Assessing Patient Ownership in clerkships: An exploratory study of student and clerkship directors' perceptions

Purpose: The phrase “take ownership of your patients” is commonly used by physicians to communicate the importance of demonstrating dedication and commitment to patients and their care. In an attempt to understand how patient ownership is supported in students’ clerkship experiences, this exploratory study collected data on students’ perceptions of ownership in their clerkships and the ways in which clerkship directors supported students in taking ownership. Method: An adapted survey on psychological ownership was distributed to 233 third-year medical students upon a clerkship completion. The survey assessed the students' perception of ownership and the extent to which clerkships supported its development patient care. Follow-up interviews with clerkship directors were conducted to interpret the data and understand how each of the clerkships support students’ development of patient ownership. Results: The results demonstrate differences between clerkship experiences. In those clerkships where students perceive the clerkship as developing their ownership, clerkship directors were intentional in setting up a system that supported this goal. Data suggest that when clerkship directors use consistent language across the clerkship, provide resident and faculty training to support students in taking ownership, and are explicit in their expectations for students’ to engage in patient ownership behavior, students perceive the clerkship as supporting their ability to take ownership. Conclusion: Clerkship directors have the ability to impact students’ ability to take ownership of their patients by being intentional in their development of the clerkship climate.