Third and fourth year medical students' attitudes about and experiences with callousness: The good, the bad and the ambiguous

Background: This study solicits third and fourth year medical students' attitudes about and experiences with callousness. Methods: Medical students were asked to respond to an on-line survey assessing demographic information, their experiences with seeing callousness modeled by mentors and their attitudes about callousness. Participants included 74 students roughly split on gender and year in school. Results: A 2 × 2 between-subjects MANOVA was conducted (dependent variables - attitudes about and experiences with callousness; independent variables - gender and year in school). Significant results were found for gender; follow-up analyses revealed that women hold more unfavorable attitudes about callousness than men. Although students generally regarded callousness as undesirable, they reported seeing callousness modeled by their mentors 20% of the time across a variety of situations. Conclusions: Students' attitudes about callousness are negative; women's attitudes are more negative than men's. Despite this, students (regardless of their demographic variations) regularly see it modeled by their mentors. Some students' narrative responses suggest they think being callous toward patients and colleagues can serve them well in some situations. The authors offer several questions to motivate further empirical and ethical inquiry into callousness and urge medical educators to consider its influence on students' conceptions of professionalism.