Exploratory study of nocebo effect in senior medical students.

Background: Νocebo Effect is known to induce adverse symptoms after negative expectations which can be manifested on a physical and psychological level. As 6th year medical students often face a wide range of clinical challenges and may be prone to negative expectations or beliefs affecting their pre-clinical and clinical success, we want to investigate how they are affected by the Nocebo Effect. Objective: To investigate whether a nocebo effect can be induced when exposing final-year students to the clinical context of their training. Methods: We used verbal suggestions as a nocebo mechanism and by using three tools, the Illness Attitude Scales, the Symptom Checklist-90, and the State-Trait Anxiety Inventory, we examined the difference in scores on measures of psychometric parameters in 33 participants who were on their 6th year medical and attended three clinics for the first time during their education. The administrations were given before and after attending each clinic, and negative verbal suggestions were given prior to the first administration. We also measured whether the overall number of clinics, had an effect on psychometric parameters. Results: The results revealed a significant increase in second administration overall in the three clinics in specific psychometric parameters but no statistically significant difference was observed after attending consecutive clinics. Conclusion: Students reported the occurrence of adverse symptoms in the investigated psychometric parameters, which should be noted in order to avoid potential educational clinical failure.