Unclear if future physicians are learning about patient-centred care: Content analysis of curriculum at 16 medical schools

Abstract

Purpose: Given barriers of patient-centred care (PCC) among physicians and trainees, this study assessed how medical schools addressed PCC in curriculum. Method: The authors used content analysis to describe PCC in publicly-available curriculum documents of Canadian medical schools guided by McCormack's PCC Framework, and reported results using summary statistics and text examples. Results: The authors retrieved 1459 documents from 16 medical schools (median 49.5, range 16-301). Few mentioned PCC (301, 21.2%), and even fewer thoroughly or accurately described PCC. Significantly more clerkship versus pre-clerkship (24.0% vs 12.6%, p < 0.00001), and elective compared with core course descriptions (24.7% vs 14.9%, p < 0.00001) mentioned PCC. The domain of foster a healing relationship was common (79.0%) compared with other domains: address concerns (16.5%), exchange information (14.9%), enable self-care (10.4%), share decisions (4.5%), and manage uncertainty (1.3%). Conclusions: Overall, few documents mentioned or described PCC or related concepts. This varied by school, and was more frequent in clerkship and elective courses, suggesting that student exposure may be brief and variable. Thus, it remains unclear if medical students are fully exposed to what PCC means and how to implement it. Future research is needed to confirm if PCC content in medical curriculum is lacking.

Person-centered care content in medicine, occupational therapy, nursing, and physiotherapy education programs

“…In this study, we did not explore study guidelines, but it is not unreasonable to assume, as other studies have shown [24,25], that the identified terms regarding PCC used in Swedish national study programs are inconsistently described. Bowden [27] pointed out that documents are rarely developed for research and, therefore, often contain few detailed descriptions.…”

“…In several countries, PCC is being introduced into the university and college education systems, including Australia [21], Scotland [22], and Sweden [23]. Some studies have explored PCC in medical and nursing undergraduate curricula [24][25][26]. However, to the best of our knowledge, no studies have examined the emphasis on or inclusion of PCC concomitantly across multiple national education programs in different clinical areas.…”

Optimising planned medical education strategies to develop learners' person‐centredness: A realist review

“…A recent study of 16 medical schools curricula in Canada questioned if learners are receiving teaching on person‐centred concepts 108 . A lack of explicit person‐centred theory in medical education may help to explain why studies have shown that both students and doctors hold superficial and unclear understandings of person‐centredness 109,110 .…”

“…A recent study of 16 medical schools curricula in Canada questioned if learners are receiving teaching on person‐centred concepts. 108 A lack of explicit person‐centred theory in medical education may help to explain why studies have shown that both students and doctors hold superficial and unclear understandings of person‐centredness. 109 , 110 Learners may regard person‐centred practice as ‘implicit’ and ‘obvious’ 109 in contrast to a paradigmatic shift in practice described in academic and policy papers.…”

The pelvic exam as bellwether for patient‐led care in the curriculum

“…Indeed, despite half a century of orientation to PCC 2 and more recent attention to cultural competence, a contemporary review of curricular materials at 16 medical schools in Canada reveals outdated content. 3 Student exposure to PCC in curricular materials was found to be brief and variable, with little mention, definition or description of patient-or person-centred care.…”