How can stories of patient and professional experience contribute to BESST in clinical medical education? Part 1: Patient Voices (original) (raw)
Related papers
Students Learning from Patients: Let’s Get Real in Medical Education
Advances in Health Sciences Education, 2008
Medical students must be prepared for working in inter-professional and multi-disciplinary clinical teams centred on a patient's care pathway. While there has been a good deal of rhetoric surrounding patient-centred medical education, there has been little attempt to conceptualise such a practice beyond the level of describing education of communication skills and empathy within a broad 'professionalism' framework. Paradoxically, while aiming to strengthen patient-student interactions, this approach tends to refocus on the role modelling of the physician, and opportunities for potentially deep collaborative working relationships between students and patients are missed. A radical overhaul of conventional doctor-led medical education may be necessary, that also challenges the orthodoxies of individualistic student-centred approaches, leading to an authentic patient-centred model that shifts the locus of learning from the relationship between doctor as educator and student to the relationship between patient and student, with expert doctor as resource. Drawing on contemporary poststructuralist theory of text and identity construction, and on innovative models of work-based learning, the potential quality of relationship between student and patient is articulated in terms of collaborative knowledge production, involving close reading with the patient as text, through dialogue. Here, a medical 'education' displaces traditional forms of medical 'training' that typically involve individual information reproduction. Students may, paradoxically, improve clinical acumen through consideration of silences, gaps, and contradictions in patients as texts, rather than treating communication as transparent. Such paradoxical effects have been systematically occluded or denied in traditional medical education.
Patients’ stories in healthcare curricula: learning the art of healthcare practice with patients
Journal of Further and Higher Education, 2019
in 2018. He has a background in occupational therapy and an interest in epistemology and ethics in relation to professional and personal development. His PhD was on understanding how occupational therapy students can develop professionally through engaging in reflective discussions with their peers. His research interest is in reflective practice, healthcare education and pedagogy. Claire Job is a lecturer in adult nursing with a background in cancer and palliative care. She teaches on both undergraduate and postgraduate programmes. She has a special interest in the provision of patient and public involvement in educational programmes. Dr Sally Anstey is a senior lecturer (Adult Nursing) and deputy research theme lead for the Optimising well-being in health and illness research theme at School of Healthcare Sciences, Cardiff University. She is a registered nurse (Adult Nursing) and has a clinical background. She teaches across undergraduate and postgraduate programmes, specifically on the subjects of cancer, genetics, palliative and end of life care, research and ethics. Acknowledgements: The authors would like to thank the patients, carers, educators and students for their participation in the oncology nursing module which inspired the writing of this paper. Patients' stories in healthcare curricula: Learning the art of healthcare practice with patients In our previous paper, we theorised that patients' stories prepare students by allowing them to reflect on their practice in the safety of the academic environment. This paper furthers this theory by arguing that when engaging with patients through storytelling, students grow epistemologically, where they develop knowledge about empathetic practice, and ontologically, where they learn to form and maintain relationships with the patients in their care. These new forms of knowing then inform practice and their professional decision making. Patients' stories galvanise students to think more deeply about their practice and their patient engagement. Through that, they develop their art of healthcare practice, becoming competent, empathetic practitioners who are constantly motivated to developing their practice.
Learning from patients: trainers’ use of narratives for learning and teaching
BJGP open, 2017
Background: There is a growing interest in how doctors learn from narratives about individual cases, reflected, for example, in the use of e-portfolios. Aim: This study aimed to evaluate how GP trainers conceptualised 'learning from patients', and what use they currently made of narrative recounts in training. Design & setting: Thematic analysis (TA) and corpus-linguistic (CL) analysis, with data collected from a convenience sample of trainers in the UK, Ireland, and Spain. Method: GP trainers in the three settings were contacted, and volunteers recruited (22 in UK, 24 in Ireland, and 16 in Spain). Volunteers were interviewed and asked to offer a narrative about 'a patient you learned from' and whether they used narratives as a training device. Results: There were no differences between settings. Trainers described an engaged and personal relationship with patients. They described learning about themselves, the human condition, and about how to live and die well. Their narratives were structured in various ways. At times, they led to precise conclusions: at times, they were perceived as meaningful, but resisting analysis. As regards teaching through narrative, it was reported as commonly used, but present practice appears ad hoc rather than planned. Discussion: The lack of difference between settings suggests a degree of commonality about how trainers perceive learning and teaching in the areas explored, but cannot be generalised further. The level of personal engagement was more than anticipated, and suggests the label 'doctorpatient relationship', as the term is used, may not be adequate to describe the nature of some interactions. How this fits in The study of individual cases and the narratives through which they are phrased is widely used-for example, through e-portfolios-to help doctors understand the clinical and wider context of their job, and to develop professionally. The narratives trainers tell about their own learning and teaching through individual cases, however, suggests 'learning' is perceived often as involving wisdom about the human condition, rather than issues usually covered by such terms as doctor-patient relations.
The patient ' s voice in health and social care professional education
International Journal of Health Governance, 2016
Purpose – The purpose of this paper is to present a statement about the involvement of patients in the education of health and social care professionals developed at an international conference in November 2015. It aims to describe the current state and identify action items for the next five years. Design/methodology/approach – The paper describes how patient involvement in education has developed as a logical consequence of patient and public participation in health care and health research. It summarizes the current state of patient involvement across the continuum of education and training, including the benefits and barriers. It describes how the conference statement was developed and the outcome. Findings – The conference statement identifies nine priorities for action in the areas of policy, recognition and support, innovation, research and evaluation, and dissemination and knowledge exchange. Originality/value – The conference statement represents the first time that an inte...
Medical Teacher, 2019
Background: The extent to which patients and service users are involved in medical education varies widely. There is a need for an up to date systematic review of the literature that examines what involvement (description), the potential outcome of such involvement (justification) and 'why' such involvement impacts students (clarification). Methods: Systematic searches of four databases was undertaken. Citations were screened and consensus reached for inclusion / exclusion of studies. Quality of study design and interventional presentation were assessed. Synthesis was planned at three levels-descriptive, meta-analysis and meta-ethnography, where sufficient data was available. Results: A total of 11,140 articles were initially identified, with 39 included in the review. Using the Towle Taxonomy for patient involvement in medical education we identified 4 studies that were encounter based, 17 with patients sharing their personal experiences with students, 16 with patients involved in teaching and/or evaluating students, 2 studies describing consumers as tutors and none with involvement at the institutional level. The majority (29) of studies employed outcomes at level 1 or level 2 of Kirkpatrick's hierarchy (learner reactions and modification of attitudes or skills). Outcomes in terms of benefits to learners included increased empathy and understanding of illness as experienced by patients, improved communication with patients and a greater understanding of patient-centre care. Educational quality assessment showed specific weaknesses in theoretical underpinning, curriculum outcomes, content or pedagogy. Conclusions: Patients can offer learning opportunities that are at least as effective as faculty trainers in imparting practical clinical skills and can enrich medical education by allowing learners to explore patient
Medical Education, 2009
Objectives Patients play an integral part in medical education, either as passive, clinical exemplars or as more active facilitators in the development of skills. In theory, the patient-teacher may enhance the student learning experience by creating an environment similar to that of the medical workplace and encouraging the process of becoming a professional. Although many medical schools have integrated patient-teachers within their curricula, there is little evidence of how those involved in providing or receiving medical education view patient-teachers’ contributions to their education. This study investigates the views and experiences of medical tutors and students of involving patients in undergraduate curricula.Methods We conducted a cross-sectional survey employing qualitative research methods. Semi-structured focus group interviews were used to elicit participants’ views and experiences of patient involvement in medical education. The transcripts were content-analysed using a coding framework.Results A total of 46 participants consisting of medical educators and medical students took part in nine focus groups. Four themes emerged: the role of the patient in learning and teaching; the impact of the patient-teacher; the impact of being the storyteller, and mechanisms to explain the patient-teacher role in medical training.Conclusions There is support for patient involvement in teaching. The logistics involved in supporting programmes of patient involvement and the need to link the teaching to overall course objectives should be addressed.