think it’s important! It was going to help her become a better doctor”.
“I think I’m hopefully helping to make a better doctor down the road”.
“It doesn’t bother me because my mother is a retired R.N. so how else are people going to learn? They’re the next generation of people who could be taking care of me. I think it’s part of training”.
Willing participation. Many patients very willingly participated in having a college student observe from an altruistic perspective.
“For the benefit of the student, I was willing”.
“If having her here for my visit helps her and her future, then good”.
Patients who had previous interactions with learners, though not necessarily students who were shadowing, expressed this as reason to participate (“When I saw Dr. ___ in November in her other office, I had a student evaluate me initially and so I’m perfectly comfortable with it. I also had a student at my physical therapy session recently too.” “It’s like if you go to a hospital, especially in Boston where I’m from originally, at teaching hospitals you’ll have a group of half a dozen. A doctor with numerous interns or residents who accompany them around and it’s fine.”).
Those patients who have been in a learning role themselves indicated this was a reason they allowed the college students to shadow (“It’s always nice to see a student. I appreciate them. I was a student not too long ago, so…why not.” “I’m used to students working in the hospital and I was a student myself once upon a time and I was always appreciative of all the experiences I could get and the people that allowed me to be a part.”).
Sensitive issues. Although the vast majority of patients’ comments were positive about having college students shadow during the visit with their physician, a few patients raised a theme about potential sensitive issues. One aspect was being uncomfortable depending on the gender of the college student.
“If I had to have a GYN exam, I would have a woman doctor. Yeah, and then she could have someone come in unless it was a guy. That would bother me”.
“Geez, I hate to even bring this up, but with my being a man and the student being a female, this stuff, normal physical stuff doesn’t bother me at all, but once again, taking my socks off, if I had to show my foot to her, that might have been a little intimidating”.
Other patients noted sensitivity around privacy matters (“Well, I wouldn't want her to look when I was being checked by the doctor in that personal place, you know." "I wouldn't want to talk about my sex life in front of her, but other than that." "If I had a kind of touchy subject, I would say I prefer a one-on-one with my doctor.").