How Clinical Teachers Perceive the Doctor—Patient Relationship and Themselves as Role Models

PURPOSE: Teachers must be good role models. In order to act the part, however, they must reflect on and articulate the attitudes and behaviors they wish to convey. The aim of this study was to describe how clinicians who teach clerks and residents represent the doctor-patient relationship and how they see themselves as role models for this relationship. METHOD: In the fall of 1997, 28 clinical teachers in family medicine and various medical and surgical specialties at Laval University Faculty of Medicine participated in individual semistructured interviews regarding their perceptions of the doctor-patient relationship and how it is taught. The interviews were conducted by a trained research assistant and the content of the interviews was coded by three independent observers, who then performed a qualitative analysis. RESULTS: The clinical teachers identified competencies associated with the doctor-patient relationship that differed in complexity and specificity. Paramount among these competencies were the ability to conduct interviews effectively and politely, the ability to understand and involve the patient, and, in some cases, the ability to handle emotionally-charged situations. The clinical teachers tended to demand more of their students in doctor-patient relationships than they did of themselves. Lack of time and a negative attitude toward the doctor-patient relationship, on the part of both teachers and students, were obstacles to teaching and learning this essential competency, even to the point of making it difficult for teachers to demonstrate and supervise these competencies during their daily clinical activities. CONCLUSIONS: Most of the teachers had difficulty describing situations or behaviors in which they modeled the doctor-patient relationship. Being a role model requires a fairly precise idea of what one is modeling and accomplishing, and what one wants trainees to understand about the relationship. Efforts must be made to help clinical teachers to integrate the doctor-patient relationship into their clinical supervision and to provide them with tools to demonstrate this relationship effectively.