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Grau Canét-Wittkampf C, Trippenzee M, Jaarsma D, Diemers A. Candid insights and overlooked facets: what medical students write about patient-centeredness in diaries on longitudinal patient contacts. MEDICAL EDUCATION ONLINE 2024; 29:2363611. [PMID: 38861676 PMCID: PMC11168331 DOI: 10.1080/10872981.2024.2363611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/30/2024] [Indexed: 06/13/2024]
Abstract
Despite students' exposure to patient-centered care principles, their dedication to patient-centeredness often experiences a wane throughout their academic journey. The process of learning patient-centeredness is complex and not yet fully understood. Therefore, in our study, we sought to explore what aspects of patient-centeredness students spontaneously document in their diaries during interactions with actual patients. This investigation will help to identify gaps in the current educational practices and better prepare future clinicians to deliver patient-centered healthcare. We analyzed 92 diaries of 28 third-year undergraduate medical students at UMC Utrecht in the Netherlands who participated in an educational intervention, following four patients each as companions over a two-year period early in their clerkships. We conducted thematic analysis, using inductive and deductive coding, within a social-constructionist paradigm. We identified four key themes: communication, the person behind the patient, collaboration and organization in healthcare, and students' professional development. Within these themes, we observed that students spontaneously documented 9 of 15 dimensions of patient-centeredness as outlined in the model of Scholl : 'clinician-patient communication', 'patient as unique person', 'biopsychological perspective', 'essential characteristics of the clinician', 'clinician-patient relationship', 'involvement of family and friends', 'patient-information', 'emotional support' and 'coordination and continuity of care' (mainly principles of patient-centeredness). Conversely, we noted that students underreported six other dimensions (enablers and activities): 'access to care', 'integration of medical and non-medical care', 'teamwork and teambuilding', 'patient involvement in care', 'patient empowerment' and 'physical support'. Throughout their longitudinal journey of following patients as non-medical companions, students spontaneously documented some aspects of patient-centeredness in their diaries. Additionally, students reflected on their own professional development. Our findings suggest that incorporating education on the broadness of the concept of patient-centeredness coupled with enhanced guidance, could potentially enable students to learn about the complete spectrum of patient-centeredness within their medical education.
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Affiliation(s)
- Christel Grau Canét-Wittkampf
- Wenckebach Institute for Education and Training, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Miranda Trippenzee
- Department of Health Psychology, Health Sciences, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Debbie Jaarsma
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- LEARN (Lifelong Learning, Education and Assessment), University Medical Center Groningen, Groningen, The Netherlands
| | - Agnes Diemers
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- LEARN (Lifelong Learning, Education and Assessment), University Medical Center Groningen, Groningen, The Netherlands
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Kangasjarvi E, Forsey J, Simpson JS, Ng SL. "We're back in control of the story and we're not letting anyone take that away from us": patient teacher programs as means for patient emancipation. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:487-505. [PMID: 37455294 DOI: 10.1007/s10459-023-10255-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/04/2023] [Indexed: 07/18/2023]
Abstract
While patient engagement in healthcare professions education (HPE) has significantly increased in the past decades, a theoretical gap remains. What are the varied reasons as to why patients get involved with HPE programs? With a focus on understanding what drives patient involvement with HPE programs, this study examined how a patient as teacher (PAT) program was experienced by medical students, patient teachers, and faculty within a medical school. Through a phenomenographic approach, this study captures and describes the different ways our study participants experienced a PAT program (the 'phenomenon'). 24 semi-structured interviews were conducted in total, comprised of interviews with patient teachers (N = 10), medical students (N = 10) and program facilitators (N = 4) who participated in a PAT program. Our focus was on participants' description of the program and was grounded in their experiences of as well as their beliefs about it. Our findings captured 4 layers representing the qualitatively different (yet interrelated) ways in which participants experienced/perceived and conceptualized the various aspects of their experience with the PAT program: (1) A productive disruption of the learning space (2) A re-humanization within healthcare (3) A means of empowerment and agency (4) A catalyst for change and emancipation. Our outcome space results can be visually illustrated by a nesting "Matryoshka" doll, representing the four layers and depicting the process of uncovering the less conscious layers of sense-making within this phenomenon. HPE programs that are co-produced with patients and actively involve patients as teachers have the potential, but not guarantee, to be emancipatory. To engage in PAT programs that exhibit an emancipatory potential, we need to consider transformative paradigms of education, which are aligned with social change, and disrupt the traditional teacher-learner hierarchy.
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Affiliation(s)
- E Kangasjarvi
- Li Ka Shing Knowledge Institute, Applied Education Research Operatives (AERO), Faculty of Medicine, University of Toronto at St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
| | - J Forsey
- University of Toronto, Rehabilitation Sciences Institute, Toronto, ON, Canada
| | - J S Simpson
- Division of General Surgery, St. Michael's Hospital, Unity Health Toronto, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - S L Ng
- University of Toronto, Centre for Interprofessional Education, University Health Network Toronto, Toronto, ON, Canada
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Alanazi M, Bajmal E, Aseeri A, Alsulami G. Empowering adult patients with diabetes for health educators' role within their family members: A cross-sectional study. PLoS One 2024; 19:e0299790. [PMID: 38626054 PMCID: PMC11020498 DOI: 10.1371/journal.pone.0299790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/16/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Patient engagement as partners in diabetes prevention for family members/close relatives is a novel and underexplored approach. This paper aims to assess patients' willingness and confidence in their ability to succeed as health educators for their family members and investigate the influencing factors. METHODS A cross-sectional descriptive study was conducted between January 2023 and April 2023. A newly developed and validated self-reported questionnaire, based on the Health Belief Model (HBM) and previous research, was administered to a convenient sample of 134 adult participants diagnosed with diabetes. These participants sought care at primary healthcare clinics at King Abdul-Aziz Medical City, Ministry of National Guard Health Affairs in Riyadh and Jeddah (MNGHA). The data was examined using statistical methods including descriptive analysis, ANOVA, Tukey's HSD (Honestly Significant Difference) Post Hoc tests, and Pearson's correlation coefficients. RESULTS The majority of participants expressed a willingness to assume the role of health educators for their family members (n = 117, 87.31%) and reported a high level of willingness and confidence, as indicated by self-efficacy scores ranging from 12.00 to 25.00, with a mean of 21.12 (SD = 2.76). Participants' willingness to be health educators exhibited positive correlations with their perceptions of diabetes severity and susceptibility (r = .433, p < .01), perceived benefits and barriers (r = .451, p < .01), cues to action (r = .520, p < .01), self-efficacy (r = .789, p < .01), and the total score of the questionnaire (r = .640, p < .01). CONCLUSIONS The majority of participants expressed their willingness to assume the role of health educators for their family members, and a significant portion reported confidence in their capacity to accomplish this objective. Healthcare providers should emphasize the importance of equipping patients with the skills and knowledge necessary to effectively convey health messages and serve as health educators within their communities. This expansion of the approach holds the potential to have a significant impact on public health strategies for diabetes prevention.
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Affiliation(s)
- Mona Alanazi
- College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of the National Guard Health Affairs Riyadh, Riyadh, Saudi Arabia
| | - Eman Bajmal
- College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of the National Guard Health Affairs Riyadh, Riyadh, Saudi Arabia
| | - Abeer Aseeri
- Nursing College-Muhyil Asir, King Khalid University, Abha, Saudi Arabia
| | - Ghaida Alsulami
- Nursing College, Umm Al-Qura University, Mecca, Saudi Arabia
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Comrie CE, Coe TM, Moses J, Dageforde LA. Evaluating Medical Students' Perceptions of Patient-Led Transplant Surgery Education 1-2 Years Later. J Surg Res 2024; 296:149-154. [PMID: 38277951 DOI: 10.1016/j.jss.2023.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/16/2023] [Accepted: 12/28/2023] [Indexed: 01/28/2024]
Abstract
INTRODUCTION Medical students value the opportunity to learn from patients as a supplement to traditional faculty-led education; however, long-term follow-up to understand the educational impact of these experiences is lacking. We surveyed medical students who conducted non-medical virtual encounters with transplant recipients or living donors to understand the impact on students' patient care approach after 1-2 y. METHODS Students who completed their surgery clerkship from July 2020 to September 2021 were surveyed about this nonmedical patient encounter in January 2023. Quantitative and qualitative survey data were analyzed using descriptive statistics and inductive thematic analysis, respectively. RESULTS Of the 27 respondents (46% response rate), 44.4% completed the experience 1 y ago and 55.6% completed the experience 2 y ago. Nearly all respondents (96.3%) agreed that this experience was an effective way to learn about organ donation and transplantation and that learning from patients was beneficial to their development as a doctor. Over 50% felt this experience changed how they provide care to patients. Qualitatively, students reported that this activity cultivated their empathy for patients, provided unique insight into patients' illness experiences, and enhanced their understanding of the longitudinal patient-surgeon relationship. CONCLUSIONS Utilizing patients as teachers in transplant surgery not only taught medical students more about organ donation and transplantation but also built empathy and highlighted unique, non-clinical aspects of the patient experience that persisted over time. This is one of the first studies to evaluate patient-led teaching of this type over a year later and assess its unique influence on medical student development.
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Affiliation(s)
| | - Taylor M Coe
- Harvard Medical School, Boston, Massachusetts; Surgery Department, Massachusetts General Hospital, Boston, Massachusetts
| | - Joy Moses
- Surgery Department, Massachusetts General Hospital, Boston, Massachusetts
| | - Leigh Anne Dageforde
- Harvard Medical School, Boston, Massachusetts; Surgery Department, Massachusetts General Hospital, Boston, Massachusetts.
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Massé J, Grignon S, Vigneault L, Olivier-D'Avignon G, Tremblay MC. Patients' perspectives on their motivations for participating in non-clinical medical teaching and what they gain from their experience: a qualitative study informed by critical theory. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:217-243. [PMID: 37382856 DOI: 10.1007/s10459-023-10262-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/18/2023] [Indexed: 06/30/2023]
Abstract
In 2019-2021, we engaged in a project aimed at developing, implementing, and evaluating an educational intervention actively involving patient-teachers in undergraduate medical education at Université Laval, Quebec, Canada. Patient-teachers were invited to participate in small group discussion workshops during which medical students deliberate on legal, ethical, and moral issues arising from medical practice. Patients were expected to bring other perspectives, based on their experience with illness and the healthcare system. Little is still known about patients' perspectives on their participation experience in such context. Informed by critical theory, our qualitative study aims to document,: (i) the motivating factors for patients' participation in our intervention; and (ii) what patients gained from the experience. Data collection was based on 10 semi-structured interviews with patient-teachers. A thematic analysis was conducted using NVivo software. Motivators for participation arose from: (i) perceived consistency between patients' individual characteristics and those of the project, and (ii) conceiving the project as a means to reach individual and social goals. What patients gained mainly refers to (1) the appreciation of a positive, enriching, motivating yet uncomfortable and destabilizing experience; (2) a deconstruction of biases against the medical field and critical thinking about their own experience; (3) new knowledge, with a potential impact on their future interactions with the healthcare system. Results reveal patients as non-neutral thinking and knowing subjects, engaged in the participation experience as active teachers and learners. They also highlight the empowering and emancipatory nature of the learning gained through patients' participation experience. These conclusions prompt us to promote transformative interventional approaches that question the pervasive power issues in medical teaching and value patients' specific knowledge in teaching and learning the Art of Medicine.
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Affiliation(s)
- Julie Massé
- Faculty of medicine, Université Laval, 1050 avenue de la Médecine, Quebec City, Québec, Canada.
- Faculty of nursing, Université Laval, 1050 avenue de la Médecine, Quebec City, Québec, Canada.
- Vitam, Centre de recherche en santé durable, 2480 chemin de la Canardière, Quebec City, Québec, Canada.
| | - Sophie Grignon
- Faculty of medicine, Université Laval, 1050 avenue de la Médecine, Quebec City, Québec, Canada
- Patient-Partner, Quebec City, Québec, Canada
| | - Luc Vigneault
- Faculty of medicine, Université Laval, 1050 avenue de la Médecine, Quebec City, Québec, Canada
- Vitam, Centre de recherche en santé durable, 2480 chemin de la Canardière, Quebec City, Québec, Canada
- Patient-Partner, Quebec City, Québec, Canada
| | | | - Marie-Claude Tremblay
- Faculty of medicine, Université Laval, 1050 avenue de la Médecine, Quebec City, Québec, Canada
- Vitam, Centre de recherche en santé durable, 2480 chemin de la Canardière, Quebec City, Québec, Canada
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Brito S, Rau A, Escobar C, Garza P, Sriprasert I, Mitchell Chadwick N. Raising patient voices in medical education: an assessment of patient perceived effect of social determinants of health conversations and the patient-physician relationship on quality of obstetric care, to inform the development of patient driven medical education curricula. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1283390. [PMID: 38435087 PMCID: PMC10905965 DOI: 10.3389/frph.2024.1283390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
Background Conventional medical education lacks the lived experiences of patients which may authentically convey the social determinants of health (SDOH) and resulting health disparities. Videos of first-person patient narratives may prove a valuable education tool in this regard. The objective of this study is to investigate how patient demographics, satisfaction with care, and patient-physician relationships influence obstetric patient interest and willingness to contribute to a SDOH video curriculum by sharing their lived experiences through first-person narratives. Methods Study design included an anonymous, cross-sectional survey and an optional semi-structured telephone interview. Participants were 18 years old with a live-birth delivery <8 weeks prior to recruitment and received care during their pregnancy at Los Angeles General Medical Center (LAGMC). Variables surveyed included demographics, satisfaction with care, aspects of the patient-physician relationship, perceived utility, and personal interest in contributing to an educational SDOH video. A bivariate analysis was conducted to compare participants' characteristics and responses on interest in contributing and perceived helpfulness of first-person patient SDOH videos. Results 72.43% of participants (N = 70) believed a patient's first-person video on SDOH would be "Helpful" in preparing physicians to provide competent medical care; however, 71.43% responded "No" to "Interest" in sharing with physicians their experiences with SDOH. English preference and being U.S. born were factors significantly associated with viewing first-person SDOH video as "Helpful" (P > 0.001). Major themes from telephone interviews reflected enthusiasm for first-person patient narratives and perceived benefits of using patient experiences to educate physicians on SDOH. However, participants cited barriers to disclosing SDOH including brief and strictly clinical interactions with physicians, lack of continuity of care, and fear of being judged by physicians. Conclusion While most participants recognized the utility of addressing social needs in medical education and reported satisfaction with their obstetricians and care, these factors did not uniformly translate into willingness to contribute first-person patient narratives. To improve the representation of patients from racial, ethnic, gender, linguistic, and sexual minorities into medical curricula, further research and strategies are needed to overcome the barriers discouraging patient disclosure of social needs to physicians.
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Affiliation(s)
- S. Brito
- Department of Obstetrics and Gynecology, Keck School of Medicine of USC, Los Angeles, CA, United States
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Chevillotte E, Dondé C. Peer workers to address discrimination against women in psychiatry and mental health. L'ENCEPHALE 2024; 50:108-110. [PMID: 37400333 DOI: 10.1016/j.encep.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/27/2023] [Accepted: 05/04/2023] [Indexed: 07/05/2023]
Abstract
Compared to the general population and to males with mental health disorders, women with these disorders face more obstacles in psychiatric and mental health care settings. This strongly encourages mental health policies and psychiatric care to consider specific strategies that prevent gender bias in treatment among women with mental health issues. A growing body of research demonstrates the benefits of having peer workers-professionals with a lived experience of mental health issues who use their own experiences of mental distress to support others with comparable experiences-in mental health services. We postulate that peer support can become an important and integrated aspect of preventing and addressing discrimination against women in psychiatry and mental health care. First, women peer workers may combine their lived experiences as service users and as women to provide unique, experience- and gender-based support to women users who experience discrimination. Non-women or women peer workers who did not experience gender discrimination in psychiatric settings may nevertheless benefit from the integration of gender education in their curriculum and, in turn, bring a feminist lens to their work to achieve this mission. Second, using their experience as service users, peer workers have the credible ability to communicate and translate women patients' needs to the medical staff, and thus facilitate concrete, need-based adjustments of services. Third, peer workers' involvement as instructors in medical schools could provide early awareness of injustices experienced by women in psychiatry and mental health care. Further research is required to test the effectiveness of peer workers in addressing discrimination against women in real-world clinical settings. More broadly, from a diversity perspective, we believe that peer workers are one of the critical elements in the fight against discrimination in psychiatry and mental health.
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Affiliation(s)
- Elise Chevillotte
- Adult Psychiatry Department, CH Alpes-Isère, 38000 Saint-Egrève, France
| | - Clément Dondé
- Adult Psychiatry Department, CH Alpes-Isère, 38000 Saint-Egrève, France; University Grenoble Alpes, 38000 Grenoble, France; Adult Psychiatry Department, CHU de Grenoble-Alpes, 38000 Grenoble, France.
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Kennedy SKF, Dawdy K, Cao X, McGuffin M, Bristow B, Szumacher E. Patient engagement in CPD in radiation oncology and radiation therapy across Canada: A national survey. J Med Imaging Radiat Sci 2023; 54:583-589. [PMID: 37673706 DOI: 10.1016/j.jmir.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/27/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND The aim of this study was to investigate patient engagement (PE) in the development and delivery of Continuing Professional Development (CPD) programs for health care providers within radiation oncology, radiation therapy and medical physics across Canada. This study looked at the current state of PE in CPD programs across Canada and how to address the benefits and barriers to PE to advance these programs. METHODS A quantitative, exploratory survey was conducted among radiation oncologists, radiation therapists and medical physicists across Canada. The questionnaire was developed by a multi-disciplinary team and piloted among interprofessional (IP) faculty with a special interest in patient education. The survey was web-based and disseminated through the Canadian Association of Medical Radiation Technologists (CAMRT) and Canadian Radiation Oncologists (CARO) professional associations. RESULTS A total of 97 responses were obtained, 43.3% (n = 41) were radiation oncologists 64% (n = 54) were radiation therapists and 2(2%) were medical physicists. There was representation from all provinces, except Newfoundland, with the majority 36% (n = 35) from Ontario. 57% (n = 46) of participants agreed that patients should be involved in CPD, and 11% (n = 9) disagreed. The most agreed-upon barriers are financial costs for patients and clinician bias when selecting patients. The most agreed-upon solutions were improving patient resources and creating training programs for patients. Radiation therapists agreed significantly more (p<0.05) with the potential benefits of PE in CPD, compared to radiation oncologists. DISCUSSION PE in CPD programs is a novel and controversial topic but is still highly rated and important. We intend to advocate for patients to take an active role in our CPD programs. Further research is warranted.
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Affiliation(s)
| | - Krista Dawdy
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Xingshan Cao
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Merrylee McGuffin
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Bonnie Bristow
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Ewa Szumacher
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Cai W, You M, Li J, Li Q, Wang D, Wang H. Application of "immersive contextualization based-learning teaching" mode in the orthopaedic musculoskeletal disorder module of clinical medicine education. BMC MEDICAL EDUCATION 2023; 23:906. [PMID: 38031076 PMCID: PMC10687819 DOI: 10.1186/s12909-023-04831-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To evaluate the effect and influence of the "immersive contextualization-based learning" teaching mode (ICBLT) in the orthopaedic musculoskeletal disorder module of clinical medicine education. METHODS Undergraduate students in five consecutive semesters of clinical medicine in West China Hospital, Sichuan University were enrolled in this study. During the teaching process in each semester, a cross-over design was applied, and students were randomly divided into two classes (Class A and Class B) to receive the designated experimental courses with different routes. After they took the final exams, the scores of the selected chapters (sports injury chapter and osteoarthritis chapter) were extracted to conduct Tests of Between-Subjects Effects. Q-Q plot was drawn to test whether the distribution of the scores follows normal distribution. The part of the feedback questionnaires to assess these two teaching modes were also extracted for comparison. RESULTS A total of 441 students were enrolled in this study, among which, Class A teaching route was implemented to 222 students and Class B to the rest 219. The results of Tests of Between-Subjects Effects showed that ICBLT mode could lead to better scores compared to the Lecturing-based learning teaching (LBLT) mode (p < 0.0001). In terms of mastery of practical skills, help to deepen the memory of knowledge and satisfaction with the teaching mode, the ICBLT mode showed better results (p < 0.0001). CONCLUSION ICBLT mode had better potential in helping mastery of practical skills and deepening the memory of knowledge.
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Affiliation(s)
- Wufeng Cai
- Department of Orthopedics, West China Hospital, Orthopedic Research Institute, Sichuan University, Chengdu, China
- Department of Engineering, University of Exeter, Exeter, England
| | - Mingke You
- Department of Orthopedics, West China Hospital, Orthopedic Research Institute, Sichuan University, Chengdu, China
| | - Jian Li
- Department of Orthopedics, West China Hospital, Orthopedic Research Institute, Sichuan University, Chengdu, China.
| | - Qi Li
- Department of Orthopedics, West China Hospital, Orthopedic Research Institute, Sichuan University, Chengdu, China
| | - Duan Wang
- Department of Orthopedics, West China Hospital, Orthopedic Research Institute, Sichuan University, Chengdu, China.
| | - Haoyang Wang
- Department of Orthopedics, West China Hospital, Orthopedic Research Institute, Sichuan University, Chengdu, China.
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Berger S, Harada C. A patient-centered approach to learning social determinants of health for first year medical students. MEDICAL TEACHER 2023; 45:1263-1267. [PMID: 37383016 DOI: 10.1080/0142159x.2023.2225727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
INTRODUCTION To address health disparities, future physicians must understand the role of social determinants of health (SDH). Teaching SDH can be challenging. We created an authentic SDH curriculum using four real myocardial infarction (MI) patients. METHODS During the three academic years from 2019-2020 to 2021-2022, 579 first year medical students participated in the four day curriculum. Day 1: students interviewed and learned about their patient's MI. Day 2: students met in small groups and shared their patient's history. At session end, students were familiar with four patient stories. Day 3: students explored their patient's neighborhood and then interviewed their patient again, focusing on SDH. Day 4: students gave formal patient presentations that highlighted SDH. Group discussion followed and reinforced the role of SDH. Students wrote reflections on SDH that were read and graded. End of course evaluations were reviewed. RESULTS Five hundred and seventy-nine students completed the curriculum. Course directors graded SDH reflections on a six-point rubric for the years of 2020-2021 and 2021-2022. Ninety percent and 96% of the SDH reflections during the respective years contained 5-6/6 of the rubric components. Ninety-six percent to 98% of students 'agreed' or 'strongly agreed' that the curriculum was effective for their learning. DISCUSSION For educators in need of an SDH curriculum that is both engaging and effective, we have found this activity to be feasible, low cost, and highly impactful for first year medical students.[Box: see text].
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Affiliation(s)
- Stephanie Berger
- Department of Pediatrics, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Caroline Harada
- Department of Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
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Eijkelboom MCL, de Kleijn RAM, Baten L, Frenkel J, van der Schaaf MF. Perspective-Taking and Perspective-Sharing in Pediatric Education: Exploring Connections Between Strategies of Medical Students and Patients' Caregivers. PERSPECTIVES ON MEDICAL EDUCATION 2023; 2:372-384. [PMID: 37810548 PMCID: PMC10558030 DOI: 10.5334/pme.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/07/2023] [Indexed: 10/10/2023]
Abstract
Introduction In pediatric education, caregivers are increasingly involved to share their perspective. Yet, an in-depth understanding of the perspective-taking process between medical students and caregivers is lacking. This study explored: 1) Which strategies do medical students use to take a caregiver's perspective and which facilitators and constraints do they perceive? 2) Which strategies do caregivers use to share their perspective with students? and 3) How do students' perspective-taking strategies relate to caregivers' perspective-sharing strategies? Methods In an online lesson: two caregivers of pediatric patients, shared their story with 27 fourth-year Dutch medical students. After the session, students undertook an assignment where they individually reflected on how they took perspective. Students' reflections were collected via audio recordings. Caregivers were individually interviewed. Data were analyzed through thematic and cross-case analysis. Results Students used eight perspective-taking strategies, in various combinations. Students used inferential strategies, where they made inferences from available information, and cultivating strategies, where they attempted to elicit more information about the caregiver. Students perceived individual-, contextual- and caregiver-related facilitators and constraints for taking perspective. Caregivers shared their perspective by adopting multiple strategies to share their story and create a trusting learning environment. We visualized connections between students' perspective-taking strategies, facilitators/constraints, and caregivers' perspective-sharing strategies. Discussion By combining data from both perspective-takers (students) and perspective-sharers (caregivers), this study provides a foundation for future research to study perspective-taking between students and patients in an educational context. On a practical level, our findings provide tools for students, patients, and educators to enhance perspective-taking processes.
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Affiliation(s)
- M. C. L. Eijkelboom
- Faculty of Medicine, Utrecht University, the Netherlands
- Department of Pediatrics, University Medical Center Utrecht, the Netherlands
| | - R. A. M. de Kleijn
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, the Netherlands
| | - L. Baten
- Faculty of Medicine, Utrecht University, the Netherlands at the time she contributed to the research
| | - J. Frenkel
- Department of Pediatrics, University Medical Center Utrecht, the Netherlands
| | - M. F. van der Schaaf
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, the Netherlands
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Massé J, Beaura S, Tremblay MC. Fostering the development of non-technical competencies in medical learners through patient engagement: a rapid review. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:47-69. [PMID: 37719397 PMCID: PMC10500390 DOI: 10.36834/cmej.73630] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Background To train physicians who will respond to patients' evolving needs and expectations, medical schools must seek educational strategies to foster the development of non-technical competencies in students. This article aims to synthetize studies that focus on patient engagement in medical training as a promising strategy to foster the development of those competencies. Methods We conducted a rapid review of the literature to synthetize primary quantitative, qualitative and mixed studies (January 2000-January 2022) describing patient engagement interventions in medical education and reporting non-technical learning outcomes. Studies were extracted from Medline and ERIC. Two independent reviewers were involved in study selection and data extraction. A narrative synthesis of results was performed. Results Of the 3875 identified, 24 met the inclusion criteria and were retained. We found evidence of a range of non-technical educational outcomes (e. g. attitudinal changes, new knowledge and understanding). Studies also described various approaches regarding patient recruitment, preparation, and support and participation design (e.g., contact duration, learning environment, patient autonomy, and format). Some emerging practical suggestions are proposed. Conclusion Our results suggest that patient engagement in medical education can be a valuable means to foster a range of non-technical competencies, as well as formative and critical reflexivity. They also suggest conditions under which patient engagement practices can be more efficient in fostering non-instrumental patient roles in different educational contexts. This supports a plea for sensible and responsive interventional approaches.
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Affiliation(s)
- Julie Massé
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Canada
- VITAM, Centre de recherche en santé durable, Quebec, Canada
- Faculty of nursing, Université Laval, Quebec, Canada
| | - Stéphanie Beaura
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Canada
| | - Marie-Claude Tremblay
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Canada
- VITAM, Centre de recherche en santé durable, Quebec, Canada
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Sagnol G, Haesebaert J, Termoz A, Michel P, Schott AM, Potinet V, Pomey MP, Tazarourte K, Douplat M. Assessing patient partnership among emergency departments in France: a cross-sectional study. BMC Health Serv Res 2023; 23:897. [PMID: 37612727 PMCID: PMC10463322 DOI: 10.1186/s12913-023-09905-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES This study aims to describe the use of patient partnership, as defined by the Montreal Model, in emergency departments (EDs) in France and report the perception of patient partnership from both the practitioner and patient perspectives. METHODS This cross-sectional study was conducted between July 2020 and October 2020. First, a survey was sent to 146 heads of EDs in both teaching hospitals and non-teaching hospitals in France to assess the current practices in terms of patient partnership in service organization, research, and teaching. The perceived barriers and facilitators of the implementation of such an approach were also recorded. Then, semi-structured telephone interviews were carried out with patients involved in a service re-organization project. RESULTS A total of 48 answers (response rate 32.9%) to the survey were received; 33.3% of respondents involved patients in projects relating to service re-organization, 20.8% involved patients in teaching projects, and 4.2% in research projects. Overall, 60.4% of the respondents were willing to involve patients in re-organization or teaching projects. The main barriers mentioned for establishing patient partnership were difficulties regarding patient recruitment and lack of time. The main advantages mentioned were the improvement in patient/caregiver relationship and new ideas to improve healthcare. When interviewed, patients mentioned the desire to improve healthcare and the necessity to involve people with different profiles and backgrounds. A too important personal commitment was the most frequently raised barrier to their engagement. All the patients recognized their positive role, and more generally, the positive role of patient engagement in service re-organization. CONCLUSION Although this preliminary study indicates a rather positive perception of patient partnership among heads of EDs in France and partner patients, this approach is still not widely applied in practice.
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Affiliation(s)
- Geoffrey Sagnol
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
| | - Julie Haesebaert
- Pôle de Santé Publique, service de recherche et d’épidémiologie cliniques, Hospices Civils de Lyon, Lyon, France
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
| | - Anne Termoz
- Pôle de Santé Publique, service de recherche et d’épidémiologie cliniques, Hospices Civils de Lyon, Lyon, France
| | - Philipe Michel
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- Hospices civils de Lyon, Lyon, 69002 France
| | - Anne-Marie Schott
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
| | - Véronique Potinet
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
| | - Marie-Pascale Pomey
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montreal, Montreal, QC Canada
| | - Karim Tazarourte
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Edouard Herriot, 5 place d’Arsonval, Lyon, F-69003 France
| | - Marion Douplat
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- UMR 7268 ADéS, Aix-Marseille Université / EFS / CNRS, Espace éthique méditerranéen, Hôpital Adultes La Timone, 264 rue Saint Pierre, Marseille cedex 05, France
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14
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Li YS, Dahri K, Chan F. Environmental scan of the patient voice in Canadian E2P PharmD programs. CURRENTS IN PHARMACY TEACHING & LEARNING 2023:S1877-1297(23)00157-0. [PMID: 37357129 DOI: 10.1016/j.cptl.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 05/16/2023] [Accepted: 06/18/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION There has been an increasing interest in embedding patients' voices in the education of healthcare professionals. The purpose of this study was to conduct an environmental scan of entry to practice doctor of pharmacy (E2P PharmD) programs in Canada to determine to what extent pharmacy educators in Canada incorporate real patient voices in course delivery. METHODS A web-based survey was distributed to an estimated total number of 750 pharmacy educators at eight Canadian English-speaking E2P PharmD programs. Respondents answered questions related to their experience incorporating patients' voices into their teaching, the value of patients' voices, and their perceived barriers. Aggregate data were analyzed using descriptive statistics. RESULTS Fifty-three pharmacy educators (7%) responded. Most respondents (93%) agreed that patients' voices are indispensable in pharmacy education, while only 32% reported that they had involved real patient voices in their courses in the past three years. Patient speech or presentation was reported as the most used method to involve real patient voices in their courses (39%), followed by question-and-answer sessions (17%). The top barriers perceived by pharmacy educators for involving real patients were insufficient teaching time (33%) and difficulty in recruiting patients (27%). CONCLUSIONS Patients' voices were used by one-third of the E2P PharmD educators who participated, though over 90% recognized its value. Where deployed, patients were invited to speak on a variety of topics relevant to their personal experiences. More research is needed to determine what benefits can result from patient voices and how to improve its sustainability.
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Affiliation(s)
- Yaqing Shirley Li
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Karen Dahri
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada; Vancouver General Hospital, Vancouver Coastal Health, 855 West 12(th) Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Fong Chan
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
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15
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Alberti S, Ferri P, Ghirotto L, Bonetti L, Rovesti S, Vannini V, Jackson M, Rossi F, Caleffi D. The patient involvement in nursing education: A mixed-methods systematic review. NURSE EDUCATION TODAY 2023; 128:105875. [PMID: 37336122 DOI: 10.1016/j.nedt.2023.105875] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 04/26/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE To evaluate the effects patient involvement in nursing education has on students, patients and academic staff using a specific theoretical framework. DESIGN Mixed-methods systematic review based on Joanna Briggs Institute methodology (Prospero no. CRD42022327158). DATA SOURCES Seven databases (PubMed, Cochrane Library, Cinahl, PsychINFO, Scopus, ERIC, Embase), Google Scholar and reference lists were searched. REVIEW METHODS Qualitative, quantitative and mixed-method studies published from 2012 to 2022 were included. Two reviewers independently assessed the studies for eligibility and quality; any disagreement was discussed with a third reviewer. Data were extracted and analysed according to the Joanna Briggs Institute converged integrated approach. RESULTS Twenty-one qualitative, one quantitative and five mixed-methods studies met the inclusion criteria. Data were provided from three points of view: students, patients and academic staff. Student integrated findings included: (i) students' reactions towards patient involvement in education; (ii) students' views on the learning process and (iii) on ethical issue. From the patient point of view, the integrated findings addressed (i) patients' goals and effects on students' learning; (ii) how patients teach and get involved with students; (iii) how patients perceived their role; the patients' views on facilitators (iv) and barriers (v) in education; (vi) the perceived effects of being involved in education. Four integrated findings were derived from the academic staff's point of view: (i) academics' perceptions on patient vulnerability; (ii) perceived barriers to the efficacy of patient involvement in education; (iii) effects of patient involvement in nursing education; and (iv) methodological aspects of patient involvement in university curriculum. CONCLUSIONS This systematic review provides useful information from all stakeholders' perspectives on the effects of patient involvement in nursing education. It offers a broader view of the implications for implementation and for developing theoretical frameworks and hypotheses for future research.
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Affiliation(s)
- Sara Alberti
- Clinical and Experimental Medicine PhD Program, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. https://twitter.com/SaraAl30973595
| | - Paola Ferri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL-IRCCS of Reggio Emilia, Italy
| | - Loris Bonetti
- Nursing Research Competence Centre, Department of Nursing, Ente Ospedaliero Cantonale (EOC), Switzerland; Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Switzerland.
| | - Sergio Rovesti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Valeria Vannini
- Clinical and Experimental Medicine PhD Program, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Azienda USL di Imola, Imola, Italy
| | - Mathieu Jackson
- Center of Excellence on Partnerships with Patients and the Public, University of Montreal Hospital Research Center, Canada
| | - Francesca Rossi
- EduCare Laboratory, Interdepartmental Center for Educational Innovation, University of Modena and Reggio Emilia, Modena, Italy
| | - Dalia Caleffi
- Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
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Papanagnou D, Ankam N, Feingold-Link J, Poluch M, Kilpatrick J, Fernandez A, Vaid U, Ziring D. Practical tips for moving your patient panel online. MEDEDPUBLISH 2023; 13:19. [PMID: 37089867 PMCID: PMC10113798 DOI: 10.12688/mep.19613.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 04/03/2023] Open
Abstract
Patient panels are an inspiring, highly rated educational tool to complement course goals and objectives for students in medical education programs. The COVID-19 pandemic brought challenges on the ability to successfully host in-person patient panels. These challenges resulted in the need to pivot in-person patient panels to online platforms, while still ensuring the quality and intimacy of patient narratives. In this 12 tips article, we share lessons learned in transitioning patient panels in our health systems science curriculum to an online experience for students enrolled in a pre-clinical medical education program.
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Affiliation(s)
- Dimitrios Papanagnou
- Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Nethra Ankam
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Jordan Feingold-Link
- Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Maria Poluch
- Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Jared Kilpatrick
- Departments of Emergency Medicine and Medical Education, Western Michigan University Homer Stryker, MD School of Medicine, Kalamazoo, MI, 49007, USA
| | - Andres Fernandez
- Department of Neurology, Sidney Kimmel College at Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Urvashi Vaid
- Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Deborah Ziring
- Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 19107, USA
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17
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Adam HL, Eady K, Moreau KA. Patient references in the 2005 and 2015 CanMEDS frameworks. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:63-69. [PMID: 36998493 PMCID: PMC10042792 DOI: 10.36834/cmej.74993] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Patient involvement in postgraduate medical education (PGME) can help residents improve their communication, professionalism, and collaboration. The CanMEDS Framework defines such competencies for physicians and informs teaching and assessment activities in PGME. However, it is unclear how patients are referenced in the CanMEDS Framework and if these references encourage the active involvement of patients in PGME. To inform how patients are referenced in the revisions of the CanMEDS Framework, scheduled for publication in 2025, our aim was to determine how patients are referenced in each the 2005 and 2015 CanMEDS Frameworks. Methods We used document analysis to examine how the term 'patient(s)' is referenced in the 2005 and 2015 CanMEDS Frameworks. Results Several 2005 and 2015 CanMEDS Roles include patients in the descriptions but do not reference them in the competencies. Others do not reference patients in the descriptions or competencies, potentially detracting from the importance of involving patients. As it stands, the 2015 Health Advocate is the only Role that describes and references patients working with physicians as partners in care, facilitating potential opportunities for patient involvement in PGME. Conclusion There are inconsistencies in how patients are described and referenced as potential partners in PGME throughout past and present CanMEDS Frameworks. Understanding these inconsistencies can inform the revision of CanMEDS that is scheduled for publication in 2025.
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Affiliation(s)
- Holly L Adam
- Faculty of Education, University of Ottawa, Ontario, Canada
| | - Kaylee Eady
- Faculty of Education, University of Ottawa, Ontario, Canada
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18
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Eijkelboom C, Brouwers M, Frenkel J, van Gurp P, Jaarsma D, de Jonge R, Koksma J, Mulder D, Schaafsma E, Sehlbach C, Warmenhoven F, Willemen A, de la Croix A. Twelve tips for patient involvement in health professions education. PATIENT EDUCATION AND COUNSELING 2023; 106:92-97. [PMID: 36266155 DOI: 10.1016/j.pec.2022.09.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Moving towards person-centered care, with equal partnership between healthcare professionals and patients, requires a solid role for the patient in the education of students and professionals. Patients can be involved as teachers, assessors, curriculum developers, and policy-makers. Yet, many of the initiatives with patients are isolated, small events for targeted groups and there is a lack of patient involvement at the institutional level. To support educators in involving patients, both at the institutional level and at single educational encounters, we offer twelve practical tips. This paper came about through an innovative collaboration between healthcare professionals, educators, teachers, and patients. These tips can be used as a tool to start or reinforce patient involvement in health professions education and provide guidance on how to make it a sustainable part of the curriculum. The article involves organizational conditions for success, tips for sustainable partnerships, ideas for curriculum design and proposes concrete teaching strategies. Finally, besides practical tips, we stress that involving patients in education is not business as usual, and paradoxically this needs to be acknowledged before it can become business as usual.
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Affiliation(s)
- Charlotte Eijkelboom
- Department of Pediatrics, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Marianne Brouwers
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Joost Frenkel
- Department of Pediatrics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Petra van Gurp
- Department of General Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Debbie Jaarsma
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Roos de Jonge
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jur Koksma
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Dante Mulder
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Evelyn Schaafsma
- Wenckebach Institute for Education, University Medical Center Groningen, Groningen, the Netherlands
| | - Carolin Sehlbach
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Franca Warmenhoven
- Skillslab, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Agnes Willemen
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Anne de la Croix
- Research in Education, Faculty of Medicine, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Heginbotham L, Baugh G, Lefeber T, Friehling L, Barnhart C, Miller LA, Moore L, Cottrell L. A parent-led, patient-centered medical home model instruction for interprofessional undergraduate and graduate learning opportunities. MEDICAL EDUCATION ONLINE 2022; 27:2012105. [PMID: 34919018 PMCID: PMC8725748 DOI: 10.1080/10872981.2021.2012105] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/14/2021] [Accepted: 11/25/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Despite national efforts to establish patient-centered medical homes (PCMH), 57.3% of children with special health care needs are receiving care that does not meet medical home criteria. Project DOCC, a national curriculum designed by parents of children with disabilities or chronic disease, has shown documented strengths in medical resident learner education of children with special health care needs from the parent perspectives for over a decade. Because of the importance of PCMH and the need to provide compassionate care, our team adapted the curriculum to incorporate team-based learning in the rural setting. MATERIALS AND METHODS Reading materials were distributed to learners prior to an in-person workshop at which time, learners reviewed a video and discussed PCMH materials to identify elements of the PCMH. Learners then engaged with parent mentors across three breakout sessions. A final group reflection was completed to review and discuss efforts providers would take to establish and maintain the PCMH in their own practice. Baseline and post-workshop PCMH perceptions and parent mentor reflections were collected and compared using t-test comparisons. RESULTS Learner knowledge, perceptions, and comfort significantly increased after the workshop. Parent mentor comments also highlighted an increased understanding for the provider. Discussion: The adapted PCMH curriculum significantly impacted learner outcomes using a feasible approach that fit nicely within health professional curricula and limited resources of the rural setting. Parents enjoyed the opportunity to serve as mentors and valued the instruction format.
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Affiliation(s)
- Lori Heginbotham
- Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA
| | - Gina Baugh
- Director of the Wv Office of Interprofessional Education, West Virginia University School of Pharmacy, Morgantown, WV, USA
| | - Timothy Lefeber
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
| | - Linda Friehling
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
| | - Christy Barnhart
- Nursing Workshop, West Virginia University Adult Health Department
| | - Lee Ann Miller
- West Virginia University, Patient Safety Simulation Center (WV STEPS), Morgantown, WV, USA
| | - Lucas Moore
- Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA
| | - Lesley Cottrell
- Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
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20
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DaSilva D, Roberts R, Jones M, Yong J, Park S. Can a training hub deliver undergraduate medical education with patient educators? EDUCATION FOR PRIMARY CARE 2022; 33:347-351. [PMID: 36471566 DOI: 10.1080/14739879.2022.2137855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Medical schools may find it difficult to coordinate GP practices to support undergraduate medical education in primary care. In England, every Integrated Care System area now has a funded training hub to plan and upskill the primary care and community health workforce. We evaluated whether a training hub could help deliver undergraduate medical education, co-facilitated by patient educators. No published research has evaluated this model before. METHODS We used before and after surveys (617 students), interviews (28) and focus groups (20 people) with undergraduate medical students, patient educators and training hub and medical school team members. FINDINGS It was feasible for a training hub to develop and co-deliver a workshop with patient educators. 61% of Year 4 undergraduate students (first clinical year) took part, a high attendance rate during the COVID-19 pandemic. 80% of students said they learnt a lot about managing conditions in primary care and the community as a result. They particularly valued engaging with patient educators and seeing interprofessional working between GPs and pharmacists, which were cornerstones of the training hub approach. The hub was able to recruit and retain patient educators more effectively than the medical school alone. Patient educators said they felt valued and developed new skills. CONCLUSIONS Working with training hubs may be part of the solution to issues medical schools face when organising undergraduate education about primary care. This small evaluation suggests that this model could be tested further.
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21
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Eijkelboom MCLC, Kalee MM, de Kleijn RAMR, van Wijngaarden JJJ, de Jonge RRR, van der Schaaf MFM, Frenkel JJ. Making knowledge clips with patients: What learning mechanisms are triggered in medical students? PATIENT EDUCATION AND COUNSELING 2022; 105:3096-3102. [PMID: 35725527 DOI: 10.1016/j.pec.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To prepare medical students for a rapidly changing healthcare landscape, where new means of communication emerge, innovative teaching methods are needed. We developed a project-based learning course in which medical students design audiovisual patient information in collaboration with patients and with students in Communication and Information Sciences (CIS). We studied what learning mechanisms are triggered in medical students by elements of a project-based-learning course. METHODS In this qualitative study, twelve sixth year medical students that participated in the course were individually interviewed. Data were analyzed according to the principles of qualitative template analysis. RESULTS We identified four learning mechanisms: Challenging assumptions about patients' information needs; Becoming aware of the origin of patients' information needs; Taking a patient's perspective; Analyzing language to adapt to patients' needs. These learning mechanisms were activated by making a knowledge clip, collaborating with patients, and collaborating with CIS students. CONCLUSION Collaborating with patients helped students to recognize and understand patients' perspectives. Working on a tangible product in partnership with patients and CIS students, triggered students to apply their understanding in conveying information back to patients. PRACTICE IMPLICATION Based on our findings we encourage educators to involve patients as collaborators in authentic assignments for students so they can apply what they learned from taking patients' perspectives.
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Affiliation(s)
- M C L Charlotte Eijkelboom
- Department of Pediatrics, University Medical Center Utrecht, Utrecht, the Netherlands; Faculty of Medicine, Utrecht University, Utrecht, the Netherlands, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - M Melanie Kalee
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, the Netherlands
| | - R A M Renske de Kleijn
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J J Jacqueline van Wijngaarden
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, the Netherlands
| | - R R Roos de Jonge
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, the Netherlands
| | - M F Marieke van der Schaaf
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J Joost Frenkel
- Department of Pediatrics, University Medical Center Utrecht, Utrecht, the Netherlands
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22
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Fiquet L, Dupard M, Fortier H, Pancher M, Annezo F, Renaut P, Allory E. Perspectives of patient educators about their participation in an interprofessional program for healthcare students and postgraduate medical students. J Interprof Care 2022; 37:464-472. [PMID: 36153743 DOI: 10.1080/13561820.2022.2099817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Including patients in interprofessional education (IPE) programs adds value to healthcare students' education. However, little is known about the perspective and experience of the involved patient educators (PEs). An IPE program (Interprofessional Seminars, IPS) that includes PEs was developed in France in 2009. The aim of this study was to describe the PEs' perspectives about their involvement in IPS. Data were collected using semi-structured interviews with 32 experienced PEs, and analyzed using a reflexive thematic analysis in the framework of an inductive approach. PEs had an identifiable profile. They were motivated by a sense of civic service, had well-developed communication skills, and were prepared to share their experiential knowledge with students. They were concerned about their capacity to express themselves in front of students and the need to consolidate their involvement through a structured partnership that involves briefing, collaboration, remuneration, and feedback. They proposed to establish compulsory interprofessional training for all students and to strengthen the collaboration between an interprofessional group of students and a PE. Our results highlight the PEs' desire to be involved in IPE and to develop a genuine patient-student partnership. These insights should support the systematic integration of PEs in IPE.
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Affiliation(s)
- Laure Fiquet
- Department of general practice, University of Rennes, Rennes, France
- CHU Rennes, Inserm, CIC 1414 (Centre d’Investigation Clinique de Rennes), Rennes, France
| | - Marie Dupard
- Department of general practice, University of Rennes, Rennes, France
| | - Hélène Fortier
- Department of general practice, University of Rennes, Rennes, France
| | - Marie Pancher
- Department of general practice, University of Rennes, Rennes, France
| | - Françoise Annezo
- AFDET (Association Française pour le développement de l’éducation thérapeutique), Paris, France
| | - Pierric Renaut
- Department of general practice, University of Rennes, Rennes, France
| | - Emmanuel Allory
- Department of general practice, University of Rennes, Rennes, France
- CHU Rennes, Inserm, CIC 1414 (Centre d’Investigation Clinique de Rennes), Rennes, France
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Burnier I, Northrop G, Fotsing S. Nomenclature of real patients in health professional education by role and engagement: a narrative literature review. CANADIAN MEDICAL EDUCATION JOURNAL 2022; 13:69-76. [PMID: 36310908 PMCID: PMC9588179 DOI: 10.36834/cmej.72429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
RESEARCH PROBLEM Real patients living with a disease and engaged in the education of healthcare professionals are referred to by different terms. To address this, A.Towle proposed a draft taxonomy. OBJECTIVE Our objective is to extract from the literature the definitions given for the following terms: (1) patient educator, (2) patient instructor, (3) patient mentor, (4) partner patient, (5) patient teacher, (6) Volunteer Patient in order to clearly identify their roles and level of engagement. METHODS The literature search was carried out in Medline, CINAHL, PsychInfo and Eric by adding medical education or healthcare professional to our previously identified keywords to ensure that it is indeed literature dealing with real patients' involvement in the education of healthcare professionals. RESULTS Certain terms refer to real and simulated patients. Roles are more or less well described but may refer to multiple terms. The notion of engagement is discussed, but not specifically. CONCLUSION Explicitly defining the terms used according to the task descriptions and level of engagement would help contribute to Towle's taxonomy. Real patients would thus feel more legitimately involved in health professional education.
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Affiliation(s)
- Isabelle Burnier
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Grace Northrop
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Salomon Fotsing
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada
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Gibson CM, Gordon S, White A, Borja-Hart N, Santee J. An assessment of patient experiences as teachers of cultural sensitivity in an interprofessional setting. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:1032-1039. [PMID: 36055693 DOI: 10.1016/j.cptl.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 06/16/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND PURPOSE The importance of cultural sensitivity training in pharmacy education is well-recognized, though best practices are not well described. Traditional teaching approaches such as faculty lectures may result in overgeneralization, lack of nuance, or tokenization. Utilizing patients from diverse special populations as teachers of cultural sensitivity may mitigate these risks. However, faculty must ensure patients feel comfortable, empowered, valuable, and prepared to serve as partners in education. EDUCATIONAL ACTIVITY AND SETTING Patients were used as teachers of cultural sensitivity in an interprofessional education panel activity at two colleges of pharmacy over two years. Patient experiences with training and preparation for the activity as well as their perceived benefits of partnering in student education were assessed. FINDINGS Overall, patients reported that training was adequate, and the educational activity provided a sufficient platform for sharing their knowledge with students. Patients felt they provided meaningful contributions to student education, learned valuable information in the process, and formed sincere relationships with each other and faculty. SUMMARY Faculty at other institutions may wish to adapt this activity to meet the needs of their own institution and empower patients to contribute to the education of health professions students. Practical recommendations are provided for promoting a positive patient experience. A comprehensive training program prepared and empowered patients to teach cultural sensitivity principles to an interprofessional group of health care students.
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Affiliation(s)
- Caitlin M Gibson
- Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, 410 N. 12(th) Street, Richmond, VA 23298, United States.
| | - Sarah Gordon
- Department of Pharmacy Practice, Manchester University College of Pharmacy, Natural & Health Sciences, 10627 Diebold Road, Fort Wayne, IN 46845, United States.
| | - Annesha White
- Department of Pharmacotherapy, University of North Texas Health Science Center College of Pharmacy, 3500 Camp Bowie Blvd IREB Office 211, Fort Worth, TX 76107, United States.
| | - Nancy Borja-Hart
- Department of Clinical Pharmacy and Translational Science, The University of Tennessee Health Science Center College of Pharmacy, 301 S. Perimeter Park Dr. Suite 220, Nashville, TN 37211, United States.
| | - Jennifer Santee
- Division of Pharmacy Practice and Administration, School of Pharmacy, University of Missouri - Kansas City, 2464 Charlotte, St. Kansas City, MO 64108, United States.
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Hache C, Honoré S, Hache G. Implementation of a patient-teaching workshop to improve pharmacy students' competencies in patient-centered communication: a case report. BMC MEDICAL EDUCATION 2022; 22:555. [PMID: 35850724 PMCID: PMC9295494 DOI: 10.1186/s12909-022-03618-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The pharmacist-patient relationship has evolved over recent decades and the development of clinical pharmacy requires pharmacists to take patient-centered responsibilities. This requires a specific set of skills, such as patient-centered communication. Evaluation of students' competencies in patient-centered communication is challenging in academic settings and complementary assessment methods may be designed in order to overcome the limits of traditional preceptors' ratings or objective structured clinical examination (OSCE). There is increasing interest in a more active patient role in healthcare professional education and there are very few reports about patient-led education in pharmacies. Thus, the objective of this work was to implement a patient-teaching workshop and to assess its impact on pharmacy students' competencies in patient-centered communication. METHODS The workshop was developed in collaboration between four patients, a senior clinical pharmacist and a lecturer in education sciences and implemented in the hospital pharmacy residency program. The main course objective was acquiring the three competencies of the Calgary-Cambridge guide to the medical interview: (i) building a relationship, (ii) conducting structured interview and (iii) gathering information. The learning process integrated: working on participants' perception of pharmacists-patient communication, a first simulated interview, didactic learning and a second simulated interview. After simulated interviews, patients and peer residents assessed learner's performance with a competency chart and provided individual feedback. Assessment methods included comparisons between the first and second interview scores and an anonymous post-course survey. RESULTS Forty-seven residents and 19 patient teachers attended the session. Competency scores were higher after the second interview in all three competencies as rated by both patients (+ 25%) and peer residents (+ 29%). Residents expressed a high satisfaction and reported learning about conducting interviews and soft skills contributing to the development of a relationship with patients. "The involvement of patients" was expressed as most appreciated in the majority of the evaluation charts (87%) and the residents valued the importance of collaborative and interprofessional learning during the workshop. Three themes emerged: (1) patients' expertise, (2) reliability and (3) relationship, which underlined that the students estimated the patients were credible sources of information in this pedagogical context. CONCLUSION This patient-teaching approach improved patient-centered competencies of pharmacy residents and promoted partnership between patients and pharmacy students.
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Affiliation(s)
- Caroline Hache
- Aix Marseille Univ, ADEF, 57 avenue escadrille Normandie Niemen, Marseille, 13013, France
| | - Stéphane Honoré
- Aix Marseille Univ, Faculté de Pharmacie, Laboratoire de Pharmacie Clinique, 27 boulevard Jean Moulin, Marseille, 13005, France
- Aix Marseille Univ, AP-HM, Hôpital de La Timone, Service de Pharmacie, 264 rue saint Pierre, Marseille, 13005, France
| | - Guillaume Hache
- Aix Marseille Univ, AP-HM, Hôpital de La Timone, Service de Pharmacie, 264 rue saint Pierre, Marseille, 13005, France.
- Aix Marseille Univ, Faculté de Pharmacie, 27, boulevard Jean Moulin, 13005, Marseille, France.
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Cullen M, Cadogan C, George S, Murphy S, Freeney S, Fitzpatrick R, Strawbridge J. Key stakeholders' views, experiences and expectations of patient and public involvement in healthcare professions' education: a qualitative study. BMC MEDICAL EDUCATION 2022; 22:305. [PMID: 35449105 PMCID: PMC9026974 DOI: 10.1186/s12909-022-03373-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Patients and the public have an integral role in educating healthcare professionals. Authentic partnerships between higher education institutions and patients and the public are essential. This study examined key stakeholders' views, experiences and expectations of patient and public involvement (PPI) including the nature of the involvement and requirements for partnership. METHODS Purposive and snowball sampling was used to recruit key stakeholders, including patients and members of the public involved in health professions education, and academics interested in PPI. Focus groups were held with patient and public participants, providing the opportunity to gain multiple perspectives in an interactive group setting. Academics with an interest in PPI were interviewed using a semi-structured approach. Topic guides were derived from the literature and piloted prior to data collection. Focus groups and interviews were conducted until data saturation was achieved. All data was audio-recorded, transcribed, anonymised and thematically analysed. RESULTS Four focus groups were conducted involving 23 patient and public participants (median number of participants per focus group of 6). Nine interviews were conducted with academics (face-to-face [n = 8] or by telephone [n = 1]). Five themes were developed: previous experiences of PPI, training requirements, challenges/barriers to PPI, facilitators of PPI and future ideas for PPI. All participants held positive views of the value of PPI. Participants had mixed views in terms of training, which depended on the level of involvement, but similar views on the challenges and facilitators for PPI in education. There was agreement that PPI requires institutional vision and investment to build strong relationships and a culture of PPI best practice. CONCLUSIONS There is a need for more strategic and formal involvement of patients and the public to ensure that that PPI becomes sustainably embedded in health professions education.
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Affiliation(s)
- Megan Cullen
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland.
- Beaumont Hospital Pharmacy Department, Beaumont Hospital, Beaumont, Dublin 9, Ireland.
| | - Cathal Cadogan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Susmi George
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - Siobhan Murphy
- Department of Surgery, RCSI Education and Research Centre, Royal College of Surgeons in Ireland, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | | | | | - Judith Strawbridge
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
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Patient engagement in the Continuing Professional Development programs within the department of radiation oncology at the University of Toronto (UTDRO): A qualitative study. J Med Imaging Radiat Sci 2022; 53:256-263. [DOI: 10.1016/j.jmir.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022]
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Jebara T, Edwards R, Tonna A. "They wanted to know what it was like through my eyes": Patients and carers views, experiences, and perceptions of active involvement in the delivery of an undergraduate pharmacy curriculum. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:281-289. [PMID: 35307086 DOI: 10.1016/j.cptl.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 11/22/2021] [Accepted: 01/09/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION There is an increasing policy and practice imperative for involving patients and carers in health-related undergraduate courses. The School of Pharmacy and Life Sciences at Robert Gordon's University, United Kingdom launched a module where patients and carers are actively involved in the delivery of the curriculum by sharing their experiences of their condition and its management with final year student pharmacists. This study aimed to evaluate this initiative by exploring patients' and carers' views and experiences of their active involvement in the delivery and their perceptions of potential future involvement in the design of the pharmacy curriculum. METHODS Face-to-face semi-structured interviews were carried out with patients and carers who were actively involved in the delivery of the pharmacy course. The interview schedule was developed based on the research aim, an extensive literature review, and peer discussion before it was piloted. All interviews were digitally recorded and thematically analysed by two independent researchers. RESULTS Seven of eight patients and carers involved in the module agreed to be interviewed. Five themes were identified: reasons for engagement with active teaching, perceived impact of active teaching on students, perceived impact of active teaching on patients and carers themselves, perceived opportunity to improve care of future patients, and challenges and suggestions for improvement. CONCLUSIONS Overall, patients and carers had a positive view of their active involvement with delivering the undergraduate pharmacy curriculum; they were however unsure about involvement in curriculum design.
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Affiliation(s)
- Tesnime Jebara
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen AB10 7GJ, United Kingdom
| | - Ruth Edwards
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, United Kingdom.
| | - Antonella Tonna
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen AB10 7GJ, United Kingdom.
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Ward K, Stanyon M, Ryan K, Dave S. Power, recovery and doing something worthwhile: A thematic analysis of expert patient perspectives in psychiatry education. Health Expect 2022; 25:549-557. [PMID: 35076965 PMCID: PMC8957736 DOI: 10.1111/hex.13375] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/29/2021] [Accepted: 10/06/2021] [Indexed: 01/31/2023] Open
Abstract
Background Objective Design Results Conclusion Patient Contribution
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Affiliation(s)
- Katie Ward
- Derbyshire Healthcare NHS Foundation Trust Derbyshire UK
| | - Miriam Stanyon
- Derbyshire Healthcare NHS Foundation Trust Derbyshire UK
| | - Karl Ryan
- Derbyshire Healthcare NHS Foundation Trust Derbyshire UK
| | - Subodh Dave
- Derbyshire Healthcare NHS Foundation Trust Derbyshire UK
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Ellaway RH. Patients! ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1459-1462. [PMID: 34812972 DOI: 10.1007/s10459-021-10084-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 06/13/2023]
Abstract
In this editorial the Editor considers the roles and representations of patients in health professional education and their implications for educational scholarship in this field. She also considers the implications of patient presence and engagement for the social contract and the ways it is being placed under stress and strain.
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Affiliation(s)
- Rachel H Ellaway
- Department of Community Health Sciences and Office of Health and Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Taliaferro LA, Mishtal J, Chulani VL, Middleton TC, Acevedo M, Eisenberg ME. Perspectives on inadequate preparation and training priorities for physicians working with sexual minority youth. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:186-194. [PMID: 34709201 PMCID: PMC8994643 DOI: 10.5116/ijme.615c.25d3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To understand pediatric and family medicine residents' and practitioners' perceived ability to work with lesbian, gay, bisexual, and queer (LGBQ) youth, assessment of their prior educational experiences, and recommendations for medical training to better prepare physicians to provide quality care to this population. METHODS We conducted semi-structured individual interviews with 24 pediatric/family medicine residents (n=20) and practicing physicians (n=4) in the U.S. Recorded interviews were professionally transcribed. Data were analyzed using Grounded Theory and qualitative content analysis approaches. RESULTS Most physicians did not feel adequately prepared to provide quality care to LGBQ youth, and many who felt knowledgeable obtained their knowledge from on-the-job experiences of caring for LGBQ patients. Findings regarding physicians' recommendations for implementing a formal training program revealed three themes: (I) medical school training (implemented earlier in medical school within a structured program as part of the normal curriculum), (II) training content (LGBQ-specific health needs, self-awareness of implicit biases, interviewing techniques, and resources), and (III) training strategies (panels of LGBQ patients, role-playing/standardized patients, and online modules). CONCLUSIONS Understanding physicians' assessment of abilities and recommendations for training improvements based on their experiences is important for advancing the quality of healthcare for LGBQ youth. Guidance came mostly from residents who recently completed medical school. Thus, their perspectives are especially useful to improve medical education and, ultimately, the care provided to LGBQ youth. Findings suggest a multi-pronged approach that offers several training modalities encompassing individual, intrapersonal, and institutional/systemic/community levels can improve medical school curricula on caring for LGBQ youth.
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Affiliation(s)
- Lindsay A. Taliaferro
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Joanna Mishtal
- Department of Anthropology, University of Central Florida, Orlando, Florida, USA
| | - Veenod L. Chulani
- Section of Adolescent Medicine, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Tiernan C. Middleton
- Department of Pediatrics, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Meagan Acevedo
- rnold Palmer Hospital for Children, Orlando Health Regional Medical Center, Orlando, Florida, USA
| | - Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, Minnesota, USA
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Khan T, Mosgrove F, Wass V. Unknown unknowns: can bringing patients' lived experience of long term conditions into curriculum design help our future doctors offer more holistic, socially accountable care? EDUCATION FOR PRIMARY CARE 2021; 32:322-325. [PMID: 34644518 DOI: 10.1080/14739879.2021.1968319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Understanding the holistic impact of long-term conditions (LTCs) on a patient, due to their high prevalence, morbidity, mortality and cost, is an important part of the primary care undergraduate medicine curriculum. Increasingly, we set learning outcomes for our students anticipating what the patient would want them to know. But are our expectations congruent with what patients would want them to know? In this leading article, we propose that patient involvement in curriculum design remains inadequate. We base our argument on (1) an existing strong theoretical premise that increasing patient incorporation enhances the delivery of medical education, (2) recommendations from major health organisations, our regulator and leading healthcare educationalists and (3) a growing body of evidence that what is important to physicians may not reflect what is important to patients. We advocate that patient involvement in curriculum design will result in a better understanding of how LTCs affect their physical, psychological and social health and of their journey through health care and community support services. This learning is essential, but unfortunately often overlooked, if we are to ensure that students in their future roles plan patient care using an empathic, holistic, patient-centred and socially accountable approach.
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Affiliation(s)
- Taha Khan
- General Practice and Community Medical Education, University of Aberdeen Medical School, Aberdeen, Scotland
| | - Fiona Mosgrove
- General Practice and Community Medical Education, University of Aberdeen Medical School, Aberdeen, Scotland
| | - Valerie Wass
- General Practice and Community Medical Education, University of Aberdeen Medical School, Aberdeen, Scotland
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Wong R, Kitto S, Kumagai AK, Whitehead CR. Paradox of Patient-Centered Care and the Implications for Patient Involvement in Continuing Professional Development. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2021; 41:238-246. [PMID: 34799517 DOI: 10.1097/ceh.0000000000000401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Patient-centered care (PCC) is widely considered as essential in chronic disease management. As the underlying rationale for engaging patients in continuing professional development (CPD) is commonly described as fostering care that is more patient-centered, we hoped to understand the discursive conditions for how educators and health professionals can (or cannot) learn with, from, and about patients. METHODS Using diabetes as a case, we conducted a Foucauldian discourse analysis of an archive of relevant policy documents, professional and educational texts, to explore different conceptualizations of practice and the implications for PCC. We also conducted in-depth interviews with a purposive sample of physicians to understand their experiences in providing and teaching PCC. We sought to understand: How has PCC been discursively constructed? Whose interests does advocating PCC serve? What are the implications for patient involvement in CPD? RESULTS We describe three discursive constructions of PCC, each extending the reach of biomedical power. PCC as a disease intervention emphasizes knowing and relating to patients to normalize laboratory test results. PCC as a form of confession promotes patients to come to their own realizations to become responsible for their own health, but through the lens and evaluation of physicians. PCC as a disciplinary technique makes visible the possibility of using a checklist to judge physician competency in providing PCC. DISCUSSION PCC may be constructed in ways that paradoxically reinforce rather than challenge conventional, provider-centric paradigms. Our results challenge educators to acknowledge the existence and effects of discourses when involving patients in the planning and delivery of CPD.
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Affiliation(s)
- René Wong
- Dr. Wong: Associate Professor, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Dr. Kitto: Professor, Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Kumagai: Vice Chair for Education and Professor, Department of Medicine, and F.M. Hill Chair in Humanism Education, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada. Dr. Whitehead: Professor, Department of Family and Community Medicine, and Director and Scientist, The Wilson Centre, BMO Financial Group Chair in Health Professions Research, University Health Network, and Professor, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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Coe TM, Chirban AM, McBroom TJ, Cloonan DJ, Brownlee SA, Moses J, Yeh H, Petrusa E, Saillant N, Dageforde LA. Virtual student-transplant patient interactions empower patients and enhance student transplantation knowledge. Am J Surg 2021; 222:1120-1125. [PMID: 34635311 PMCID: PMC10072134 DOI: 10.1016/j.amjsurg.2021.09.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/28/2021] [Accepted: 09/23/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There is variation in exposure to transplantation in undergraduate medical education. We created a program pairing medical students with transplant patients for semi-structured, virtual encounters and studied the impact on both students and patients using qualitative content analysis. METHODS Fifty medical students were paired with transplant recipients and donors for non-medical virtual encounters. Separate focus groups were conducted, deidentified, and analyzed using a constant comparative method. RESULTS Three themes related to the student experience emerged: transplant-related relationships, a deeper understanding of the patient's journey to transplant, and alterations of their personal view of organ donation and transplantation. Three themes emerged from the patient's experiences: the benefits of conversations, the patient as a teacher, and spreading the message of organ donation and transplantation. CONCLUSIONS This novel program demonstrates that virtual student-patient interactions are a useful approach to engage patients and a unique way to teach medical students about transplantation and donation.
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Affiliation(s)
- Taylor M Coe
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Ariana M Chirban
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | | | - Daniel J Cloonan
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Sarah A Brownlee
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Joy Moses
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Heidi Yeh
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Noelle Saillant
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Leigh Anne Dageforde
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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Nguyen W, O'Reilly CL, Moles RJ, Robinson JD, Brand-Eubanks D, Kim AP, El-Den S. A systematic review of patient interactions with student pharmacists in educational settings. J Am Pharm Assoc (2003) 2021; 61:678-693.e3. [PMID: 34483057 DOI: 10.1016/j.japh.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients may contribute to various aspects of student pharmacists' education within clinical, experiential and educational settings. There is an emerging body of literature describing and evaluating the contribution of patients to health care education; however, little is known about patients' contribution to pharmacy education specifically within educational settings. OBJECTIVE To explore the evidence relating to the involvement of patients in the education of student pharmacists, in terms of the nature, extent, and outcomes of their contribution. METHODS A systematic literature search was undertaken within Embase, MEDLINE, Education Resources Information Center, International Pharmaceutical Abstracts, PubMed, PsycINFO, CINAHL, and Scopus databases from inception to April 10, 2020. Inclusion criteria included primary research studies reporting on the active involvement of patients in pharmacy education, within an educational setting. Quality assessment appraisal for the included studies was conducted using the Mixed Methods Appraisal Tool. RESULTS Twelve studies were eligible for inclusion in this systematic review. Nine studies explored the use of patients as educators providing valuable insight about their lived experience. Six studies involved patients in question-and-answer sessions, providing students with opportunities to inquire about their lived experience in relation to medicines, health care, and medical conditions. Studies that reported on students' learning outcomes demonstrated improvements in communication skills, deeper understanding of patients' lived experience particularly relating to mental illness, and increased confidence in providing care for patients. Among patients, participation in the educational process led to greater satisfaction, empowerment, and knowledge from sharing personal experiences. There were no clinical outcomes measured among patients participating in the included studies. The 5 nonrandomized quantitative studies ranged from low to moderate levels of quality, the 4 mixed-methods studies were of low quality, and the 3 qualitative studies were of high quality. CONCLUSION The involvement of patients in the education of student pharmacists was found to benefit both patients and students. Student-specific outcomes included development of communication skills and new insights about patients' lived experience. Further research is needed to better understand the long-term impact of patient involvement in pharmacy education, in terms of students' learning outcomes and clinical outcomes among patients.
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Adam HL, Giroux CM, Eady K, Moreau KA. A qualitative study of patients' and caregivers' perspectives on educating healthcare providers. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:7-16. [PMID: 34567301 PMCID: PMC8463222 DOI: 10.36834/cmej.71541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Patients/caregivers can be actively involved in the education of healthcare providers (HCPs). The purpose of this study was to explore patients'/caregivers' perspectives on their involvement and roles in the education of HCPs. METHODS We invited patients/caregivers to participate in one-on-one semi-structured interviews. We analyzed the interview data using conventional content analysis to identify themes. RESULTS In terms of patient/caregiver involvement in the education of HCPs, we identified that patients/caregivers perceive that it: (a) is challenging because of power-differentials between themselves and HCPs; (b) requires patient training; (c) needs to start early in HCPs' education processes; (d) can improve patient-HCP partnerships; and (e) requires compensation for patients. With regards to the roles that patients can play in educating HCPs, we found that patients/caregivers want to: (a) teach HCPs about patients' expectations, experiences and perspectives through case studies, storytelling, and educational research; (b) provide direct feedback to HCPs; and (c) advise on curricula development and admission boards for HCPs. CONCLUSIONS Understanding patients'/caregivers' perspectives on this topic can help educational leaders and HCPs improve active patient/caregiver involvement in the education of HCPs. We need to listen to patients'/caregivers' voices in order to make effective changes in current and future health professions education.
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Affiliation(s)
- Holly L Adam
- Faculty of Education, University of Ottawa, Ontario, Canada
| | | | - Kaylee Eady
- Faculty of Education, University of Ottawa, Ontario, Canada
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Moult A, McKinley RK, Yeates P. Understanding patient involvement in judging students' communication skills in OSCEs. MEDICAL TEACHER 2021; 43:1070-1078. [PMID: 34496725 DOI: 10.1080/0142159x.2021.1915467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Communication skills are assessed by medically-enculturated examiners using consensus frameworks which were developed with limited patient involvement. Assessments consequently risk rewarding performance which incompletely serves patients' authentic communication needs. Whilst regulators require patient involvement in assessment, little is known about how this can be achieved. We aimed to explore patients' perceptions of students' communication skills, examiner feedback and potential roles for patients in assessment. METHODS Using constructivist grounded theory we performed cognitive stimulated, semi-structured interviews with patients who watched videos of student performances in communication-focused OSCE stations and read corresponding examiner feedback. Data were analysed using grounded theory methods. RESULTS A disconnect occurred between participants' and examiners' views of students' communication skills. Whilst patients frequently commented on students' use of medical terminology, examiners omitted to mention this in feedback. Patients' judgements of students' performances varied widely, reflecting different preferences and beliefs. Participants viewed variability as an opportunity for students to learn from diverse lived experiences. Participants perceived a variety of roles to enhance assessment authenticity. DISCUSSION Integrating patients into communications skills assessments could help to highlight deficiencies in students' communication which medically-enculturated examiners may miss. Overcoming the challenges inherent to this is likely to enhance graduates' preparedness for practice.
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Affiliation(s)
- Alice Moult
- School of Medicine, Keele University, Keele, UK
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Modigh A, Sampaio F, Moberg L, Fredriksson M. The impact of patient and public involvement in health research versus healthcare: A scoping review of reviews. Health Policy 2021; 125:1208-1221. [PMID: 34376328 DOI: 10.1016/j.healthpol.2021.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/30/2021] [Accepted: 07/20/2021] [Indexed: 01/18/2023]
Abstract
Many policies promote patient and public involvement (PPI) in health research and healthcare provision. However, research points to uncertainties about its impact. The aim of the article was to compare what types of impact have been reported in reviews of PPI in health research and healthcare, respectively, and to map differences and similarities between the review studies. A review of reviews was undertaken with a search strategy based on the PCC mnemonic for scoping reviews. Four online databases were searched. Studies published in English between the years 2000-2020, using a review-based method and aiming to demonstrate impact of PPI were included, resulting in sixty-one articles. More reviews of PPI impact in healthcare than in health research were found, although the latter included a larger number of empirical studies. Systematic reviews, quality assessment and quantitative studies were less common in health research. Many original studies were from the United Kingdom. In health research, reported impacts most often related to research design and delivery, while in healthcare the most commonly reported impacts were individual health outcomes/clinical outcomes. However, there is still uncertainty about the strength of evidence for PPI, in particular when it comes to collective involvement in healthcare, that is in policymaking and service improvement initiatives at hospitals or the like.
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Affiliation(s)
- Anton Modigh
- Department of Public Health and Caring Sciences, Uppsala University, Sweden. Box 564, 751 22 Uppsala, Sweden.
| | - Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, Sweden. Box 564, 751 22 Uppsala, Sweden.
| | - Linda Moberg
- Department of Public Health and Caring Sciences, Uppsala University, Sweden. Box 564, 751 22 Uppsala, Sweden; Department of Government, Uppsala University, Box 514, 751 20 Uppsala, Sweden.
| | - Mio Fredriksson
- Department of Public Health and Caring Sciences, Uppsala University, Sweden. Box 564, 751 22 Uppsala, Sweden.
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Agrawal S, Kalocsai C, Capponi P, Kidd S, Ringsted C, Wiljer D, Soklaridis S. "It was great to break down the walls between patient and provider": liminality in a co-produced advisory course for psychiatry residents. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:385-403. [PMID: 32920699 DOI: 10.1007/s10459-020-09991-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 08/24/2020] [Indexed: 05/21/2023]
Abstract
Although rhetoric abounds about the importance of patient-, person- and relationship-centered approaches to health care, little is known about how to address the problem of dehumanization through medical and health professions education. One promising but under-theorized strategy is to co-produce education in collaboration with health service users. To this end, we co-produced a longitudinal course in psychiatry that paired people with lived experience of mental health challenges as advisors to fourth-year psychiatry residents at the University of Toronto. The goal of this study was to examine this novel, relationship-based course in order to understand co-produced health professions education more broadly. Using qualitative interviews with residents and advisors after the first iteration of the course, we explored how participants made meaning of the course and of what learning, if any, occurred, for whom and how. We found that the anthropological theory of liminality allowed us to understand participants' complex experiences and illuminated how this type of pedagogy may work to achieve its effects. Liminality also helped us understand why some participants resisted the course, and how we could more carefully think about co-produced, humanistic education and transformative learning.
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Affiliation(s)
- Sacha Agrawal
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Csilla Kalocsai
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
- The Wilson Centre for Research in Education, University Health Network/University of Toronto, Toronto, ON, Canada.
| | - Pat Capponi
- , Voices from the Street, Toronto, ON, Canada
| | - Sean Kidd
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Charlotte Ringsted
- Centre for Health Sciences Education, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - David Wiljer
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- The Wilson Centre for Research in Education, University Health Network/University of Toronto, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Sophie Soklaridis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- The Wilson Centre for Research in Education, University Health Network/University of Toronto, Toronto, ON, Canada
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Adam HL. A Personal Perspective on Patient Involvement in Educating Health Care Providers: From Two Lenses. J Patient Exp 2021; 8:2374373521996959. [PMID: 34179378 PMCID: PMC8205404 DOI: 10.1177/2374373521996959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
This article provides my perspective on the importance of hearing and integrating
patients’ voices in the education of health care providers from 2 lenses, as a patient and
as a nurse. It highlights why and how patients should be actively involved in health
professions education. It is important that health care professions be reminded that
patients want to be involved in health professions education; this will enable them to
establish meaningful partnerships with patients along the continuum of their education, as
well as improve upon their delivery of patient-centred care.
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Affiliation(s)
- Holly L Adam
- Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada
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41
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Treharne GJ, Blakey AG, Graham K, Carrington SD, McLachlan LA, Withey-Rila C, Pearman-Beres L, Anderson L. Perspectives on expertise in teaching about transgender healthcare: A focus group study with health professional programme teaching staff and transgender community members. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2021; 23:334-354. [PMID: 35799950 PMCID: PMC9255215 DOI: 10.1080/26895269.2020.1870189] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND It is well established that transgender people experience considerable health inequities, which are sustained in part by limited teaching about transgender healthcare for trainee health professionals. AIMS The aim of this study was to explore the perspectives of both teaching staff from health professional education programmes and transgender community members on the best ways to teach about transgender healthcare, with a focus on ways of: 1) overcoming barriers to this teaching; and 2) involving community members in this teaching. METHODS A research advisory committee was convened to guide the project and included transgender community members, teaching staff from health professional programmes, and trainee health professionals in Aotearoa/New Zealand. Three preliminary focus groups were held with 10 transgender community members. These community members were then invited to act as transgender community 'ambassadors' in focus groups with teaching staff based on suggestions from the advisory committee. Six focus groups were conducted with 22 teaching staff from a range of health professional education programmes along with at least two transgender community ambassadors. RESULTS Teaching staff positioned themselves as lacking the expertise to teach about transgender healthcare but also as expert teachers when applying methods such as small group teaching. Transgender participants also positioned themselves as having expertise arising primarily from their own experiences and acknowledged that effective teaching about transgender healthcare would need to cover a diversity of transgender identities and healthcare outside their own experiences. Teaching staff and transgender community members were keen to pool expertise and thus overcome the shared sense of lacking the expertise to teach about transgender healthcare. DISCUSSION These findings provide insights into the current barriers to teaching about transgender healthcare and provide future directions for staff development on teaching about transgender healthcare and ways of safely involving transgender community members in teaching.
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Affiliation(s)
- Gareth J. Treharne
- Department of Psychology, University of Otago, Dunedin, Aotearoa/New Zealand
| | | | - Katie Graham
- Department of Psychology, University of Otago, Dunedin, Aotearoa/New Zealand
| | | | | | - Cassie Withey-Rila
- Department of Psychology, University of Otago, Dunedin, Aotearoa/New Zealand
| | | | - Lynley Anderson
- Bioethics Centre, University of Otago, Dunedin, Aotearoa/New Zealand
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Ocloo J, Garfield S, Franklin BD, Dawson S. Exploring the theory, barriers and enablers for patient and public involvement across health, social care and patient safety: a systematic review of reviews. Health Res Policy Syst 2021; 19:8. [PMID: 33472647 PMCID: PMC7816359 DOI: 10.1186/s12961-020-00644-3] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/13/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The emergence of patient and public involvement (PPI) in healthcare in the UK can be traced as far back as the 1970s. More recently, campaigns by harmed patients have led to a renewed focus on strengthening PPI. There is a growing awareness of the benefits of PPI in research as well as a need to address power inequities and a lack of diversity and inclusion. This review was undertaken to look at evidence for theories, barriers and enablers in PPI across health, social care and patient safety that could be used to strengthen PPI and address a perceived knowledge and theory gap with PPI in patient safety. METHODS We searched MEDLINE, EMBASE and PsycINFO from inception to August 2018, using both MeSH and free-text terms to identify published empirical literature. Protocols in PROSPERO were also searched to identify any systematic reviews in progress. The extracted information was analysed using a narrative approach, which synthesises data using a descriptive method. RESULTS Forty-two reviews were identified and grouped by key outcomes. Twenty-two papers mentioned theory in some form, 31 mentioned equality and diversity (although with no theory mentioned in this area), and only 19 cited equality and diversity as a barrier or enabler. Thirty-four reviews identified barriers and enablers at different organisational levels: personal/individual; attitudes; health professional; roles and expectations; knowledge, information and communication; financing and resourcing; training; general support; recruitment and representation, PPI methods and working with communities and addressing power dynamics. CONCLUSIONS The review findings suggest that a commitment to PPI and partnership working is dependent on taking a whole system approach. This needs to consider the complex individual and organisational enablers and constraints to this process and address imbalances of power experienced by different groups. Addressing equality and diversity and use of a theory-driven approach to guide PPI are neglected areas. The long tradition of involvement across health and social care can provide considerable expertise in thinking about ways to strengthen approaches to PPI. This is especially important in patient safety, with a much newer tradition of developing PPI than other areas of healthcare.
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Affiliation(s)
- Josephine Ocloo
- Centre for Implementation Science, Health Services, Population and Research Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK. .,National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) At King's College Hospital NHS Foundation Trust, London, UK.
| | - Sara Garfield
- Imperial College Healthcare NHS Trust, London, UK.,University College London School of Pharmacy, London, UK
| | - Bryony Dean Franklin
- Imperial College Healthcare NHS Trust, London, UK.,University College London School of Pharmacy, London, UK
| | - Shoba Dawson
- Centre for Academic Primary Care, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
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Caz B, Sarmasoglu Kilikcier S. Interaction with an ostomy patient in a laboratory setting: Expectations and experiences of first-year nursing students. NURSE EDUCATION TODAY 2021; 96:104638. [PMID: 33189000 DOI: 10.1016/j.nedt.2020.104638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 10/02/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Interacting with real patients is an important component of nursing education in all learning settings. OBJECTIVES This study aimed to determine the expectations and experiences of first-year nursing students' interaction with a real patient with an ostomy in the clinical skill laboratory. METHOD The phenomenological qualitative study was carried out with 17 first-year undergraduate nursing students. Data was collected via focus group interviews during pre- and post-nursing students and real patient with an ostomy interaction. Semi-structured questions were used during the focus group interviews. The data were analyzed by inductive content analysis method. RESULTS The findings are presented under two contexts: expectations of first-year nursing students related to interaction with an ostomy patient and experiences of first-year nursing students related to interaction with an ostomy patient. The two contexts were divided into five main themes: Emotions regarding interaction with a real patient with an ostomy, providing ostomy care to a real patient with an ostomy, predictions for living with an ostomy, effects of interaction with a real patient with an ostomy, and real patient engagement in nursing education. CONCLUSIONS In consequence of the research, the first-year nursing students were enthusiastic about the interaction with the real patient. The most important contribution to interaction with a patient was breaking down the prejudices of students concerning being a patient and having an illness. Real patients should engage in varied learning environments in nursing education, particularly via patients with different illnesses and health conditions.
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Affiliation(s)
- Busra Caz
- Gazi University Faculty of Medicine Training and Research Hospital, 06560 Ankara, Turkey.
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Hempel C, Turton E, Hasheminejad E, Bevilacqua C, Hempel G, Ender J, Rotzoll D. In Reply. Ann Card Anaesth 2021; 24:117-118. [PMID: 33938852 PMCID: PMC8081152 DOI: 10.4103/aca.aca_204_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 08/29/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Conrad Hempel
- Skills Centre, University of Leipzig, Leipzig, Germany
| | - Edwin Turton
- Department of Anaesthesiology and Intensive Care, Heart Center Leipzig, Leipzig, Germany
- Department of Anaesthesiology, University of the Free State, Bloemfontein, South Africa
| | - Elham Hasheminejad
- Department of Anaesthesiology and Intensive Care, Heart Center Leipzig, Leipzig, Germany
| | - Carmine Bevilacqua
- Department of Anaesthesiology and Intensive Care, Heart Center Leipzig, Leipzig, Germany
| | - Gunther Hempel
- Department of Anaesthesiology and Intensive Care, University of Leipzig Medical Center, Leipzig, Germany
| | - Jörg Ender
- Department of Anaesthesiology and Intensive Care, Heart Center Leipzig, Leipzig, Germany
| | - Daisy Rotzoll
- Skills Centre, University of Leipzig, Leipzig, Germany
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45
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[Impact of patient testimony in the education of medicine and pharmacy students]. Bull Cancer 2020; 108:23-29. [PMID: 33358508 DOI: 10.1016/j.bulcan.2020.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 11/23/2022]
Abstract
The initiative from patients suffering from cancer or having had the disease in speaking about their illness to medical students during an internship in a cancer control center of the faculty of medicine and to pharmacy students at the university of Strasbourg was implemented in 2014. This action was coordinated by the French Cancer League as part of the National French cancer plan 3. After training, ten patients teachers were able to freely and spontaneously explain their diagnostic and therapeutic journey as well as their feelings about the disease and their relationship with their oncologists in front of 187 medical students and 131 pharmacy students. A moderator, often a former cancer teacher, helped coordinate the discussions. Questionnaires were given to students, patients teachers and moderators in order to assess the merits of the action and the expected benefits at the end of the training. A second questionnaire was sent to the students six months after the interviews. The assessment was made by an independent firm. The students' responses were very favorable and this training met their expectations in almost 98% of the cases and 1/3 of the students were destabilized by this training. Patients teacher were very satisfied with their intervention and felt that they were able to convey a message. Six months later, the 30% of student respondents said that these testimonies had or could have an impact on their practices. This is the first assessment of the interest of resource patients in teaching cancer patients about medical and pharmacy students.
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Kangasjarvi E, Ng SL, Friesen F, Simpson JS. Patients as teachers and arts-based reflection in surgical clerkship: A preliminary exploration. MEDICAL TEACHER 2020; 42:1362-1368. [PMID: 32847442 DOI: 10.1080/0142159x.2020.1807482] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Involving patients in medical education as teachers is not a novel approach, yet it has not been widely adopted by undergraduate surgical curricula in Canada. The Patients as Teachers initiative in surgery (PAT) program, with an arts-based reflection assignment, was developed for surgical clerks with the goals of emphasizing patient-centredness in surgical practice, humanistic aspects of medicine, and to counterbalance the commonplace emphasis on technical competency in surgery. METHODS Qualitative data was collected exploring the question: What was the experience and impact of the PAT program on patient teachers and students? Patient teachers (n = 5) were invited to participate in one-on-one interviews and students (n = 46) were invited to participate in focus groups at the end of the program. RESULTS Findings converged around two main themes: what students/patient teachers valued about the PAT program and what they perceived was learned. While patient teachers felt a sense of emotional healing and appreciated a chance to contribute to medical education, students valued having protected time to learn in depth from the patient teachers. Students also begrudgingly came to appreciate the arts-based reflection assignment. CONCLUSION By bringing patient voice to the forefront and encouraging reflection, the PAT program emphasized to students the compassionate and humanistic side of surgical care. Future studies could examine the mechanisms by which learning occurs and long-term impacts.
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Affiliation(s)
- Emilia Kangasjarvi
- Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Stella L Ng
- Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Centre for Ambulatory Care Education, Women's College Hospital, Toronto, Ontario, Canada
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Farah Friesen
- Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jory S Simpson
- Department of Surgery, Division of General Surgery, Faculty of Medicine, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
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Wen HL, Feng C, Zhang SL, Li XW. Supportive psychological intervention on psychological disorders in clinical medicine students with English Learning Difficulties: A protocol of systematic review. Medicine (Baltimore) 2020; 99:e23196. [PMID: 33217830 PMCID: PMC7676519 DOI: 10.1097/md.0000000000023196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study aims to examine the effect of supportive psychological intervention (SPI) on psychological disorders (PD) in clinical medicine students (CMS) with English Learning Difficulties (ELD). METHODS We will perform a comprehensive literature search from the following databases: Cochrane Library, MEDLINE, EMBASE, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All databases will be performed from their inception to the present without language limitation by 2 independent reviewers. We will also look for grey literature, such as conference proceedings, dissertations or theses. Newcastle-Ottawa Scale will be used to assess study quality, and RevMan 5.3 software will be applied to carry out statistical analysis. RESULTS This study will summarize the most recent evidence to assess the effect of SPI on PD in CMS with ELD. CONCLUSION This study may provide helpful evidence of SPI on PD in CMS with ELD. OSF REGISTRATION NUMBER:: osf.io/tah2s.
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Affiliation(s)
- Hong-li Wen
- Department of English, Mudanjiang Medical University
| | - Chen Feng
- First Ward of Orthopedics Department, The Affiliated Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, China
| | | | - Xiao-wei Li
- Department of English, Mudanjiang Medical University
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Hache C, Honoré S, Hache G. Active involvement of patients in pharmacist education has a positive impact on students' perspective: a pilot study. BMC MEDICAL EDUCATION 2020; 20:322. [PMID: 32958057 PMCID: PMC7507651 DOI: 10.1186/s12909-020-02241-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/10/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND Patient-led education contributes to the implementation of practical experience of working with patients in health care professional curricula. There are few descriptions of patients' involvement in pharmacists' training and most often, the patients have been used as passive props to facilitate training. More recently, greater emphasis has been given to a more active form of patient involvement but the application in the curriculum of pharmacy has not been conceptualized. Thus, the aim of our study was to implement a workshop involving patients as partners in undergraduate pharmacy educational programme, and to evaluate its impact of on students' perspectives. METHOD On a prospective observational study basis, the impact was assessed in terms of relevance, learning outcomes and achievement transfer using the Kirkpatrick training assessment method. In addition, we evaluated social representations of the students before and after the workshop. RESULTS Ninety-four students attended the sessions. All participants were satisfied and emphasized the relevance of the involvement of patients. Postworkshop scores were significantly improved in both competencies to be acquired. At the end of the workshop, students reported two to three actions to implement in order to meet patients' expectations, illustrating an intent to transfer learning outcomes in professional context. Interestingly, about patients' expectations on pharmacist's role, students' social representations had evolved significantly after the session. CONCLUSION These results highlight the positive impact of the innovative workshops and the additive value of patients' involvement in the pharmacy undergraduate programme.
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Affiliation(s)
- Caroline Hache
- Aix Marseille Univ, ADEF, 57 avenue escadrille Normandie Niemen, 13013, Marseille, France
| | - Stéphane Honoré
- Aix Marseille Univ, Faculté de Pharmacie, Laboratoire de Pharmacie Clinique, 27, boulevard Jean Moulin, 13005, Marseille, France
- Aix Marseille Univ, APHM, Hôpital de la Timone, Service de Pharmacie, 264 rue saint Pierre, 13005, Marseille, France
| | - Guillaume Hache
- Aix Marseille Univ, APHM, Hôpital de la Timone, Service de Pharmacie, 264 rue saint Pierre, 13005, Marseille, France.
- Aix Marseille Univ, INSERM, INRAE, C2VN, Faculté de Pharmacie, 27 boulevard Jean Moulin, 13005, Marseille, France.
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Romme S, Bosveld MH, Van Bokhoven MA, De Nooijer J, Van den Besselaar H, Van Dongen JJJ. Patient involvement in interprofessional education: A qualitative study yielding recommendations on incorporating the patient's perspective. Health Expect 2020; 23:943-957. [PMID: 32496648 PMCID: PMC7495081 DOI: 10.1111/hex.13073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Patient involvement in interprofessional education (IPE) is a new approach in fostering person-centeredness and collaborative competencies in undergraduate students. We developed the Patient As a Person (PAP-)module to facilitate students in learning from experts by experience (EBEs) living with chronic conditions, in an interprofessional setting. This study aimed to explore the experiences of undergraduate students, EBEs and facilitators with the PAP-module and formulate recommendations on the design and organization of patient involvement in IPE. METHODS We collected data from students, EBEs and facilitators, through eight semi-structured focus group interviews and two individual interviews (N = 51). The interviews took place at Maastricht University, Zuyd University of Applied Sciences and Regional Training Center Leeuwenborgh. Conventional content analysis revealed key themes. RESULTS Students reported that learning from EBEs in an interprofessional setting yielded a more comprehensive approach and made them empathize with EBEs. Facilitators found it challenging to address multiple demands from students from different backgrounds and diverse EBEs. EBEs were motivated to improve the person-centredness of health care and welcomed a renewed sense of purpose. CONCLUSIONS This study yielded six recommendations: (a) students from various disciplines visit an EBE to foster a comprehensive approach, (b) groups of at least two students visit EBEs, (c) students may need aftercare for which facilitators should be receptive, (d) EBEs need clear instruction on their roles, (e) multiple EBEs in one session create diversity in perspectives and (f) training programmes and peer-to-peer sessions for facilitators help them to interact with diverse students and EBEs.
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Affiliation(s)
- Sjim Romme
- Maastricht UniversityMaastrichtThe Netherlands
| | | | - Marloes A. Van Bokhoven
- Department of Family MedicineCare and Public Health Research Institute (CAPHRI)Maastricht UniversityMaastrichtThe Netherlands
| | - Jascha De Nooijer
- School of Health Professions EducationMaastricht UniversityMaastrichtThe Netherlands
| | - Hélène Van den Besselaar
- Department of Family MedicineCare and Public Health Research Institute (CAPHRI)Maastricht UniversityMaastrichtThe Netherlands
| | - Jerôme J. J. Van Dongen
- Department of Family MedicineCare and Public Health Research Institute (CAPHRI)Maastricht UniversityMaastrichtThe Netherlands
- Research Centre for Community CareZuyd University of Applied SciencesHeerlenThe Netherlands
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50
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Dijk SW, Duijzer EJ, Wienold M. Role of active patient involvement in undergraduate medical education: a systematic review. BMJ Open 2020; 10:e037217. [PMID: 32718925 PMCID: PMC7389514 DOI: 10.1136/bmjopen-2020-037217] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/14/2020] [Accepted: 06/15/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To identify the scope of active patient involvement in medical education, addressing the current knowledge gaps relating to rationale and motivation for involvement, recruitment and preparation, roles, learning outcomes and key procedural contributors. METHODS The authors performed a systematic search of the PubMed database of publications between 2003 and 2018. Original studies in which patients take on active roles in the development, delivery or evaluation of undergraduate medical education and written in English were eligible for inclusion. Included studies' references were searched for additional articles. Quality of papers was assessed using the Mixed Methods Appraisal Tool. RESULTS 49 articles were included in the review. Drivers for patient involvement included policy requirements and patients' own motivations to contribute to society and learning. Patients were engaged in a variety of educational settings in and outside of the hospital. The vast majority of studies describe patients taking on the role of a patient teacher and formative assessor. More recent studies suggest that patients are increasingly involved in course and curriculum development, student selection and summative assessment. The new body of empirical evidence shows the wide range of learning objectives was pursued through patient participation, including competencies as professional, communicator, collaborator, leader and health advocate, but not scholar. Measures to support sustainable patient involvement included longitudinal institutional incorporation, patient recruitment and/or training, resource support and clear commitment by faculty. The importance and advantages of patient involvement were highlighted by students, faculty and patients themselves; however, organisations must continue to consider, monitor and take steps to mitigate any potential harms to patients and students. DISCUSSION This systematic review provides new knowledge and practical insights to physicians and faculty on how to incorporate active patient involvement in their institutions and daily practice, and provides suggested action points to patient organisations wishing to engage in medical education.
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