Background/Purpose: Physicians may have difficulties dealing with patients with chronic rheumatic and musculoskeletal diseases, in particular due to bias against handicap. There may be preconceived ideas about these diseases associated with disabilities, leading to altered patient-physician interactions. In other specialties, the technique of focus groups (FG) including medical students who can discuss their preconceived ideas, followed by interactions with patients, has been used [1]. The objective of this study was to explore the usefulness of FG and interactions with patient associations during undergraduate training for medical students.

Methods: This was a pilot experience in one French University. Five FG were organized during spring 2016. Students in the fourth year of medical studies volunteered in one 3-hours FG, about one of the following themes: handicap (2 sessions), obesity (2 sessions) or mental health. The discussion groups were moderated by a neutral coordinator (Assistant Professor), attended by an observer and a transcriber. In the 2 handicap FG, the students first discussed together about 3 pre-defined questions: 1) which perception do you have about handicap and disabled people? 2) Do you have difficulties when you are faced with clinical examination of disabled people? 3) According to you, what do the handicapped people expect from medical doctors? After one-hour discussion, the students met the representatives of patient associations and shared the main elements resulting from the FG. Satisfaction was assessed through anonymous likert-scale questionnaires comprising 10 questions (final score 0-100%).

Results: Of the 375 students initially contacted by the University, 70 volunteered, and 5 FG of 14 students were organized: 2 FG (28 students) were centered on handicap. Preconceptions of undergraduates included difficulties to examine handicapped patients and to take care of them, with an uncomfortable feeling about how to look at them and how to behave, and the fear to harm them. The interaction with the patient associations allowed the students to compare their bias to the truth of living with a handicap. Satisfaction ratings among students were very high (mean value 93%). All the students (100%) reported that discussing about preconceived ideas was useful, and 92% declared that the FG helped them to observe the importance of social representations in the care of disabled patients. Interestingly, 54 % of the students estimated that medical training on handicap was not sufficient before attending the FG. The satisfaction rating of the patient association was 100%.

Conclusion: FG followed by a moment for dialogue and exchange with patients allow medical undergraduate students to express their bias against handicap, and to compare them with the truth of living with a handicap. This method, leading to high levels of satisfaction in our pilot study, may help in future teaching of patient-physician relationships and interactions around handicap. Long-term impact on care relationship remains to be studied. References: 1. Stalmeijer RE, Mcnaughton N, Van Mook WN. Using focus groups in medical education research: AMEE Guide No. 91. Med Teach. 2014;36(11):923-39.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/adressing-medical-students-concerns-in-the-patientphysician-interaction-with-people-with-rheumatic-and-musculoskeletal-diseases-leading-to-handicap-a-pilot-experience-including-student-foc/