Predictors of US medical students' prevention counseling practices

Objective. To understand predictors of medical students' prevention counseling practices. Methods. We surveyed medical students (n = 2316 individuals) in the Class of 2003 at freshman orientation, and again at entrance to wards and senior year in a nationally representative sample of 16 US medical schools (response rate = 80.3%). Main outcome measures. Perceived relevance of prevention counseling and seniors' frequency of prevention counseling. Results. Healthier personal practices (p < 0.0001), intention to become a primary care practitioner (p = 0.0007), and attending a medical school that encouraged healthy personal practices (p = 0.002) significantly predicted the frequency with which seniors reported currently counseling patients about preventive interventions (using a validated measure). Perceived counseling relevance was also significantly predicted by intention to become a primary care practitioner (p < 0.0001), attending a school that encouraged healthy personal practices (p = 0.0007), being earlier in one's training (p < 0.0001), more interested in prevention (p < 0.0001), female (p < 0.0001), non-White (p = 0.007), and by having healthy personal practices (p = 0.008). Conclusions. Several of the variables predicting physician counseling also predict US medical students' reporting counseling (especially personal health practices and specialty type). In addition, the avidity with which medical schools encourage students to be healthy significantly influences their reported patient counseling. These findings can give a fresh, evidence-based direction to help create physicians who counsel patients about prevention. (c) 2006 Elsevier Inc. All rights reserved.