This study represents the first time that perceptions of COI have been assessed simultaneously for both students and preclinical lecturing faculty. These results are limited by the fact that they come from one institution and there was a much lower survey response rate for faculty. However, these results still provide new insight into perceptions of COI and hold some implications for COI policy at academic medical centers.
Student and faculty perceptions of COI are largely similar. This suggests that the process of medical training does not dramatically change perceptions of COI. Specifically, the first year medical students surveyed in this study may not have yet been exposed to COI within medical training and healthcare, while all faculty surveyed have likely witnessed COI during their medical training, healthcare experience, or continuing medical education courses.
The differences that did arise in student and faculty and student opinions provide further insight into how medical training may change perceptions. Namely, faculty were more likely than students to believe that disclosure should be required, but less likely to believe that disclosure would ensure the presentation of less biased material. There are several possible explanations for this finding. First, it may be that faculty have had experiences (e.g. witnessing COI influence patient care) during their medical training that has reinforced the importance of disclosing COI. Further, these experiences may have also led faculty to recognize that disclosure alone is not enough to limit the influences of COI. Second, it is possible that since we had a lower survey response rate from faculty than from students, we may have selected for faculty that recognize the importance of COI disclosure, but also its limitations. Third, it could be that faculty perceive themselves and other faculty to be more objective than they are perceived to be by their students, thus making faculty less likely to believe that disclosure will lead to the presentation of more objective information. While we cannot state with certainty the reason for these differences, these results at least suggest that faculty may have had experiences during medical training which lead them to believe that disclosure alone is not enough to temper the influences of COI.
These results also provide support for the stronger COI policies being advocated for by several authors internationally and by national organizations within the United States. Specifically, these results suggest that students and faculty are largely in favor of these policies. Both students and faculty indicated that their peers are more susceptible to the influence of COI than they were themselves. This trend has been found in the past for physicians  and indicates an increased need for COI education amongst students and faculty. Additionally, there was general agreement that it was unacceptable to receive gifts from industry, disclosure should be required to learners, and that disclosure to patients should even be required in certain situations.
Last, these results shed some light on the motivations for student and faculty opinions regarding COI. Unsurprisingly, both students and faculty who believe that receiving gifts in unacceptable also believe that contact with industry representatives should be limited. For faculty, the perceived acceptability of accepting gifts from pharmaceutical or medical device representatives was linked to the belief that accepting gifts has the power to alter behaviors. However, this relationship did not hold true for students, suggesting that faculty are more likely than students to consider forces of COI to alter practice patterns when forming opinions related to COI. Further, for students the perceived acceptability of receiving gifts was linked to opinions about when COI should be disclosed. This relationship did not hold true for faculty, suggesting that other factors, such as the perceived effectiveness or feasibility of such a disclosure, may have a stronger influence on beliefs regarding appropriate COI disclosure.