Can medical students acquire patient centered attitudes at medical schools?

Progress in psychosomatic medicine will largely depend on the kind of attitudinal learning that takes place at medical schools. What can be achieved by a patient-centered training programme emphasizing attitudinal learning? In a research programme 350 students were introduced to principles of patient-centered medicine in so-called peer groups on history taking ('Anamnesegruppen'). By the end of group work, students exhibited more realistic and less defensive expectations towards the patients and felt more confident about their peers' support. The interviewing skills had improved. The training scheme appeals to approximately 20% of the students. It has been adopted by various other places in the Federal Republic of Germany and Switzerland. Basic institutional aids became apparent: access to patients, supervision, regional meetings. It is assumed that students learn how to link role performance with personal self-awareness, how to trust and be accepted, how to face the faculty. Four overlapping stages basic to the learning process (exposing, reflecting, acting, progressing) are discussed. It is concluded that in medical schools patient-oriented attitudinal learning is possible. Peer learning seems to be decisive. Interdisciplinary research into peer learning is recommended.