Professionalism Deficiencies in a First-Quarter Doctor–Patient Relationship Course Predict Poor Clinical Performance in Medical School

BACKGROUND: The purpose of this study was to determine whether four types of professionalism deficiencies in medical students identified during a first-year course on doctor-patient relationships might predict poor performance in third-year clerkships. METHOD: Preceptors identified students who had deficiencies in interviewing patients: extreme shyness, poor process skills, paternalism, or a negative attitude toward interviewing. Deficient students were matched by academic ability to a control group. Performance on third-year clerkships was compared. RESULTS: Students with paternalistic behavior or negative attitudes had significantly lower third-year grades. CONCLUSIONS: Professionalism deficiencies that result in the inability of the student to establish patient rapport are detectable early and predict problems in future clinical performance.