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January 7, 1998

Patient Satisfaction and Ambulatory Encounters Involving Medical Students

Author Affiliations

Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998

JAMA. 1998;279(1):18-19. doi:10.1001/jama.279.1.17

To the Editor.—The article by Dr Frank and colleagues1 examines a number of issues involved with shifting undergraduate medical education to the outpatient ambulatory setting. This important topic has received little attention in the literature to date. Using the Medical Outcomes Study 9-item visit rating scale,2 the authors determined that patient satisfaction did not decrease when medical students were involved. However, the authors note that students were substantially more likely to see patients who were poorer (with Medicaid) and who were members of a minority group, independent of other potential confounding variables such as reason for visit, severity of illness, and insurance status. Previous research3 has suggested that patients from a lower social class tend to have significantly more positive attitudes about student involvement in their care than do patients from other demographic groups. Thus, the conclusion by Frank and colleagues on this issue is drawn into question. Measuring patient satisfaction is a complex task. Introducing students into the equation further complicates the issue.