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The Decline in Attitudes Towards Physician-nurse Collaboration from Medical School to Residency

Background: Interprofessional education is often part of early medical school curricula; however, as learners progress through their training, there is often less instruction in this important area.  Little is known of the impact of clinical exposure on medical students’ and residents’ attitudes towards physician-nurse collaboration.


Methods: Third year medical students and residents completed the validated Jefferson Survey of Attitudes Towards Physician Nurse Collaboration. This instrument has 20 questions in which trainees indicate their level of agreement with statements regarding physician-nurse collaboration.  All items were scored on a 4-point Likert scale (1= strongly disagree to 4= strongly agree).  Student and resident scores were compared using Student’s t-tests.


Results: The survey was completed by 129 medical students and 260 residents.  The response rate for medical students was 75% and for residents was 16.5%. Resident respondents agreed more strongly with the notion of physician as dominant authority, “the primary function of the nurse is to carry out the physician’s orders” (students: 2.02 ± 0.72 v. residents: 2.45 ± 0.82; p=0.0001) and “doctors should be the dominant authority in all health care matters” (students: 2.36 ± 0.84 v. residents: 2.67 ± 0.89; p=0.0011).


Discussions: Resident physicians’ perceptions of the nurse-physician relationship are significantly less favorable than the views of third year medical students, particularly in the area of authority.  There may be some aspects of the hidden curriculum which contribute to the development of these interprofessional attitudes.


Keywords: Communication Skills, Healthcare Workforce, Interprofessional, Personal Characteristics/Attitudes, Professionalism

Topics: CREOG & APGO Annual Meeting, 2017, Clerkship Director, Residency Director, Professionalism, Interpersonal & Communication Skills, GME, Team-Based Learning,

General Information

Clerkship Director,Residency Director,
Professionalism,Interpersonal & Communication Skills,
Team-Based Learning,
Clinical Focus

Author Information

Samantha Kempner, MD; Helen Morgan, MD; Emily Kobernik, MPH, CPH; Melissa Brackmann, MD

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