Objectives: To investigate attitudes of medical students from the first, fourth and sixth year towards information of patients in clinical research and practice settings.
Design and setting: A multiple-choice questionnaire was administered. Responses were registered on anonymous response-forms. The study was conducted at the two Schools of Medicine of Naples, in southern Italy.
Results: 773 students answered the questionnaire. Students believe that the quality of patient care is better within than outside a clinical trial, but anxiety and fear are the most frequent reactions to the idea of being offered the opportunity of participating, as patients, in a clinical trial. The patients' right to be informed of their participation in a clinical experiment is omitted by 30 to 50% of students. The majority of students believe that doctor's uncertainty should not be disclosed. About one-third believe that possible benefits of treatment should not be presented to patients and about one-fifth believe that information on possible drawbacks of treatment should be omitted. Many students believe that information on alternative types of treatment should be denied to patients entering a trial. Fourth year students consistently reported the highest percentage of negative responses. In clinical practice, as compared with clinical research, there is a higher tendency of students to give information to patients. The doctor's role is predominant when students indicate who should decide how much information to give to a patient entering into a clinical trial.
Conclusions: Medical education should focus more closely on uncertainty and error analysis; principles of medical research and ethics should be covered throughout academic medical training.