The impact on patients and parents of their involvement in the training of healthcare professionals

Patient Experience in Health Professions Curriculum Development

To enhance student learning, many health profession programs are embracing involvement of patients in their curricula, yet little is known about the impact of such an experience on patients.

OBJECTIVE

To understand the experiences of patients who contributed to the creation of a Verbatim Reader's Theater used in health professions curriculum.

METHODS

A semi-structured interview was conducted with a focus group of 3 patients who participated in curriculum development. The interview was recorded, transcribed verbatim, and analyzed for themes using van Manen approach to hermeneutic phenomenology.

RESULTS

Five themes emerged: (1) contextualizing contribution, (2) addressing expectations, (3) changing health-care service delivery, (4) sharing common experiences, and (5) coordinating participation.

CONCLUSION

Patients had a positive experience contributing to curriculum development and found meaning in sharing their lived experience to shape the values of future clinicians. Strategies to promote continued success in partnership between patients and health professional curriculum developers include clear communication about the project's direction and early discussion of patient role and expectations.

The Benefits and Risks of Being a Standardized Patient: A Narrative Review of the Literature

Standardized patients (SPs) are a widely used, valid, and reliable means of teaching and evaluating healthcare providers (HCPs) across all levels of training and across multiple domains of both clinical and communication skills. Most research on SP programs focuses on outcomes pertinent to the learners (i.e., HCPs) rather than how this experience affects the SPs themselves. This review seeks to summarize the current literature on the risks and benefits of being an SP. We reviewed the literature on the effects that simulation has on adults, children/adolescents, and medical professionals who serve as SPs, in addition to real patients (RPs) who are involved in teaching by sharing their medical histories and experiences. To collect the literature, we conducted two separate systematic searches: one for SPs and one for RPs. Following the searches, we applied standardized eligibility criteria to narrow the literature down to articles within the scope of this review. A total of 67 studies were included that focused on the outcomes of SPs or RPs. The benefits for those portraying SP roles include improved health knowledge and attitudes, relationships with their HCPs, and changed health behaviors. Negative effects of being an SP include anxiety, exhaustion/fatigue, and physical discomfort immediately following a simulation, but the literature to date appears to indicate that there are no long-lasting effects. These findings are consistent across age groups and the type of role being simulated. They are also supported by studies of RPs who are involved in medical education. Overall, the benefits of being an SP appear to outweigh the known risks. However, there are significant limitations in the current literature, and additional studies are needed to better characterize the SP experience.

Decisões em saúde no relacionamento entre o profissional e o paciente com transtorno alimentar

O paciente diagnosticado com transtorno alimentar pode ser visto como alvo de orientação ou ser posicionado, junto ao profissional, como especialista na condução do tratamento. Buscou-se compreender, a partir das práticas discursivas de pessoas diagnosticadas com esses transtornos, como profissionais e pacientes constroem as decisões sobre o tratamento. Foram realizadas entrevistas com 12 pacientes de um serviço especializado na área, e quatro foram selecionadas para análise, que teve como fundamento o discurso construcionista social. A análise permitiu abordar os movimentos denunciativos das participantes com relação às decisões unilaterais tomadas por profissionais de saúde, e seu pleito por maior participação do paciente nas decisões do tratamento. Essas realidades relacionais foram discutidas a partir dos discursos sociais privilegiados nas práticas discursivas empreendidas no relacionamento profissional-paciente, da problematização da organização das políticas públicas em saúde em nosso país e do modo de funcionamento das instituições hospitalares.

“All eyes are on you”: anorexia nervosa patient perspectives of in-patient mealtimes

The aim of this qualitative study was to investigate in-patient perceptions of mealtimes on eating disorders units. Individual interviews were conducted with 12 women with anorexia nervosa. Using thematic analysis, three themes emerged as important: 1) Mealtime delivery (logistical factors influencing meals); 2) Individual outcomes (cognitions, emotions, behaviours and physical sensations during meals); and 3) Mealtime characteristics (including disengagement, perceived battlegrounds, and a desire for involvement in mealtimes). Future research should focus on areas of treatment delivery identified as important by patients. Recommendations are made regarding mealtime protocols based on patients’ views, with increased recognition of behavioural, cognitive, physical and emotional aspects.