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Open Access Open Badges Research article

Do medical student attitudes towards patients with chronic low back pain improve during training? a cross-sectional study

Hayley Morris1, Cormac Ryan2, Douglas Lauchlan3 and Max Field1*

Author Affiliations

1 College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK

2 School of Health and Social Care, Teesside University, Middlesbrough, UK

3 School of Health and Social Care, Glasgow Caledonian University, Glasgow, UK

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BMC Medical Education 2012, 12:10  doi:10.1186/1472-6920-12-10

Published: 19 March 2012



Health care professionals with positive attitudes towards the functional abilities of patients with low back pain are more likely to encourage activity and avoidance of rest as per recommended guidelines. This study investigated whether medical student training fosters positive attitudes towards patients with back pain and their ability to function.


First (n = 202) and final (n = 146) year medical students at the University of Glasgow completed the Health Care Professionals' Pain and Impairment Relationship Scale (HC-PAIRS) questionnaire. This measures attitudes of clinicians towards the functional ability of patients with back pain. A group of first (n = 62) and final year (n = 61) business students acted as non-health care controls. Attitudes were compared using two-way ANOVA with year of study and discipline of degree as independent variables.


Both year of study [F(1,465) = 39.5, p < 0.01] and discipline of degree [F(1,465) = 43.6, p < 0.01] had significant effects on total HC-PAIRS scores and there was a significant interaction effect [F(1,465) = 9.5, p < 0.01]. Medical students commenced their course with more positive attitudes than non-health care students (65.7 vs. 69.2 respectively; p < 0.01) - lower scores translating into more positive attitudes. In their final year, the difference between the two student groups had widened (56.4 vs. 65.3; p < 0.01).


Undergraduate medical training promotes positive attitudes towards the functional ability of patients with back pain, suggesting that students may be more likely to develop an evidence-based approach to this patient group after qualification. Some adjustments to training may be warranted to encourage a more positive shift in attitudes.

Back pain; HC-PAIRS; Attitudes; Evidence based medicine