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Empowerment and Opportunity in Primary Care: Enhancing the Real-time Patients’ Journey through Undergraduate Medical Education

Lookup NU author(s): Helen Finnamore, Dr Doyin AlaoORCiD, Professor Hugh Alberti, Professor David Kennedy, Dr Bryan BurfordORCiD, Dr Susan Moloney, Professor Gill Vance


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Background:Patients presenting acutely to general practice (GP) with real-time illness provide valuable learning opportunitiesfor medical students. These ‘real-time’ patients, who may not have had prior experience of medical studenteducation, contrast with expert or volunteer patients who tend to plan contacts and have been previously briefedas to their role in the teaching exercise. As undergraduate curricula evolve to incorporate more teaching in primarycare, educators will increasingly need to draw on these real-time patients, and hence GPs need to know how bestto actively involve their patients. However, the educational role of this expansive group of patients, in contrast tothose already engaged in education, has been little studied.1,2As part of a study to understand real-time patient involvement in medical education, we conducted a workshopwith patients, GPs and medical students to discuss ways in which to address barriers identified in our qualitativeanalysis.Methodology:A half-day workshop was held with students (n=8), GPs (n=17) and patients (n=14). This included small groupdiscussions, co-facilitated by researchers and patients, which considered practical solutions to selected barriers:gaining consent for student involvement in the consultation; informing patients about the student’s role, andproviding feedback to both students and patients. Discussions were summarised on flip charts and these summarieswere analysed by framework analysis.Results:Analysis is on-going, but initial findings have identified patient empowerment and practice processes as keysolutions to real-time patient involvement.Patient empowerment was critical to involvement: patients felt they have much to offer students - both inenhancing the nature and quality of clinical information students receive, as well as providing feedback to thestudent about their performance. However, they felt that they needed ‘permission’ to educate. When patientsunderstood better the educational processes around the student, and felt that their contribution was valued, theywere more inclined to take the opportunity to participate.Educationally naïve patients take a ‘journey’ through undergraduate medical education, and this journey could beeased by attention to practice processes. Patients need clear, relevant and visible information materials, but,crucially, also an ‘invitation’ to start the journey. While a good doctor-patient relationship most often led to thisinvitation, patient’ experiences could be variable, and ways to addressing the attitudes and approach of all practicestaff, and students, could also help normalise real-time patient involvement in clinical encounters.Discussion:Real-time patients are invaluable to community-based teaching, but perhaps due to the hierarchical nature ofmedicine, need to feel empowered to educate students. The patient’s role may be supported by practicalinformation materials, but we also need to encourage a practice culture where patient involvement is the rule,rather than exception. Further work to implement findings in this curriculum will be explored.References:1 Spencer J., Some activity but still not much action on patient and public engagement. Medical Education 2016; 50: 5-72 Spencer J. Patients in health professional education: so much known, yet much to understand. Medical Education; 2010; 44: 9-11

Publication metadata

Author(s): Finnamore H, Alao A, Alberti H, Kennedy DJ, Burford B, Hrisos S, Vance G

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Association for the Study of Medical Education Annual Scientific Meeting

Year of Conference: 2018

Pages: 100-100

Online publication date: 11/07/2018

Acceptance date: 02/04/2018

Publisher: Association for the Study of Medical Education