Patient-Centered Attitudes and Associated Factors Among Medical Students in Spain: A Cross-Sectional Study

Introduction: Patient-centered care (PCC) is fundamental to healthcare quality, yet no data on patient-centered attitudes among medical students in Spain exist. This study assessed these attitudes using the Patient-Practitioner Orientation Scale (PPOS), identified associated factors, and compared findings internationally. Methods: A cross-sectional survey was conducted of all six year groups at the University of Murcia, Spain, using the 18-item PPOS administered online. Bivariate and multivariate analyses were performed. Results: Of 1,300 students invited, 359 participated (27.6% response; 66.3% female). Scores indicated patient-centered orientations (total PPOS 4.41 ± 0.40; Caring 4.82 ± 0.45; Sharing 4.01 ± 0.53). Female students scored higher across all scales (p < 0.001; d = 0.51). Sharing scores were the lowest dimension across all subgroups, regardless of sex, year, or motivation. No statistically significant difference was observed between preclinical and clinical students after Bonferroni correction, though this comparison remains inconclusive given the Caring subscale's limited reliability (α = 0.50) and unequal participation across year groups. In multiple linear regression, female sex and being in a relationship were significant predictors; complementary logistic regression confirmed these associations (OR = 0.44 and 0.58, respectively), though overall explained variance was low (R² < 0.08). Conclusions: Spanish medical students showed patient-centered orientations compared with international data. The consistently low Sharing scores suggest that students endorse empathic care more readily than shared decision-making, identifying the latter as a priority for communication skills training. The Caring subscale's limited reliability points to the need for a psychometrically validated Spanish version.