Patient-centred education: what do students think?

Abstract

Context: Medical educators endeavour to foster patient-centred learning. Although studies of patient-educators report general increases in patient-centredness, no formal review of students' reflections on the role of patients in their education has yet been undertaken. Our research questions were: (i) What themes might be identified through a qualitative analysis of students' reflective writing on patient-centred education? (ii) What are common students' perceptions regarding patients as educators?

Methods: For two academic years, Year 2 pre-clinical students (189 and 167 students, respectively, in each academic year) submitted a 250-word writing assignment in response to one of four questions meant to promote reflection on the role of patients in their education. Using a grounded theory approach, we performed a qualitative analysis of these written reflections for emerging themes. A synthesis of these themes was prepared and was presented for validation and discussion by two focus groups of six and three students, respectively. We analysed the transcripts of the focus group discussions and compared them with results from the analysis of written reflections and used them to further inform and refine our initial thematic framework.

Results: A total of 356 reflective writing assignments were analysed. The major themes were: (i) students seeing the condition within the context of patients' lives; (ii) patients supporting students' learning; (iii) students recognising patients' needs; (iv) students seeing the patient as a capable part of the team, and (v) students recognising the complexity of practising medicine. The two focus group discussions confirmed these main themes, but placed greater emphasis on the first and second themes. These themes mapped closely to the conceptualisation of patient-centred care defined by the International Alliance of Patients' Organizations.

Conclusions: Students' reflections on their experiences of patient-educators cover an important and broad range of key concepts in patient-centred care that are well aligned with patient-generated conceptualisations of patient-centred care.