Student discussion groups on doctor-patient relationships: a critical assessment

Regular discussion groups for all students were introduced at a new clinical medical school to enable students to discuss freely their responses to patients. The main aim was to prevent the alleged dehumanizing effect of medical education. The groups were monitoring by attendance records, questionnaires and tape-recordings. In fact, the majority of students stopped attending so that only two of the five groups survived longer than 6 months. Despite improvements in organization and styles of conducting the groups, a similar fall in attendance occurred in the next year's intake. paradoxically, in most meeting there was a lively and apparently beneficial discussion on the students' reactions to their contacts with patients, so it was difficult to explain the overall drop in attendance. It was concluded that, while organizational details and inappropriate styles of conducting the groups were partly responsible, the main problem was the apparent conflict in attitudes between the students medical teachers and their group conductors (who were mainly psychiatrists), i.e. between the concepts of modern technological medicine and those of psycho-social medicine. This induced a conflict of motivation in the students, who naturally need to identify with their teachers, which most of them resolved by avoiding the groups. It is suggested that more effective integration between general medical teachers and the organizers of such groups is needed, and that group conductors should include general practitioners and clinical supervisors as well as psychiatrists.