Decline in medical students' attitudes to interprofessional learning and patient-centredness.

CONTEXT: Interprofessional learning (IPL) is valuable in preparing health care students to work collaboratively in teams, with patients' needs at the core. Patient-centredness is the impetus for communication and collaboration in health care. Debate continues on when it is best to develop positive student attitudes towards these aspects of care. Should IPL commence early before attitudes to patients, professional stereotypes and identity are formed, or later for advanced learners with greater experience of their roles and responsibility in health care? This study explores graduate-entry medical students' attitudes to IPL and patient-centred care, on programme entry and after an early interdisciplinary clinical experience (ICE). METHODS: An extended version of the Readiness for Interprofessional Learning Scale (RIPLS) was administered to four cohorts of medical students (n = 279) on entry and after the 3-week placement. This 26-item RIPLS comprised four subscales: team work and collaboration; professional identity; roles and responsibilities; and patient-centredness. The impact of the placement on students' attitudes was assessed by using repeated measures analysis of variance to compare pre- and post-ICE subscale scores. RESULTS: There were significant main effects of time (pre- versus post-ICE) for the subscales of teamwork and collaboration, professional identity and patient-centredness, but not for roles and responsibilities. Scores for teamwork and collaboration, professional identity and patient-centredness were all lower post-ICE. CONCLUSIONS: The students' less positive attitudes to teamwork and collaboration and professional identity may be due to the experience itself, or because it reinforced negative beliefs about the value of learning from non-medical health professionals. Perhaps the students' idealised view of their future role as a doctor was challenged by the experience, or they had an underdeveloped professional identity. Limited student experience of patients having an active role in their own health care may explain the decrease in attitudes to patient-centredness. A longitudinal qualitative study will explore these results.

Word-frequency and phonological-neighborhood effects on verbal short-term memory.

Immediate memory span and maximal articulation rate were assessed for word sets differing in frequency, word-neighborhood size, and average word-neighborhood frequency. Memory span was greater for high- than low-frequency words, greater for words from large than small phonological neighborhoods, and greater for words from high- than low-frequency phonological neighborhoods. Maximal articulation rate was also facilitated by word frequency, phonological-neighborhood size, and neighborhood frequency. In a final study all 3 lexical variables were found to influence the recall outcome for individual words. These effects of phonological-word neighborhood on memory performance suggest that phonological information in long-term memory plays an active role in recall in short-term-memory tasks, and they present a challenge to current theories of short-term memory.