摘要：Background: Faculty and residents routinely offer feedback about medical students’ specialty career preferences, yet influence of feedback has not been quantitatively evaluated. This study aims to report incidence and balance of primary care comments heard by medical students and determine the effect of comments on career interest. Methods: This multicenter observational cohort study used text messaging and online surveys to examine positive and negative feedback about primary care, as reported by medical students in real time between September 2012 and April 2013. Participants from three universities sent short text messages when primary care comments were heard during two 30-day periods; each period was preceded and followed by surveys assessing career interest. Results: A total of 120 students (86.3% of recruits) participated in at least one texting period; 87 (62.6%) participated in all aspects of study. Overall, positive comments (851) outnumbered negative (616). Total number of negative comments reported per student was associated with a significantly lower interest in primary care career ( β =-.04). There was an association between students’ negative-to-positive comment ratios and lower interest in primary care that approached significance ( β =-.145) but only became significant ( β =-.191) when variables including institution were added to a linear regression model, supporting the hypothesis that culture toward primary care within an institution can influence graduates’ primary care interest. Conclusions: Negatively perceived primary care comments were associated with lower interest in primary care careers by medical students. The study provides real-time quantitative data supporting the association between feedback received about primary care and students’ career choices.
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