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

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.Low back pain (LBP) affects > 80% of the population [1], with recurrent symptoms resulting in absence from work in 37% of patients [2]. The estimated total cost of LBP to the United Kingdom is 1-2% of the gross domestic product [3], a drain attributable to direct health care costs and lost productivity. Current LBP guidelines advocate continued activity and early return to work [2,4], and the interventions advocated in these guidelines facilitate better patient outcomes and cost effective practice [5,6]. However, compliance of medical professionals with these treatments tends to be poor [7] and seems not to have changed in re