Clinical Setting Differences in Third-Year Medical Students’ Perceptions of “Ownership”

Ownership in clinical settings is a construct that be described as feelings of responsibility and accountability towards a patient, which has potential implications for patient safety and care. Researchers were interested in examining differences in students' perception of ownership across main and regional campuses. The purpose of this study is to assess third-year students' perception of "ownership" during their clerkship rotations in different clinical settings. Items from a validated instrument on psychological ownership were adopted to suit a clinical environment. Scores on each of the sub-scales of: a) Territoriality, b) Accountability, c) Self-efficacy, d) Belongingness, and e) Self-Identification were calculated by averaging the items. The survey was administered to 233 third-year medical students multiple times throughout the academic year. Responses from regional campus or community provider settings were compared to the main campus. To examine students' psychological ownership scores in different clinical settings, analysis of variance (ANOVA), was performed. A Tukey-Kramer multiple comparison procedure was used to examine post hoc pair-wise differences between two clinical settings. We received 265 of responses from 95 of responders. There were no statistically significant differences between campuses for Territoriality scores. On Self-Efficacy, Accountability, Self-Identification and Belongingness scales other community providers and regional campuses had significantly higher scores than main campus (p<0.05). Follow up ANOVA analysis were performed for all scales on individual items resulting in 1/5 for Accountability, 2/6 on Self-Efficacy, 5/5 on Belongingness, and 6/7 for Self-Identification been statistically significant. Ownership is considered an important aspect of patient care, patient safety, professional identity formation, etc., yet researchers have not examined how clinical settings impact students' perceptions of patient ownership during their clerkship years. Our study is the first step to operationalize and conceptualize ownership, its development over time, and differences in clinical experiences.   None of the authors has a conflict of interest. This study was approved by our institution’s Institutional Review Board.