The determinants of attitudinal change among medical students participating in home care training: A multi-center study

Joseph H. Flaherty, Diana A. Fabacher, Roberta Miller, Andrea Fox, Jeremy Boal

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Purpose. To report attitudinal changes of medical students from five medical schools rotating through a home care program, and to determine which of the program characteristics influenced attitudes the most. Method. A survey instrument covering four home care domains (general attitudes, home-based therapies, home care training, and time and reimbursement) was designed and validated by the five schools involved. Using pre- and post-rotation scores, analyses were done to evaluate for attitudinal changes within and among schools. The programs had similar basic characteristics (home visits, attending physicians' involvement, didactics), but had differing degrees of these components. Results. Significant improvements in attitude scores were found in three domains: general attitudes, home-based therapies, and home care training. For time and reimbursement, only three schools improved significantly between pre- and post-rotation scores. Among the five schools, there were significant differences in the home-based therapies and home care training domains (p < .05), and in the time and reimbursement domain the difference approached significance (p = .06). None of the students' characteristics but all of the programs' characteristics significantly correlated with changes in total scores. In the first multiple regression model, educational level (third year instead of fourth) was the only independent predictor of change in score, (adjusted r2 = .14). In Model 2, the strongest predictor was "contact with physician- program director," followed by "number of visits" and "physician-precepted visits" (r2 = .23). Conclusion. Educational home care programs of varying intensities can positively affect medical students' attitudes towards home care. At least three program characteristics, (the physician-program director, number of visits, and physician-precepted home visits), are important parts of a successful program.

Original languageEnglish
Pages (from-to)336-343
Number of pages8
JournalAcademic Medicine
Issue number4
StatePublished - 2002


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