Medical students in ENT outpatient clinics: Appointment times, patient satisfaction and student satisfaction

Abstract

Objectives. Outpatient clinics are increasingly important in medical education. The effect of students on clinic times and patient satisfaction, as well as their own satisfaction, were studied. Design. A prospective, non-randomized, controlled study using adult patient questionnaires, medical student questionnaires and clinic time sheets. Setting. Two teaching hospital ENT clinics. Subjects. Medical students and adult patients. Results. Three hundred and twenty-five patient questionnaires were collected (77% response), including 135 student encounters. Students did not affect appointment durations (19 min ± 0.48 (standard error)) except at centre B (35 min ± 1.1, P < 0.0001) where patient numbers were cut for teaching. Patient satisfaction, generally high, was not affected by students, appointment duration or gender of doctor or patient. It was slightly higher in the lower social classes (r(s) = 0.20, P = 0.003) and older patients (r(s) = 0.17, P = 0.002). Student acceptability scores were not affected by student numbers (up to four), social class or time spent alone with students. They were higher if time was spent alone with the doctor (75.3% ± 4.9) than not (63.0% ± 1.8, P = 0.024). Thirty-six per cent of patients preferred to have a student present; only 9% preferred not. Student satisfaction was higher at centre B (73.7% ± 2.3) where appointments were longer and students spent more time alone with patients than centre A (64.3% ± 2.3, P = 0.0052). Conclusions. Clinic appointments are not necessarily longer in the presence of students. When students have the chance to see patients alone during longer consultations, student satisfaction is higher. Patient satisfaction, generally high, is not altered by the presence of students, but patients given time alone with their doctor are more accepting of students. These findings have resource implications for the planning of NHS clinics in teaching hospitals.