[Physician-patient rapport in practice and clinical research: what do medical students think?]

To investigate attitudes of medical students from the first, fourth and sixth year towards information of patients in clinical research and practice settings.

A multiple-choice questionnaire was administered. Responses were registered on anonymous response-forms. The study was conducted at the two Schools of Medicine of Naples, in southern Italy.

773 students answered the questionnaire. Students believe that the quality of patient care is better within than outside a clinical trial, but anxiety and fear are the most frequent reactions to the idea of being offered the opportunity of participating, as patients, in a clinical trial. The patients' right to be informed of their participation in a clinical experiment is omitted by 30 to 50% of students. The majority of students believe that doctor's uncertainty should not be disclosed. About one-third believe that possible benefits of treatment should not be presented to patients and about one-fifth believe that information on possible drawbacks of treatment should be omitted. Many students believe that information on alternative types of treatment should be denied to patients entering a trial. Fourth year students consistently reported the highest percentage of negative responses. In clinical practice, as compared with clinical research, there is a higher tendency of students to give information to patients. The doctor's role is predominant when students indicate who should decide how much information to give to a patient entering into a clinical trial.

Medical education should focus more closely on uncertainty and error analysis; principles of medical research and ethics should be covered throughout academic medical training.