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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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Valestrand EA, Kvernenes M, Kinsella EA, Hunskaar S, Schei E. Transforming self-experienced vulnerability into professional strength: a dialogical narrative analysis of medical students' reflective writing. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10317-3. [PMID: 38401015 DOI: 10.1007/s10459-024-10317-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/04/2024] [Indexed: 02/26/2024]
Abstract
Medical students' efforts to learn person-centered thinking and behavior can fall short due to the dissonance between person-centered clinical ideals and the prevailing epistemological stereotypes of medicine, where physicians' life events, relations, and emotions seem irrelevant to their professional competence. This paper explores how reflecting on personal life experiences and considering the relevance for one's future professional practice can inform first-year medical students' initial explorations of professional identities. In this narrative inquiry, we undertook a dialogical narrative analysis of 68 essays in which first-year medical students reflected on how personal experiences from before medical school may influence them as future doctors. Students wrote the texts at the end of a 6-month course involving 20 patient encounters, introduction to person-centered theory, peer group discussions, and reflective writing. The analysis targeted medical students' processes of interweaving and delineating personal and professional identities. The analysis yielded four categories. (1) How medical students told their stories of illness, suffering, and relational struggles in an interplay with context that provided them with new perspectives on their own experiences. Students formed identities with a person-centered orientation to medical work by: (2) recognizing and identifying with patients' vulnerability, (3) experiencing the healing function of sharing stories, and (4) transforming personal experiences into professional strength. Innovative approaches to medical education that encourage and support medical students to revisit, reflect on, and reinterpret their emotionally charged life experiences have the potential to shape professional identities in ways that support person-centered orientations to medical work.
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Affiliation(s)
- Eivind Alexander Valestrand
- Center for Medical Education, Faculty of Medicine, University of Bergen, Bergen, Norway.
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Monika Kvernenes
- Center for Medical Education, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Elizabeth Anne Kinsella
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Steinar Hunskaar
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Edvin Schei
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Getchell LE, Reich M, Allu S, Woods C, Atkinson T, Beaucage M, Stalker L, Sparkes D, Turner C, L'Esperance A, Burns K, Elliott MJ, Chiu H, Rosenblum ND, Sapir-Pichhadze R. Storytelling for impact: the creation of a storytelling program for patient partners in research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:57. [PMID: 37491345 PMCID: PMC10369735 DOI: 10.1186/s40900-023-00471-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/18/2023] [Indexed: 07/27/2023]
Abstract
Storytelling is a powerful means to evoke empathy and understanding among people. When patient partners, which include patients, family members, caregivers and organ donors, share their stories with health professionals, this can prompt listeners to reflect on their practice and consider new ways of driving change in the healthcare system. However, a growing number of patient partners are asked to 'share their story' within health care and research settings without adequate support to do so. This may ultimately widen, rather than close, the gap between healthcare practitioners and people affected by chronic disease in this new era of patient and public involvement in research. To better support patient partners with storytelling in the context of a patient-oriented research network, Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network adapted an existing in-person storytelling workshop for patient educators within a hospital setting. The result is a 6-week virtual program called Storytelling for Impact, which guides patients, family members, caregivers and organ donors in developing impactful stories and sharing them at health care and research events, e.g., conferences. The online series of synchronous workshops is co-facilitated by story coaches, who are program alumni and Can-SOLVE CKD staff with trained storytelling experience. Each story follows a structure that includes a call to action, which aims to positively impact the priority-setting and delivery of care and research in Canada. The program has been a transformational process for many who have completed it, and numerous other health organizations have expressed interest in sharing this tool with their own patient partners. As result, we have also created an asynchronous online program that can be used by other interested parties outside our network. Patient partners who share their stories can be powerful mediators for inspiring changes in the health care and research landscape, with adequate structured support. We describe two novel programs to support patient partners in impactful storytelling, which are applicable across all health research disciplines. Additional resources are required for sustainability and scale up of training, by having alumni train future storytellers.
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Affiliation(s)
| | | | | | | | | | - Mary Beaucage
- Can-SOLVE CKD Network, Vancouver, Canada
- Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada
| | | | | | | | - Audrey L'Esperance
- Health and Social Services Management, École nationale d'administration publique (ENAP), Quebec City, Canada
| | - Kevin Burns
- Division of Nephrology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | | | - Helen Chiu
- Can-SOLVE CKD Network, Vancouver, Canada
- BC Renal, Vancouver, Canada
| | - Norman D Rosenblum
- Division of Nephrology, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Ruth Sapir-Pichhadze
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, QC, Canada
- Division of Nephrology, Department of Medicine, McGill University, Montreal, QC, Canada
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Burm S, Cristancho S, Watling CJ, LaDonna KA. Expanding the advocacy lens: using photo-elicitation to capture patients' and physicians' perspectives about health advocacy. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023; 28:411-426. [PMID: 36214940 DOI: 10.1007/s10459-022-10162-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 09/03/2022] [Indexed: 05/11/2023]
Abstract
Heath advocacy (HA) remains a difficult competency to train and assess, in part because practicing physicians and learners carry uncertainty about what HA means and we are missing patients' perspectives about the role HA plays in their care. Visual methods are useful tools for exploring nebulous topics in health professions education; using these participatory approaches with physicians and patients might counteract the identified training challenges around HA and more importantly, remedy the exclusion of patient perspectives. In this paper we share the verbal and visual reflections of patients and physicians regarding their conceptualizations of, and engagement in 'everyday' advocacy. In doing so, we reveal some of HA's hidden dimensions and what their images uncovered about the role of advocacy in patient care. Constructivist grounded theory guided data collection and analysis. Data was collected through semi-structured interviews and photo-elicitation, a visual research method that uses participant generated photographs to elicit participants knowledge and experiences around a particular topic. We invited patients living with chronic health conditions (n = 10) and physicians from diverse medical and surgical specialties (n = 14) to self-select photographs representing their experiences navigating HA in their personal and professional lives. Both groups found taking photographs useful for revealing the nuanced and circumstantial factors that either enabled or challenged their engagement in HA. While patients' photos highlighted their embodiment of HA, physicians' photos depicted HA as something quite elusive or as a complicated and daunting task. Photo-elicitation was a powerful tool in eliciting a diversity of perspectives that exist around the HA role and the work advocates perform; training programs might consider using visuals to augment teaching for this challenging competency.
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Affiliation(s)
- Sarah Burm
- Continuing Professional Development and Division of Medical Education, Clinical Research Centre, C-104, Dalhousie University, 5849 University Ave, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Sayra Cristancho
- Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Christopher J Watling
- Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Kori A LaDonna
- Department of Innovation in Medical Education and Department of Medicine, University of Ottawa, Ottawa, ON, Canada
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Kagawa Y, Ishikawa H, Son D, Okuhara T, Okada H, Ueno H, Goto E, Tsunezumi A, Kiuchi T. Using patient storytelling to improve medical students' empathy in Japan: a pre-post study. BMC MEDICAL EDUCATION 2023; 23:67. [PMID: 36707818 PMCID: PMC9881337 DOI: 10.1186/s12909-023-04054-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Empathy for patients is now internationally accepted as one of the competencies of physicians for patient-centered medical practice and an essential component of medical education. Recently, "patient storytelling" has attracted attention in empathy education for medical students to understand patients' experiences, feelings, and perspectives. This study aimed to quantitatively evaluate how patient storytelling enhanced undergraduate medical students' empathy in Japan to the extent that they sustained it for six months. METHODS Participants were 159 fourth-year undergraduate medical students in Tokyo in academic years 2018 and 2019. The questionnaire surveys were conducted three times: at the beginning of the class, immediately after the class, and six months after the class. The Japanese version of the Jefferson Scale of Empathy-Student Version was used in this study. Gender, age, and clinical orientation were also obtained through the self-reported questionnaire. We invited a male patient storyteller who was diagnosed with chronic kidney disease to the classes on "Professionalism." The title of his storytelling was "The Power of Medical Professionals' Words." RESULTS JSE-S scores improved significantly immediately after listening to patient storytelling. The scores remained improved six months after the class. Interest of specialty was significantly positively associated with an immediate change in JSE-S scores. However, gender had no significant association with changes in JSE-S scores either immediately or six months after education. CONCLUSIONS Our findings may suggest that patient storytelling would be useful to cultivate empathy among undergraduate medical students. It is to be expected that more medical schools will use patient storytelling to educate medical students in humanistic and communication education.
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Affiliation(s)
- Yumi Kagawa
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | | | - Daisuke Son
- Department of Community-based Family Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Haruka Ueno
- Department of Health and Dietetics, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan
| | - Eiko Goto
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Aiko Tsunezumi
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Lunen JC. Reflection, Sense of Belonging, and Empathy in Medical Education-Introducing a "Novel" Model of Empathetic Development by Literature. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231207702. [PMID: 37860600 PMCID: PMC10583515 DOI: 10.1177/23821205231207702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023]
Abstract
Empathy, self-reflection, and inclusion of the medical humanities in medical education are increasingly gaining attention. This seems prudent, as studies indicate that high physician empathy is associated with better patient outcomes and could protect against physician burnout. In addition, utilizing self-reflection has been reported to surge diagnostic accuracy and increase the ability of clinical health care providers. Therefore, in medical education, there is a need to address these, however intricate, most important skills. Not oblivious to this, for decades many medical schools have reaped experience from the humanities, sprouting the field of the medical humanities. However, significant barriers encountered when teaching the medical humanities to medical students are of concern. Consequently, a theory-based, inclusive, representative, and intuitive approach to the teachings is coveted. The aim of this article is to describe and present such an approach. To this end, I introduce a novel Model of Empathetic Development by Literature, schematizing the path from reading a text to displaying an act of empathy. Ever mindful of the relevance and feasibility to medical students, this article reflects on thoughts and evidence behind the hypothesis; that sense of belonging, self-reflection, and empathy could be gained by reading and discussing literary fiction. Referring to both original research articles, books of popular science, and philosophical considerations, a clear line of reasoning for the inclusion of literary fiction in medical education is made. Thereafter, it is outlined, how-in a medical humanities course at Copenhagen University-specific literary excerpts are utilized to bring forth reflection on different aspects, circumstances, and conditions of being a physician, thereby kindling the medical students' sense of belonging to their profession. As such, this perspective piece demonstrates a concrete approach to how a literary educative technique could manifest.
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Affiliation(s)
- Jonas Christian Lunen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Occupational Health and Social Medicine, Holbæk Hospital, Holbæk, Denmark
- Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark
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Lefkowitz A, Vizza J, Kuper A. Patients as experts in the illness experience: Implications for the ethics of patient involvement in health professions education. J Eval Clin Pract 2022; 28:794-800. [PMID: 35274414 DOI: 10.1111/jep.13672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022]
Abstract
In response to calls to increase patient involvement in health professions education (HPE), educators are inviting patients to play a range of roles in the teaching of clinical trainees. However, there are concerns that patients involved in educational programs are seen as representing a demographic larger than themselves: their disease, their social group or even patients as a whole. This leads to difficult ethical challenges related to representation, including problems of tokenistic inclusion and of inadvertently essentializing marginalized groups. We propose that conceptualizing patients as experts in their illness experience can help resolve these dilemmas of representation equitably and effectively. Just as clinical experts are involved in HPE to share their expertise and represent their clinical experience, so too should patients be invited to participate in HPE explicitly for their expertise in their illness experience. This framing clarifies the goals of patient involvement as technocratic rather than tokenistic, mandates meaningful contributions by patients, and helps frame patient involvement for learners as the presentation of expert perspectives.
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Affiliation(s)
- Ariel Lefkowitz
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Julie Vizza
- Faculty of Health Science, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Ayelet Kuper
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,The Wilson Centre, University Health Network/University of Toronto, Toronto, Ontario, Canada
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Zwaiman A, da Luz LT, Perrier L, Hacker Teper M, Strauss R, Harth T, Haas B, Nathens AB, Gotlib Conn L. The involvement of trauma survivors in hospital-based injury prevention, violence intervention and peer support programs: A scoping review. Injury 2022; 53:2704-2716. [PMID: 35773023 DOI: 10.1016/j.injury.2022.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/26/2022] [Accepted: 06/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite decades-long involvement of trauma survivors in hospital-based program delivery, their roles and impact on trauma care have not been previously described. We aimed to characterize the literature on trauma survivor involvement in hospital-based injury prevention, violence intervention and peer support programs to map what is currently known and identify future research opportunities. METHODS A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. Articles were identified through electronic databases and gray literature. Included articles described hospital-based injury prevention programs, violence intervention programs and peer support programs that involved trauma survivors leveraging their injury experiences to counsel others. Studies were screened and data were abstracted in duplicate. Data were synthesized generally and by program type. RESULTS Thirty-six published articles and four program reports were included. Peer support programs were described in 21 articles, mainly involving trauma survivors as mentors or peer supporters. Peer support programs' most commonly reported outcome was participant satisfaction (n = 6), followed by participant self-efficacy (n = 5), depression (n = 4), and community integration (n = 3). Eleven injury prevention studies were included, all involving trauma survivors as speakers in youth targeted programs. Injury prevention studies commonly reported outcomes of participants' risk behaviors and awareness (n = 9). Violence intervention programs were included in four articles involving trauma survivors as intervention counsellors. Recidivism rate was the most commonly reported outcome (n = 3). Variability exists across and within program types when reporting on involved trauma survivors' gender, age, selection and training, duration of involvement and number of survivors involved. Outcomes related to trauma survivors' own experiences and the impacts to them of program involvement were under-studied. CONCLUSIONS Significant opportunity exists to fill current knowledge gaps in trauma survivors' involvement in trauma program delivery. There is a need to describe more fully who involved trauma survivors are to inform the development of effective future interventions.
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Affiliation(s)
- Ashley Zwaiman
- University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1 Canada
| | - Luis T da Luz
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
| | - Laure Perrier
- University Health Network, 190 Elizabeth St, Toronto, ON M5G 2C4, Canada
| | | | - Rachel Strauss
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
| | - Tamara Harth
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
| | - Barbara Haas
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, 5 College St 4th Floor, Toronto, ON M5T 3M6 Canada
| | - Avery B Nathens
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, 5 College St 4th Floor, Toronto, ON M5T 3M6 Canada
| | - Lesley Gotlib Conn
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, 5 College St 4th Floor, Toronto, ON M5T 3M6 Canada.
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Molinaro ML, Cheng A, Cristancho S, LaDonna K. Drawing on experience: exploring the pedagogical possibilities of using rich pictures in health professions education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1519-1535. [PMID: 34152494 DOI: 10.1007/s10459-021-10056-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/12/2021] [Indexed: 06/13/2023]
Abstract
In both clinical and health professions education research, rich pictures, or participant-generated drawings of complex phenomena, are gaining recognition as a useful method for exploring multifaceted and emotional topics in medicine. For instance, two recent studies used rich pictures to augment semi-structured interviews exploring trainees', health care professionals' (HCPs), and parents' experiences of difficult conversations in the Neonatal Intensive Care Unit (NICU)-an environment in which communication is often challenging, anxiety-provoking, and emotionally distressing. In both studies, participants were invited to draw a picture depicting how they experienced a difficult conversation in this setting. As part of the interview process, participants were asked to both describe how they engaged with rich pictures, and to share their perceptions about the affordances and limitations of this research method. Here, their perspectives are reported and the possibilities of using rich pictures to inform pedagogical innovations in health professions education and research are considered.
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Affiliation(s)
- Monica L Molinaro
- Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada.
| | - Anita Cheng
- Department of Neonatal and Perinatal Medicine, London Health Sciences Centre, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Sayra Cristancho
- Department of Surgery, Faculty of Education, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Kori LaDonna
- Department of Innovation in Medical Education and Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Singh S, Khan AM, Dhaliwal U, Singh N. Using the health humanities to impart disability competencies to undergraduate medical students. Disabil Health J 2021; 15:101218. [PMID: 34620568 DOI: 10.1016/j.dhjo.2021.101218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/10/2021] [Accepted: 09/19/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Disability competencies were included, for the first time, in India's new undergraduate competency-based curriculum as a result of physician-led advocacy in 2019; the regulatory body also recommended the use of the humanities in medicine. OBJECTIVE To use tools from the health humanities to impart disability competencies and help students appreciate the social and human rights issues associated with disability. METHODS A module was developed and piloted in the foundation course on the new cohort of students. The tools included storytelling, visual art, poetry, narratives, and Forum Theatre; many facilitators were doctors and patients with disabilities. Learners were introduced to the concept of universal design through a field visit. Quantitative and open-ended feedback was taken from learners after module delivery; reflections were sought after four months. RESULTS The data revealed that the humanities tools used in the module had the potential to help learners explore struggle and oppression and to expose discriminatory attitudes. Learners were able to think beyond the hegemony of normalcy, and show an understanding of diversity, dignity, autonomy, disableism, social inclusion, equity, and universal design. They admitted to the misconceptions they carried and showed keenness to advocate for change. CONCLUSION This study piloted a novel disability competencies module using tools from the health humanities and found that learners were able to engage with and show an understanding of the social and human rights issues associated with disability. Conversations by, for, and with people with disabilities must be part of such interventions in developing and delivering disability courses.
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Affiliation(s)
- Satendra Singh
- Health Humanities Group, University College of Medical Sciences, University of Delhi, India.
| | - Amir Maroof Khan
- Medical Education Unit, University College of Medical Sciences, University of Delhi, India.
| | - Upreet Dhaliwal
- Health Humanities Group, University College of Medical Sciences, University of Delhi, India.
| | - Navjeevan Singh
- Health Humanities Group, University College of Medical Sciences, University of Delhi, India.
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New music therapy faculty and the pursuit of fulfillment, success, and identity: A collective autoethnography. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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LaDonna KA, Watling CJ, Cristancho SM, Burm S. Exploring patients' and physicians' perspectives about competent health advocacy. MEDICAL EDUCATION 2021; 55:486-495. [PMID: 33152148 DOI: 10.1111/medu.14408] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/27/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Many residency programmes struggle to demonstrate how they prepare trainees to become competent health advocates. To meaningfully teach and assess it, we first need to understand what 'competent' health advocacy (HA) is and what competently enacting it requires. Attempts at clarifying HA have largely centred around the perspectives of consultant physicians and trainees. Without patients' perspectives, we risk training learners to advocate in ways that may be misaligned with patients' needs and goals. Therefore, the purpose of our research was to generate a multi-perspective understanding about the meaning of competence for the HA role. METHODS We used constructivist grounded theory to explore patients' and physicians' perspectives about competent health advocacy. Data were collected using photo elicitation; patients (n = 10) and physicians (n = 14) took photographs depicting health advocacy that were used to inform semi-structured interviews. Themes were identified using constant comparative analysis. RESULTS Physician participants associated HA with disruption or political activism, suggesting that competence hinged on medical and systems expertise, a conducive learning environment, and personal and professional characteristics including experience, status and political savvy. Patient participants, however, equated physician advocacy with patient centredness, perceiving that competent HAs are empathetic and attentive listeners. In contrast to patients, few physicians identified as advocates, raising questions about their ability to train or to thoughtfully assess learners' abilities. CONCLUSION Few participants perceived HA as a fundamental physician role-at least not as it is currently defined in curricular frameworks. Misperceptions that HA is primarily disruptive may be the root cause of the HA problem; solving it may rely on focusing training on bolstering skills like empathy and listening not typically associated with the HA role. Since there may be no competency where the patient voice is more critical, we need to explore opportunities for patients to facilitate learning for the HA role.
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Affiliation(s)
- Kori A LaDonna
- Department of Innovation in Medical Education and Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Christopher J Watling
- Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Sayra M Cristancho
- Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Sarah Burm
- Division of Medical Education, Dalhousie University, Halifax, NS, Canada
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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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Sinha T. Active roles for patients in health education. CLINICAL TEACHER 2019. [DOI: 10.1111/tct.13097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tanya Sinha
- Resident Support UnitWestmead Hospital Westmead New South Wales Australia
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Williams C, Dalwood N. Patients as 'patients' and 'educators': harnessing the power and potential of the patient's voice. MEDICAL EDUCATION 2018; 52:462-464. [PMID: 29672936 DOI: 10.1111/medu.13571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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