Fostering the development of non-technical competencies in medical learners through patient engagement: a rapid review

Authors

DOI:

https://doi.org/10.36834/cmej.73630

Abstract

Background: To train physicians who will respond to patients’ evolving needs and expectations, medical schools must seek educational strategies to foster the development of non-technical competencies in students. This article aims to synthetize studies that focus on patient engagement in medical training as a promising strategy to foster the development of those competencies.
Methods: We conducted a rapid review of the literature to synthetize primary quantitative, qualitative and mixed studies (January 2000-January 2022) describing patient engagement interventions in medical education and reporting non-technical learning outcomes. Studies were extracted from Medline and ERIC. Two independent reviewers were involved in study selection and data extraction. A narrative synthesis of results was performed.
Results: Of the 3875 identified, 24 met the inclusion criteria and were retained. We found evidence of a range of non-technical educational outcomes (e. g. attitudinal changes, new knowledge and understanding). Studies also described various approaches regarding patient recruitment, preparation, and support and participation design (e.g., contact duration, learning environment, patient autonomy, and format). Some emerging practical suggestions are proposed.
Conclusion: Our results suggest that patient engagement in medical education can be a valuable means to foster a range of non-technical competencies, as well as formative and critical reflexivity. They also suggest conditions under which patient engagement practices can be more efficient in fostering non-instrumental patient roles in different educational contexts. This supports a plea for sensible and responsive interventional approaches.

Metrics

Metrics Loading ...

Author Biographies

Julie Massé, Université Laval

JULIE MASSÉ is a Doctoral Candidate in Community Health, Faculty of Nursing, Université Laval, Quebec, Canada. She is affiliated with the Office of Education and Continuing Professional Development and the Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval. She is also student member of Vitam, Centre de recherche en santé durable, Quebec, Canada.

Stéphanie Beaura, Université Laval

STÉPHANIE BEAURA is a Medical Student and Research Trainee, Faculty of Medicine, Université Laval, Québec, Canada.

Marie-Claude Tremblay, Université Laval

MARIE-CLAUDE TREMBLAY is an Associate Professor and Researcher, Office of Education and Continuing Professional Development and Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Canada. She is also a regular member of Vitam, Centre de recherche en santé durable, Quebec, Canada.

References

Pomey M-P, Flora L, Karazivan P, et al. Le « Montreal model » : enjeux du partenariat relationnel entre patients et professionnels de la santé. Sante Publique. 2015;S1(HS):41. https://doi.org/10.3917/spub.150.0041 DOI: https://doi.org/10.3917/spub.150.0041

Tuckett D, Boulton M, Olson C, Williams, A. Meetings between experts: an approach to sharing ideas in medical consultations. London: Tavistock; 1985.

Flora L, Berkesse A, Payot A, Dumez V, Karazivan P. Chapitre 3. L’application d’un modèle intégré de partenariat-patient dans la formation des professionnels de la santé : vers un nouveau paradigme humaniste et éthique de co-construction des savoirs en santé. J Int Bioethique. 2016;27(1):59. https://doi.org/10.3917/jib.271.0059 DOI: https://doi.org/10.3917/jib.271.0059

Jha V, Quinton ND, Bekker HL, Roberts TE. Strategies and interventions for the involvement of real patients in medical education: a systematic review. Med Educ. 2009;43(1):10-20. https://doi.org/10.1111/j.1365-2923.2008.03244.x DOI: https://doi.org/10.1111/j.1365-2923.2008.03244.x

Towle A, Bainbridge L, Godolphin W, et al. Active patient involvement in the education of health professionals. Med Educ. 2010;44(1):64-74. https://doi.org/10.1111/j.1365-2923.2009.03530.x DOI: https://doi.org/10.1111/j.1365-2923.2009.03530.x

Flin RH, O'Connor P, Crichton M. Safety at the sharp end: a guide to non-technical skills. Burlington, VT: Ashgate Publishing, Ltd.; 2008.

Prineas S, Mosier K, Mirko C, Guicciardi S. Non-technical skills in healthcare. In: Donaldson L, Ricciardi W, Sheridan S, Tartaglia R (eds). Textbook of Patient Safety and Clinical Risk Management. Cham, CH: Springer International Publishing; 2021. p. 413-34. DOI: https://doi.org/10.1007/978-3-030-59403-9_30

Gordon M, Baker P, Catchpole K, Darbyshire D, Schocken D. Devising a consensus definition and framework for non-technical skills in healthcare to support educational design: a modified Delphi study. Med Teach. 2015;37(6):572-577. https://doi.org/10,3109/0142159X.2014.959910 DOI: https://doi.org/10.3109/0142159X.2014.959910

Frenk, J, Chen L, Bhutta ZA, et al. Health professionals for a new entury: transforming education to strengthen health systems in a interdependent world. Lancet. 2010;376(9756):1923-58. https://doi.org/10.1016/S0140-6736(10)61854-5 DOI: https://doi.org/10.1016/S0140-6736(10)61854-5

Holton, R. A new epoch for health professionals’ education. Lancet. 2010;376(9756):1875-7. https://doi.org/10.1016/S0140-6736(10)62008-9 DOI: https://doi.org/10.1016/S0140-6736(10)62008-9

Spencer J, Balckmore D, Heard S, et al. Patient-oriented learning: a review of the role of the patient in the education of medical students. Med Educ. 2000;34(10):851-857. https://doi.org/10.1046/j.1365-2923.2000.00779.x DOI: https://doi.org/10.1046/j.1365-2923.2000.00779.x

Gordon M, Gupta S, Thornton D, Reid M, Mallen E, Melling A. Patient/service user involvement in medical education: a best evidence medical education (BEME) systematic review: BEME Guide No. 58. Med Teach. 2020;42(1):4-16. https://doi.org/10.1080/0142159x.2019.1652731 DOI: https://doi.org/10.1080/0142159X.2019.1652731

Khalife R, Gupta M, Gonsalves C, et al. Patient involvement in assessment of postgraduate medical learners: a scoping review. Med Educ. 2022;56(6):602–613. https://doi.org/10.1111/medu.14726 DOI: https://doi.org/10.1111/medu.14726

Khangura S, Konnyu K, Cushman R, Grimshaw J, Moher D. Evidence summaries: the evolution of a rapid review approach. Systematic Reviews. 2012;1(1):10-. https://doi.org/10.1186/2046-4053-1-10 DOI: https://doi.org/10.1186/2046-4053-1-10

Tricco AC, Langlois EV, Straus SE. Rapid reviews to strengthen health policy and systems: a practical guide. Geneva: World Health Organization; 2017.

Barry Issenberg S, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005;27(1):10-28. https://doi.org/10.1080/01421590500046924 DOI: https://doi.org/10.1080/01421590500046924

Hammick M, Freeth D, Koppel I, Reeves S, Barr H. A best evidence systematic review of interprofessional education: BEME Guide no. 9. Med Teach. 2007;29(8):735-51. https://doi.org/10.1080/01421590701682576 DOI: https://doi.org/10.1080/01421590701682576

Barr H, Koppel I, Reeves S, Hammick M, Freeth DS. Effective interprofessional education: argument, assumption and evidence (promoting partnership for health). New York: John Wiley & Sons; 2008.

Boet S, Sharma S, Goldman J, Reeves S. Review article: medical education research: an overview of methods. Can J Anaesth. 2012;59(2):159-70. https://doi.org/10.1007/s12630-011-9635-y DOI: https://doi.org/10.1007/s12630-011-9635-y

Aires MJ, Gagnayre R, Gross O, et al. The patient teacher in general practice training: perspectives of residents. J Patient Exp. 2019;6(4):287-95. https://doi.org/10.1177/2374373518803630 DOI: https://doi.org/10.1177/2374373518803630

Barr J, Bull R, Rooney K. Developing a patient focussed professional identity: an exploratory investigation of medical students' encounters with patient partnership in learning. Adv Health Sci Educ Theory Pract. 2015;20(2):325-38. https://doi.org/10.1007/s10459-014-9530-8 DOI: https://doi.org/10.1007/s10459-014-9530-8

Bideau M, Guerne PA, Bianchi MP, Huber P. Benefits of a programme taking advantage of patient-instructors to teach and assess musculoskeletal skills in medical students. Ann Rheum Dis. 2006;65(12):1626-30. https://doi.org/10.1136/ard.2004.031153 DOI: https://doi.org/10.1136/ard.2004.031153

Cumberland DM, Sawning S, Church-Nally M, Shaw MA, Branch E, LaFaver K. Experiential learning: transforming theory into practice through the Parkinson's disease buddy program. Teach Learn Med. 2019;31(4):453-65. https://doi.org/10.1080/10401334.2019.1580583 DOI: https://doi.org/10.1080/10401334.2019.1580583

DeSipio J, Gaughan J, Perlis S, Phadtare S. Use of real patients and patient-simulation-based methodologies for teaching gastroenterology to pre-clinical medical students. Healthcare. 2018;6(2):12. https://doi.org/10.3390/healthcare6020061 DOI: https://doi.org/10.3390/healthcare6020061

Dickinson BL, Lackey W, Sheakley M, Miller L, Jevert S, Shattuck B. Involving a real patient in the design and implementation of case-based learning to engage learners. Adv Physiol Educ. 2018;42(1):118-22. https://doi.org/10.1152/advan.00174.2017 DOI: https://doi.org/10.1152/advan.00174.2017

Duke P, Cohen D, Novack D. Using a geriatric mentoring narrative program to improve medical student attitudes towards the elderly. Educ Gerontol. 2009;35(10):857-66. https://doi.org/10.1080/03601270902782412 DOI: https://doi.org/10.1080/03601270902782412

Fitzpatrick C, Musser A, Mosqueda L, Boker J, Prislin M. Student Senior Partnership Program: University of California Irvine School of Medicine. Gerontol Geriatr Educ. 2006;27(2):25-35. https://doi.org/10.1300/J021v27n02_04 DOI: https://doi.org/10.1300/J021v27n02_04

Frey J, Neeley B, Umer A, et al. Training in Neurology: Neuro Day: An Innovative Curriculum Connecting Medical Students With Patients. Neurology. 2021;96(10):e1482-e6. https://doi.org/10.1212/WNL.0000000000010859 DOI: https://doi.org/10.1212/WNL.0000000000010859

George DR, Stuckey HL, Dillon CF, Whitehead MM. Impact of participation in TimeSlips, a creative group-based storytelling program, on medical student attitudes toward persons with dementia: a qualitative study. Gerontologist. 2011;51(5):699-703. https://doi.org/10.1093/geront/gnr035 DOI: https://doi.org/10.1093/geront/gnr035

Hendriksz T. Using patient perspective sessions to increase empathy and recall in preclinical medical students. J Am Osteopath Assoc. 2016;116(10):662-6. https://doi.org/10.7556/jaoa.2016.130 DOI: https://doi.org/10.7556/jaoa.2016.130

Henriksen AH, Ringsted C. Medical students' learning from patient-led teaching: experiential versus biomedical knowledge. Adv Health Sci Educ Theory Pract. 2014;19(1):7-17. https://doi.org/10.1007/s10459-013-9454-8 DOI: https://doi.org/10.1007/s10459-013-9454-8

Hoffman KG, Gray P, Hosokawa MC, Zweig SC. Evaluating the effectiveness of a senior mentor program: the University of Missouri-Columbia School of Medicine. Gerontol Geriatr Educ. 2006;27(2):37-47. https://doi.org/10.1300/J021v27n02_05 DOI: https://doi.org/10.1300/J021v27n02_05

Jha V, Winterbottom A, Symons J, et al. Patient-led training on patient safety: a pilot study to test the feasibility and acceptability of an educational intervention. Med Teach. 2013;35(9):e1464-71. https://doi.org/10.3109/0142159X.2013.778391 DOI: https://doi.org/10.3109/0142159X.2013.778391

Kangasjarvi E, Ng SL, Friesen F, Simpson JS. Patients as teachers and arts-based reflection in surgical clerkship: a preliminary exploration. Med Teach. 2020;42(12):1362-8. https://doi.org/10.1080/0142159X.2020.1807482 DOI: https://doi.org/10.1080/0142159X.2020.1807482

Owen C, Reay RE. Consumers as tutors - legitimate teachers? BMC Med Educ. 2004;4:14. https://doi.org/10.1186/1472-6920-4-14 DOI: https://doi.org/10.1186/1472-6920-4-14

Player E, Gure-Klinke H, North S, et al. Humanising medicine: teaching on tri-morbidity using expert patient narratives in medical education. Educ Prim Care. 2019;30(6):368-74. https://doi.org/10.1080/14739879.2019.1670097 DOI: https://doi.org/10.1080/14739879.2019.1670097

Shapiro D, Tomasa L, Koff NA. Patients as teachers, medical students as filmmakers: the video slam, a pilot study. Acad Med. 2009;84(9):1235-43. https://doi.org/10.1097/ACM.0b013e3181b18896 DOI: https://doi.org/10.1097/ACM.0b013e3181b18896

Stojan JN, Sun EY, Kumagai AK. Persistent influence of a narrative educational program on physician attitudes regarding patient care. Med Teach. 2018:1-8. https://doi.org/0142159X.2018.1436755 DOI: https://doi.org/10.1080/0142159X.2018.1436755

Coe TM, Chirban AM, McBroom TJ, et al. Virtual student-transplant patient interactions empower patients and enhance student transplantation knowledge. Am J Surg. 2021;222(6):1120-5. https://doi.org/10.1016/j.amjsurg.2021.09.025 DOI: https://doi.org/10.1016/j.amjsurg.2021.09.025

Ivory KD, Luscombe G, Klein LA, Barratt A. "Thank you for giving me a voice!" a longitudinal evaluation of patients' experience of partnering with students in an Australian Medical School. J Med Educ Curric Dev. 2017;4:2382120517692776. https://doi.org/10.1177/2382120517692776 DOI: https://doi.org/10.1177/2382120517692776

Jha V, Buckley H, Gabe R, et al. Patients as teachers: a randomised controlled trial on the use of personal stories of harm to raise awareness of patient safety for doctors in training. BMJ Qual Saf. 2015;24(1):21-30. https://doi.org/10.1136/bmjqs-2014-002987 DOI: https://doi.org/10.1136/bmjqs-2014-002987

Kumagai AK, Murphy EA, Ross PT. Diabetes stories: use of patient narratives of diabetes to teach patient-centered care. Adv Health Sci Educ Theory Pract. 2009;14(3):315-26. https://doi.org/10.1007/s10459-008-9123-5 DOI: https://doi.org/10.1007/s10459-008-9123-5

Harris M, Camenzind A-L, Fankhauser R, Streit S, Hari R. Does a home-based interview with a chronically ill patient help medical students become more patient-centred? A randomised controlled trial. BMC Med Educ. 2020;20(1):217. https://doi.org/10.1186/s12909-020-02136-y DOI: https://doi.org/10.1186/s12909-020-02136-y

Patton MQ. Utilization-focused evaluation. Thousand Oaks: SAGE; 2012.

Guba E, Lincoln Y. Fourth Generation Evaluation. Newbury Park, CA: SAGE; 1989.

Mertens DM. Transformative research and evaluation. New York: Guilford Press; 2009.

Tremblay M-C, Richard L, Brousselle A., Beaudet N. Learning reflexivity from a health promotion professional development program in Canada. Health Promotion International. 2014; 29(3):538-48. DOI: https://doi.org/10.1093/heapro/dat062

Downloads

Published

2023-02-28

How to Cite

1.
Massé J, Beaura S, Tremblay M-C. Fostering the development of non-technical competencies in medical learners through patient engagement: a rapid review. Can. Med. Ed. J [Internet]. 2023 Feb. 28 [cited 2024 Jul. 23];14(4):47-69. Available from: https://journalhosting.ucalgary.ca/index.php/cmej/article/view/73630

Issue

Section

Reviews, Theoretical Papers, and Meta-Analyses