Towards a better understanding of patient perspectives of clinical teaching in ophthalmology

Patients' perspectives on their motivations for participating in non-clinical medical teaching and what they gain from their experience: a qualitative study informed by critical theory

In 2019-2021, we engaged in a project aimed at developing, implementing, and evaluating an educational intervention actively involving patient-teachers in undergraduate medical education at Université Laval, Quebec, Canada. Patient-teachers were invited to participate in small group discussion workshops during which medical students deliberate on legal, ethical, and moral issues arising from medical practice. Patients were expected to bring other perspectives, based on their experience with illness and the healthcare system. Little is still known about patients' perspectives on their participation experience in such context. Informed by critical theory, our qualitative study aims to document,: (i) the motivating factors for patients' participation in our intervention; and (ii) what patients gained from the experience. Data collection was based on 10 semi-structured interviews with patient-teachers. A thematic analysis was conducted using NVivo software. Motivators for participation arose from: (i) perceived consistency between patients' individual characteristics and those of the project, and (ii) conceiving the project as a means to reach individual and social goals. What patients gained mainly refers to (1) the appreciation of a positive, enriching, motivating yet uncomfortable and destabilizing experience; (2) a deconstruction of biases against the medical field and critical thinking about their own experience; (3) new knowledge, with a potential impact on their future interactions with the healthcare system. Results reveal patients as non-neutral thinking and knowing subjects, engaged in the participation experience as active teachers and learners. They also highlight the empowering and emancipatory nature of the learning gained through patients' participation experience. These conclusions prompt us to promote transformative interventional approaches that question the pervasive power issues in medical teaching and value patients' specific knowledge in teaching and learning the Art of Medicine.

Co-production in nursing and midwifery education: A systematic review of the literature

OBJECTIVES

Co-producing aspects of nursing and midwifery education is increasingly being used in higher education to try to improve student learning and meet standards set by some professional accreditation bodies. This review aims to identify and synthesise evidence on this pedagogical approach.

DESIGN

Systematic review.

DATA SOURCES

Searches were conducted in CINAHL, ERIC, MEDLINE, and PubMed.

REVIEW METHODS

Four bibliographical databases were searched using relevant search terms between 2009 and 2019. Titles, abstracts, and full text papers were screened. Pertinent data were extracted and critical appraisal undertaken. Data were analysed using the framework approach and findings presented in a narrative summary.

RESULTS

Twenty-three studies were included. Two overarching themes emerged. The first focused on the impact of co-production on nursing and midwifery students, service users, and carers which had five subthemes; 1) acquiring new knowledge and skills, 2) gaining confidence and awareness, 3) building better relationships, 4) feeling vulnerable, and 5) attaining a sense of pride or enjoyment. The second theme centred on factors affecting how co-production was delivered which had three subthemes; 1) human interactional approach, 2) pedagogic quality, and 3) organisational environment.

CONCLUSION

This review provides a comprehensive update of the literature on co-production in nursing and midwifery education. Tentative evidence exists that participatory approaches could improve learning and positively impact on nursing and midwifery students, service users, and carers. Educators should consider adopting co-production and including students, service users, carers, practice staff, and other relevant stakeholders in this pedagogical process. However, more rigorous research examining how effective co-production is in improving learning over traditional methods is warranted given the additional resources required to deliver it.