Teaching practice on real patients has several advantages in terms of lower costs and genuine clinical material but it is often a concern that using real patients for undergraduate teaching may result in patient dissatisfaction and many patients would prefer not to have medical students learning with them. The study explores these concepts with a direct comparison between a group of patients (case patients) seen by undergraduates and then findings confirmed by a teacher, followed by discussions on management and another group in which patients were seen in the normal way by residents in specialist training (control patients). Prior to this, the undergraduates had been tutored in the specialty which included methods of examination. The patients were then asked to grade variables in their encounter with the physicians, such as behaviour, professional skill, interaction and quality of healthcare provided. There was no significant difference in these variables, only more time was spent with the case group patients. The study has limitations due to the small sample size but it illustrates that using real patients does not diminish patient satisfaction or quality of healthcare provided. Patients can therefore be used for teaching undergraduates without any major reservations. 

Use of real patients in teaching ENT diseases to undergraduate students and its effects on patient satisfaction: cross sectional survey.
Lofgren E, Alikoski S, Hannula S, et al.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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