Patient-centred education: How do learners’ perceptions change as they experience clinical training?

Abstract

The use of patient educators is one of many teaching strategies meant to foster principles of patient-centred care. We previously found that early patient educator exposure helped to shape the understanding of patient-centredness in pre-clerkship learners. We now expand on this work to evaluate whether there is persistence of initial perceptions and to explore general reflections on longer-term impacts of early patient educator exposures once learners are immersed in the clinical phase of their training. In this follow-up study, we conducted group interviews with a sample of learners who wrote reflections as part of their pre-clerkship patient educator experience. We explored how perspectives on patient educators changed over time, and determined which themes identified during pre-clerkship remained relevant to clinical trainees. Audio recordings were transcribed and analyzed thematically using a hybrid inductive and deductive analysis to construct a thematic framework derived through a method of constant comparison. We identified three new themes: "value of early clinical experience", "change in learners' perspectives", and "valuing and applying CanMEDS roles other than Medical Expert". Themes from pre-clerkship that remained relevant included: "patients' perspective humanizes disease", "patients' experiences with navigating the healthcare system", "learners' perceptions of the learning strategy", and "inaccuracies and inconsistencies in the learning experience." Many themes identified in pre-clerkship learners remain relevant in early clinical trainees. Further, insights from pre-clerkship experiences with patient educators evolve as learners experience clerkship with definite shifts in emphasis and new perspectives. This work illuminates the utility of patient educators for those considering this strategy for supporting the development of patient-centredness in undergraduate medical education.

Congruence between nursing students’ and patients’ views of student–patient relationships

“…As a whole, patients' insights on students' professional performance provide important information about the outcomes of education (Moquin et al 2018;Rhodes 2012). The value of patients' meaningful influence on educational priorities is essential in preparing future professionals to work in partnership with patients, delivering high-quality person-centred care (Fong et al 2019;Rowland et al 2018;Scammell et al 2016;Suikkala et al 2018).…”

Exploring how differently patients and clinical tutors see the same consultation: building evidence for inclusion of real patient feedback in medical education

“…The involvement of patients in education is recognised to align with social learning theory, bringing opportunities for authentic experience and perspectives to a learning interaction [ 1 ]. This study contributes to understanding the impact patients can have on the social learning environment of medical students [ 1 , 20 ] namely, understanding feedback capacity of patients and the perspective-specific content of their feedback.…”

“…Desirable medical graduates’ work readiness includes capabilities for lifelong learning and development through incorporating feedback into practice, an appreciation of self-regulating for improvement, and a capacity to refine a patient-centred professional identity. Including patients and their feedback perspectives in medical teaching can contribute to these outcomes [ 1 , 2 ].…”

“…The supposition driving this enquiry is that if educators and students understand the perspective-specific feedback differences more explicitly we can improve the use, acceptability and valuing of these different perspectives [6] in the learning environment to further develop understanding of patient-centredness [1,7].…”

Improving Healthcare Quality in Europe

“…To foster patient-centredness, a number of approaches have been discussed to tailor medical education already in the undergraduate phase. For instance, the concept of "patient educators", who interact with trainees from an early stage in their studies, has been successful in changing learner perspectives and achieving a new understanding of their role, beyond that of a medical expert (Fong et al, 2019).…”