Objectives To survey family planning clinic (FPC) patients who may be involved in the Diploma of the Faculty of Family Planning (DFFP) practical training; to obtain their views about the process of giving consent to their involvement; and to compare their views with current practice.Methods Questionnaire surveys of 103 female FPC patients and 40 DFFP instructing doctors. Patients were recruited from the waiting room of a community FPC, and DFFP instructing doctors from the North West of England were recruited at an updating meeting.Results Patients felt strongly that they wanted to know what to expect before deciding whether to agree to be involved in the training. Several items of information were requested. The most important of these were whether the training doctor would be seeing the patient alone; the gender of the training doctor; and the training doctor's level of experience. Patients had not always been given this information.Conclusions Clinical experience is an important part of postgraduate medical training and patients need to be able to give fully informed consent to their involvement. The information currently given to patients may be insufficient. A reluctance to see male training doctors may have implications as regards the breadth of experience gained by male training doctors; this needs further investigation. Further research including different patient populations could inform guidelines for patient involvement in training.
Objectives To discover what motivates patients who agree to doctors on postgraduate clinical training attachments being involved in their care; to explore potential negative effects on patients; and to consider how the experience could be improved for the patient.Methods Questionnaire survey of 103 female family planning clinic (FPC) patients. Patients were recruited from the waiting room of a community FPC.Results Motivation could be classified into three categories: 84% of patients gave altruistic reasons for agreeing to see training doctors, 59% indicated the possibility of personal gain and 49% felt some degree of obligation. Potential disadvantages to seeing training doctors included marginalisation of patient care, strain on the doctor-patient relationship, and exposure to potential discomfort or harm. The experience could be 103 IntroductionClinical experience is a vital part of medical training, but we should not assume that all patients are willing to be involved in this. Understanding what motivates patients to agree to play a part in medical education could have a positive influence on the way they are asked, and make the experience more rewarding for the patient.Patient motivation for involvement in medical student education has been described in some detail by Lynöe et al. 1 but there is little research into the experiences of patients with postgraduate medical training. Diploma of the Faculty of Sexual and Reproductive Healthcare (DFSRH) [formerly Diploma of the Faculty of Family Planning and Reproductive Health Care (DFFP)] training doctors are post-registration doctors, mainly general practice registrars or gynaecology senior house officers, who attend family planning clinics (FPCs) to gain clinical experience towards their diploma. This study sought the views and experiences of patients attending a community FPC that frequently has DFSRH training doctors in attendance. Depending on their level of experience, these doctors may observe or lead consultations in the presence of a more senior member of staff, or see patients on their own, under supervision of a Faculty instructing doctor. Practical procedures such as intrauterine device (IUD) and implant insertions would always be performed in the presence of an experienced doctor. MethodsThe study methodology was as described in the first article in this series. Discussion and conclusions Patients were motivated to become involved in training for a variety of reasons, mainly altruism, personal gain or a sense of obligation. There is evidence that patients may not be fully aware of the potential disadvantages of seeing a training doctor. Patients may benefit from being given more choice about their level of involvement to enable them to give informed consent before seeing a training doctor. Patients should feel comfortable about saying no. There is potential to develop the teaching role of some of the most motivated patients. Ethical approvalEthical approval for the study was granted by the Cheshire Local Research Ethics Committee. Results ...
Objectives To look at patients' views about the way in which they are recruited to assist with postgraduate medical training (i.e. Who is the best person to ask patients to participate? When is the best time for patients to be asked?) and to compare these with clinical practice. Medical education at undergraduate and postgraduate level relies on the recruitment of patients who are willing to involve students or training doctors in their care. There is little in the literature about the recruitment process for postgraduate medical training; most references are to medical students. MethodsThis study sought the views of patients attending a family planning clinic (FPC) where postgraduate medical training takes place. The 'training doctors' are postregistration doctors, mainly general practice registrars or gynaecology senior house officers, who attend FPCs to gain clinical experience towards the Diploma of the Faculty of Family Planning (DFFP). These doctors all work with experienced Faculty 'instructing doctors' and, depending on their level of experience, they may observe or lead consultations in the presence of a more senior member of staff, or see patients on their own under the supervision of a Faculty instructing doctor. Practical procedures, such as intrauterine device and implant insertions, would always be performed in the presence of an experienced doctor.Patient preferences were compared with the practice reported in a survey of family planning instructing doctors. difficult to refuse the training doctor. In practice, the commonest person to recruit patients is the instructing doctor. Patients wanted to be given some time to consider the request; this was not always given. Discussion and conclusionsPatients may feel coerced into seeing training doctors because they find it difficult to refuse requests, particularly when they are being recruited by doctors. Non-medical staff may be more appropriate for the initial recruitment of patients. Patients need time to consider their involvement. The provision of written information may be useful. Further research is indicated to empower patients' decision-making and reduce the likelihood of coercion. MethodsThe study methodology was as described previously. 2 Patients were recruited from the waiting room of a community FPC serving a mid-sized town in a rural part of Cheshire, UK. A questionnaire that had been pre-piloted in the same clinic sought quantitative and qualitative data about patients' experiences and expectations of their role in DFFP training.Patients were initially approached by the receptionist on arrival at the clinic, and those who expressed an interest in taking part in the study were seen by the researcher. Further information was given verbally and in writing, and if the patient was able to give fully informed consent then the questionnaire was filled in by the patient in privacy. Most questionnaires were completed in the clinic, but stamped addressed envelopes were provided for patients who wished to return them later. The questionnai...
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