Professionalism Deficiencies in a First-Quarter Doctor–Patient Relationship Course Predict Poor Clinical Performance in Medical School

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The purpose of this study was to determine whether four types of professionalism deficiencies in medical students identified during a first-year course on doctor–patient relationships might predict poor performance in third-year clerkships.


Preceptors identified students who had deficiencies in interviewing patients: extreme shyness, poor process skills, paternalism, or a negative attitude toward interviewing. Deficient students were matched by academic ability to a control group. Performance on third-year clerkships was compared.


Students with paternalistic behavior or negative attitudes had significantly lower third-year grades.


Professionalism deficiencies that result in the inability of the student to establish patient rapport are detectable early and predict problems in future clinical performance.

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