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Table 1 Characteristics of included studies

From: Healthcare students’ attitudes towards patient centred care: a systematic review with meta-analysis

Author name (year) Study location Student discipline Age—Mean (SD) (unless otherwise specified) Sex, n (%) female (unless otherwise specified) Sample Size Name of Measurement Tool (subcales) Mean (SD) measurement score and/or % who have positive attitudes (author defined) towards patient centred care Subscales score, mean (SD)
Ahmad et al. (2015) Pakistan Medicine Not reported 557 (71.10%) 783 Patient-Practitioner Orientation Scale 3.40 (0.49) Sharing: 3.18 (0.56); Caring: 3.63 (0.56)
Balentine et al. (2010) U.S Medicine Not reported 70 (30%) 236 Patient-Practitioner Orientation Scale 4.50, no SD or CI provided Not reported
Davis et al. (2006) U.S Medicine and Physician Assistant Individual breakdown for each profession not reported. Entire sample mean age = 28.30 Individual breakdown for each profession not reported. Entire sample (32) = 15 males, 12 females, 5 unreported Total 32, 14 students (6 medicine, 8 physician assistant) Patient-Practitioner Orientation Scale Medicine: 4.70 (0.30)
Physician Assistant: 4.60 (0.30)
Not reported
Dockens et al. (2016) U.S Pre-service speech and hearing sciences All: 22.60 (5.40)
Low Exposure: 23.50 (7.50)
Medium Exposure: 22.30 (4.30) High Exposure: 21.70 (2.80)
All: 75 (80.60)
Low Exposure: 26 (78.80)
Medium Exposure: 32 (82.10)
High Exposure: 17 (81.00)
All: 93
Low Exposure: 33
Medium Exposure: 39
High Exposure: 21
Patient-Practitioner Orientation Scale All: 4.13 (0.50)
Low Exposure: 4.10 (0.40)
Medium Exposure: 4.10 (0.50)
High Exposure: 4.24 (0.50)
All: sharing: 4.29 (0.60), caring: 3.97 (0.40)
Low Exposure: sharing 4.20 (0.60), caring: 3.95 (0.40)
Medium Exposure: sharing 4.21 (0.50), 3.98 (0.40)
High Exposure: sharing: 4.46 (0.70), 4.01 (0.40)
Fothan, Eshaq & Bakather (2019) Saudi Arabia Medicine Not reported 75 (56.80%) 132 Patient-Practitioner Orientation Scale 4.00 (1.50) sharing: 4.20 (1.50)
caring: 3.80 (1.40)
Gaufberg et al. (2018) U.S Medicine Not reported Gold Humanism Honor Society: 52 (50.50%)
Non-Gold Humanism Honor Society: 219 (45.40%)
All: 583 (103 Gold Humanism Honor Society, 480 non)
at year 4: 570 (98 Gold Humanism Honor Society, 472 non)
at year 3: 378 (64 Gold Humanism Honor Society, 314 non)
at year 2: 389 (66 Gold Humanism Honor Society, 323 non)
at year 1: 479 (80 Gold Humanism Honor Society, 399 non)
Demographics table: (92 Gold Humanism Honor Society, 448 non-Gold Humanism Honor Society)
Patient-Practitioner Orientation Scale Gold Humanism Honor Society:
All: 4.45 (0.42)
Year 1: 4.39 (0.46)
Year 2: 4.44 (0.53)
Year 3: 4.40 (0.47)
Year 4: 4.49 (0.53)
Non-Gold Humanism Honor Society:
All: 4.27 (0.39)
Year 1: 4.26 (0.43)
Year 2: 4.33 (0.47)
Year 3: 4.23 (0.52)
Year 4: 4.28 (0.50)
Not reported
Grilo et al. (2013) Portugal Nursing Male 1st year: 20.77(4.52)
Male 2nd year: 22.68(3.95)
Male 4th tear: 22.00(0.75)
Male Total including nurses: 24.71(7.73)
Female 1st year: 19.53(3.23)
Female 2nd year: 20.82(2.44)
Female 4th tear: 22.43(2.61)
Female Total including nurses: 22.78(6.90)
1st: 207 (87.00)
2nd: 126 (80.80)
4th: 111 (85.40)
Nurses: 84 (77.80)
Total (including nurses): 528 (83.50)
1st year: 238
2nd year: 156
4th year: 130
Nursing students total: 524
nurses (ineligible: 108)
study total: 632
Patient-Practitioner Orientation Scale 1st: 4.31 (0.40)
2nd: 4.70 (0.43)
4th: 4.96 (0.38)
Nurses (exclude): 4.48 (0.53)
Total (nurses included): 4.57 (0.49)
Sharing:
1st: 4.11 (0.55)
2nd: 4.62 (0.61)
4th: 4.94 (0.52)
nurses(exclude): 4.25 (0.64)
Total (nurses included): 4.43 (0.66)
Caring:
1st: 4.51
(0.44)
2nd: 4.80 (0.44)
4th: 4.98 (0.40)
nurses (exclude): 4.71 (0.60)
total (nurses included): 4.71 (0.49)
Haidet et al. (2001) U.S Medicine Not reported 120(41%) 293 Patient-Practitioner Orientation Scale 4.58 (0.46) Not reported
Haidet et al. (2002) U.S Medicine fourth year students: 25(2.30) 1st year: 118 (45)
3rd year: 65 (41)
4th year: 36 (41)
1st year: 263
3rd year: 158
4th year: 89
Total: 510
Patient-Practitioner Orientation Scale Total: 4.57 (0.48)
1st: 4.61
3rd: 4.59
4th: 4.48
Not reported
Hammerich et al. (2019) Canada, U.S., Wales, Denmark, France, Australia Chiropractic Age (% of sample)
17–19: 84 (5%)
20–24: 1060 (57%)
25–29: 523 (28%)
30–34: 95 (5%)
35 + : 87 (5%)
1048 (57%) 1858 Patient-Practitioner Orientation Scale PPOS:
Canadian Memorial Chiropractic College: 4.27 (0.46)
Parker University: 4.06 (0.53)
Northwestern Health Sciences University: 4.13 (0.46)
Southern Denmark University: 4.11 (0.45)
University of South Wales: 4.15 (0.43)
Central Queensland University: 4.31 (0.54)
L’Institut Franco-Europeen de Chiropraxie: 4.22 (0.43)
Total:
4.18 (0.48)
Caring:
Canadian Memorial Chiropractic College: 4.50 (0.48)
Parker University: 4.25 (0.55)
Northwestern Health Sciences University: 4.33 (0.48)
Southern Denmark University: 4.55 (0.47)
University of South Wales: 4.40 (0.49)
Central Queensland University: 4.53 (0.54)
L’Institut Franco-Europeen de Chiropraxie: 4.75 (0.46)
Sharing:
Canadian Memorial Chiropractic College: 4.05 (0.61)
Parker University: 3.86 (0.68)
Northwestern Health Sciences University: 3.94 (0.59)
Southern Denmark University: 3.68 (0.62)
Unoversity of South Wales: 3.91 (0.63)
Central Queensland University: 4.09 (0.69)
L’Institut Franco-European de Chiropraxie: 3.70
Henschen et al. (2015) U.S Medicine Not reported Traditional Curriculum: 30 (44%)
Education- centred medical home: 40 (58%)
137 (Traditional curriculum = 68, education- centred medical home = 69) Patient-Practitioner Orientation Scale Traditional Curriculum: 4.3 (0.80)
Education- centred Medical Home: 4.6 (0.50)
Not reported
Hirsh et al. (2012) U.S Medicine Not reported Not reported 67 (27 Cambridge integrated Clerkship, 40 traditional) Patient-Practitioner Orientation Scale Cambridge integrated clearkship: 5.00
Traditional: 4.87
Not reported
Hur, Cho & Choi (2017) South Korea Medicine Not reported 75 (37.90%) 198 total (89 in 2006, 109 in 2009) Patient-Practitioner Orientation Scale 3.90 (0.40) Sharing: 3.61 (0.49)
Caring: 4.18 (0.45)
Krupat et al. (2009) U.S Medicine Not reported Not reported 49 total (32 Principal clinical experience, 17 control) Patient-Practitioner Orientation Scale Principal clinical experience: 5.00
Control group: 4.90
Not reported
Lee et al. (2008) Singapore Medicine Range 20–23 92 (40.70) 226 Patient-Practitioner Orientation Scale 4.10 (0.42) Sharing: 3.84 (0.51)
Caring: 4.36 (0.49)
Madham, Rajpurohit & Gayathri (2010) India Dentistry 26.18 (2.07) 90 (44.60%) 202 Patient-Practitioner Orientation Scale 3.38 (0.63) Sharing: 3.11 (0.65)
Caring: 3.5 (0.88)
Meirovich et al. (2016) Israel Medicine 22.9 (range 21–29) 25 (46%) 32 (16 experimental, 16 control) Patient-Practitioner Orientation Scale Experimental: 4.21 (0.37)
Control: 4.26 (0.43)
Not reported
Michael, Dror & Miller (2019) Israel Medicine and Dentistry 27.49 (3.60) 359 (57.80%) 653 Patient-Practitioner Orientation Scale 4.45 (0.44) Not reported
Moore (2009) Nepal Medicine Not reported 12 (26.75) 63 total
45 students
Patient-Practitioner Orientation Scale 4.26 Not reported
Mudiyanse et al. (2015) Sri Lanka Medicine 23 (2.30) 289 (53.20%) 543 (254 males, 289 females) Patient-Practitioner Orientation Scale Male: 4.40 (0.60)
Female: 4.40 (0.50)
Male
Sharing: 3.90 (0.70)
Caring: 4.80 (0.70)
Female:
Sharing: 4.00 (0.70)
Caring: 4.90 (0.60)
Pers et al. (2019) Poland Medicine Clinical Communication Course + : 23.49 (1.08)
Clinical Communication Course-: 24.82 (0.85)
Clinical Communication Course English + : 25.2 (2.03)
Clinical Communication Course + : 94 (60.26%)
Clinical Communication Course-: 87 (73.73%)
Clinical Communication Course English + : 20 (37.74%)
Clinical Communication Course + : 156
Clinical Communication Course-: 118
Clinical Communication Course English + : 53
Total: 327
Patient-Practitioner Orientation Scale Clinical Communication Course + : 2.91 (0.50)
Clinical Communication Course-: 2.74 (0.47)
Sharing
Clinical Communication Course + (n = 160): 3.06 (0.63), range 1.44 -5.11
Clinical Communication Course- (n = 122): 2.95 (0.62), range 1.22–4.67
Caring:
Clinical Communication Course + : 2.75 (0.51), range 1.11–4.11
Clinical Communication Course-: 2.52 (0.48), range 1.33–3.67
Ribeiro, Krupat & Amaral (2007) Brazil Medicine Not reported 360 (48.8%) 738 Patient-Practitioner Orientation Scale 4.66 (0.44) Caring Male: 5.04 (0.47)
Caring Female: 5.26 (0.43)
Sharing Male: 3.82 (0.58)
Sharing Female: 4.18 (0.58)
Total:
Sharing: 4.10 (0.66)
Caring: 5.20 (0.45)
Rosewilliam et al. (2019) United Kingdom Physiotherapy: 47 (22%)
Medicine: 86 (41%)
Nursing: 28 (13%)
Speech and Language Therapy: 50 (24%)
22.7 (4.90) 176 (83%) 211 Patient-Practitioner Orientation Scale 18-item average, total score (SD of total score)
4.09, 73.62 (8.81)
9-item average, total score (SD of total score)
Sharing: 4.30, 38.72 (5.4)
Caring: 3.87, 34.91 (5.1)
Ross & Haidet (2011) U.S Physical Therapy Not reported Not reported 46 Patient-Practitioner Orientation Scale Sum total mean (SD): 81.30 (7.70) Sharing total mean(SD): 39.30 (4.70)
Caring total mean: 41.90 (4.10)
Sweeney and Baker (2018) United Kingdom Medicine Not reported not reported 39 Patient-Practitioner Orientation Scale 78.8 Not reported
Tsimtsiou et al. (2007) Greece Medicine Not reported Year 4: 111 (46.20%)
Year 6: 98 (40.30%)
Year 4: 240 students
Year 6: 243 students
The same cohort was surveyed twice
Patient-Practitioner Orientation Scale Year 4: 3.96
Year 6: 3.81
Sharing
Year 4: 3.50
Year 6: 3.24
Caring:
Year 4: 4.41
Year 6 4.38
Harris et al. (2020) Switzerland Medicine Not reported 195 (63.70) 306 Patient-Practitioner Orientation Scale- D12 4.19 (0.47) Not reported
Liu et al. (2019) China Medicine  <  = 22: 378 (73.70%)
 > 22 = 135 (26.30%)
Five year clinical category: 238
Seven-year: 72
Total: 310 (60.4%)
Total: 513
Five-year clinical category: 394
Seven-year clinical category 119
Chinese Revised-Patient-Practitioner Orientation Scale 3.63 (0.54) Sharing: 2.88 (0.67)
Caring: 4.53 (0.82)
McNair et al. (2016) Australia Medicine Not reported 56% (likely 113, but unclear) 203 Adapted 9 questions from Patient-Practitioner Orientation Scale Inner metropolitan: 4.00 (0.39)
Outer metropolitan: 4.00 (0.36)
Rural: 4.00 (0.35)
Not reported
El-Awaisi et al. (2017) Qatar Medicine: 6
Pharmacy: 24
Pharmacy technician: 6
Public health: 11
n (%)
 < 20: 4(8.59%)
20–24: 42(89.40%)
25–29: 1(2.10%)
44 (93.60%) 47 Readiness for Interprofessional Learning Scale Median (IQR)
23 (5)
No relevant subscales
Hudson et al. (2016) Australia Medicine Not reported not reported 279 Readiness for interprofessional learning and attitude to patient-centredness survey Mean = 23.42, SEM = 0.11 No relevant subscales
Norris et al. (2015) U.S Medicine, Pharmacy, Nursing, Public Health Exploratory Factor Analysis:
13–22: 14
23–32: 230
33–42: 65
43–52:21
53–62: 10
63–72: 2
Confirmatory Factor Analysis:
13–22: 7
23–32: 239
33–42: 54
43–52: 23
53–62: 12
63–72: 0
Total:
13–22:
21(3.10)
23–32: 469 (69.30)
33–42: 119 (17.60)
43–52: 44 (6.50)
53–62: 22 (3.20)
63–72: 2 (0.30)
Exploratory Factor Analysis: 208 (60.80)
Confirmatory Factor Analysis: 202 (60.30)
Total: 410 (60.60)
Exploratory Factor Analysis: 342
Confirmatory Factor Analysis: 336
Total: 678
Readiness for Interprofessional Learning Scale Exploratory Factor Analysis: 4.60 (0.50)
Confirmatory Factor Analysis: 4.62 (0.46)
No relevant subscales
Zaudke et al. (2016) U.S Medicine, Nursing, Pharmacy Not reported Not reported 252
Medicine: 153
Nursing: 23
Pharmacy: 46
Readiness for Interprofessional Learning Scale 4.65 (0.47) No relevant subscales
Zeeni et al. (2016) Lebanon Nursing, Nutrition, Pharmacy, Social Work and Medicine 21.1 (0.12) 108 (70.10%) 157 (46 medicine, 67 pharmacy, 21 nursing, 23 nutrition) Readiness for Interprofessional Learning Scale 22.75 (2.46) No relevant subscales
Batenburg (1997) Netherlands Medicine Not reported Not reported 476 Doctor-Patient Scale 3.50 (0.24) Not reported
Batenburg et al. (1999) Netherlands Medicine Not reported 24 (60%) 40 Doctor-Patient Scale General Practice Clerks: 64.0% (5.60), Surgery Clerks 58.6% (6.30) Not reported
Bombeke et al. (2011) Belgium Medicine Communication Skills Training* (-): 24.80, Communication Skills Training ( +): 24.60 Communication Skills Training (-): 30 (63%), Communication Skills Training ( +): 22 (59%) 85 (Communication Skills Training (-): 48, Communication Skills Training ( +): 37) Doctor-Patient Scale Communication Skills Training (-): 3.45 (0.30)
Communication Skills Training ( +): 3.54 (0.22)
Not reported
Noble et al. (2007) United Kingdom Medicine 19 (2.00), range 17 -31 270 (59%) 454 Doctor-Patient Scale Old Curriculum (n = 199): 3.20 (0.20)
New curriculum (n = 255): 3.22 (0.20)
No relevant subscales
Davis et al. (2018) U.S Nursing and Medical Assistant Bachelor of Science Nursing: 26.80
Medical Assistant: 30.80
BSN: 10 (90.90)
MA: 18 (85.70)
Bachelors of Science Nursing: 11
Medical Assistant: 21
Interprofessional attitudes scale Entire sample size pooled (n = 32): 33.60 (2.40) No relevant subscales
King & Violato (2020) Canada Nutrition, Dental Hygiene, Dentistry, Medical Laboratory Science, Medicine, Radiation Therapy, Nursing, Pharmacy and Pharmaceutical Sciences, Kinesiology, Physical Therapy, Occupational Therapy, Speech Language Pathology Not reported Not Reported 337 Interprofessional Attitude Scale Patient centredness for all participants:
6.65 (0.49)
No relevant subscales
Hardeman et al. (2015) U.S Medicine Race:
age: n(%)
White:
18–24: 2085 (72%)
25- 35 or older: 811 (28%)
African America:
18–24: 195 (65%)
25–35 or older: 104 (35%)
Race:
Female: n (%)
White:
Female: 1390 (48%)
African American:
Female: 198 (66%)
White: 2890
African American: 301
Total: 3191
Health Beliefs Attitudes Survey Low Health Beliefs Attitudes Survey: 1543
High Health Beliefs Attitudes Survey: 1667
Not reported
Burnard & Morrison (1991) not reported District nursing, Health visiting, Nursing Not reported Not reported District nursing student: 24
health visiting students: 24:
Nursing students: 21
Nelson-Jones and Patterson Counsellor Attitude Scale Mean score (range)
District Nursing: 37 (24–47)
Health Visiting: 45 (32–59)
Nursing: 44 (24–63)
Not reported
Rolfe (1994) United Kingdom Nursing 18–22: 189 (3.81)
23–27: 60 (5.08)
28–32: 19 (5.82)
33 + : 45 (4.51)
Not reported 315 Patient-centredness Multi-choice Questionnaire 37.78 (4.41) Not reported
Mirsu-Pau, Tucker & Hardt (2012) U.S Medicine 26 (3.40), range 22–56 114 (53%) 216 Tucker-Culturally Sensitive Health Care Inventory Provider Form 3.30 (0.37) Not reported
Beach et al. (2007) U.S Medicine 21–30: 146 (86%), > 30: 22 (14%) 76 (45%) 177 No name reported Cut point of "patient centredness" created at a score of 68. 85 scored < 68, 83 scored > 68 No relevant subscales
Hauer et al. (2010) U.S Medicine Not reported 169 (54%) 336 No name reported 75 (6.60) range: 53–100 Not reported
Ster et al. (2015) Slovenia Medicine Not reported 109 (68.60%) 159 No name reported 4.57 (1.44) No relevant subscales
Stoner et al. (2018) U.S Osteopathic Medicine Not reported Not reported 69 No name reported 3.39 (0.35) No relevant subscales
Welch Bacon et al. (2018) U.S Athletic training 23.29 (2.05) 138 (62.44%) 221 No name reported Patient Centred Care implementation: 3.20 (0.38)
Rating of importance of Patient Centred Care: 3.61 (0.35)
No relevant subscales
  1. U.S. United States