Learning from patients: Understanding student experiences with patient involvement in medical education

Abstract

Moving towards person-centred care requires a solid role for patients in the education of healthcare professionals. Patient involvement is the active involvement and engagement of patients in health professions education. The goal of this dissertation was to better understand how medical students learn from patients. It describes three educational interventions with patients involved, namely a project-based learning course, a patient lecture, and patient feedback. We explored how students learn from patients by building on existing theory and conceptual frameworks from social sciences. Our findings suggest that interaction between students and patients facilitates learning from patients. We identified mechanisms through which students learned from patients and describe how students took patients’ perspectives by combining perspective-taking strategies. Furthermore, we explored students’ perceptions regarding patient feedback. Whereas students had positive perceptions about patient feedback, our results also indicate that patient feedback is not a straightforward means to learn. Students made complex judgments about patients' credibility as feedback providers, critically weighing aspects of patients' perceived trustworthiness, competence, and goodwill. Moreover, a therapeutical alliance between a student and a patient could hinder open feedback conversations. We provide suggestions to support students and patients in the challenging task of learning trough patient feedback. Finally, to bridge the gap between research and educational practice, this dissertation provides practical guidance for patient involvement in health professions education and for receiving feedback.