Caring attitudes in medical education: Perceptions of deans and curriculum leaders

BACKGROUND: Systems of undergraduate medical education and patient care can create barriers to fostering caring attitudes. OBJECTIVE: The aim of this study is to survey associate deans and curriculum leaders about teaching and assessment of caring attitudes in their medical schools. PARTICIPANTS: The participants of this study include 134 leaders of medical education in the USA and Canada. METHODS: We developed a survey with 26 quantitative questions and 1 open-ended question. In September to October 2005, the Association of American Medical Colleges distributed it electronically to curricular leaders. We used descriptive statistics to analyze quantitative data, and the constant comparison technique for qualitative analysis. RESULTS: We received 73 responses from 134 medical schools. Most respondents believed that their schools strongly emphasized caring attitudes. At the same time, 35% thought caring attitudes were emphasized less than scientific knowledge. Frequently used methods to teach caring attitudes included small-group discussion and didactics in the preclinical years, role modeling and mentoring in the clinical years, and skills training with feedback throughout all years. Barriers to fostering caring attitudes included time and productivity pressures and lack of faculty development. Respondents with supportive learning environments were more likely to screen applicants' caring attitudes, encourage collaborative learning, give humanism awards to faculty, and provide faculty development that emphasized teaching of caring attitudes. CONCLUSIONS: The majority of educational leaders value caring attitudes, but overall, educational systems inconsistently foster them. Schools may facilitate caring learning environments by providing faculty development and support, by assessing students and applicants for caring attitudes, and by encouraging collaboration.