Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada.
Maple Leaf Medical Clinic, Toronto, Ontario, Canada.
Med Educ. 2018 May;52(5):471-479. doi: 10.1111/medu.13501. Epub 2018 Jan 19.
Patients are increasingly being engaged in providing feedback and consultation to health care institutions, and in the training of health care professionals. Such involvement has the potential to disrupt traditional doctor-patient power dynamics in significant ways that have not been theorised in the medical literature. Critical theories can help us understand how power flows when patients are engaged in the training of medical students.
This paper applies postcolonial theory to the involvement of patients in the development and delivery of medical education. First, I review and summarise the literature around patient involvement in medical education. Subsequently, I highlight how postcolonial frameworks have been applied to medical education more broadly, extrapolating from the literature to apply a postcolonial lens to the area of patient engagement in medical education.
Concepts from postcolonial theory can help medical educators think differently about how patients can be engaged in the medical education project in ways that are meaningful and non-tokenistic. Specifically, the positioning of the patient as 'subaltern' can provide channels of resistance against traditional power asymmetries. This has curricular and methodological implications for medical education research in the area of patient engagement.
患者越来越多地参与到医疗机构的反馈和咨询以及医疗保健专业人员的培训中。这种参与有可能以尚未在医学文献中理论化的方式显著打破传统的医患权力动态。批判理论可以帮助我们理解当患者参与医学生培训时权力是如何流动的。
本文将后殖民理论应用于患者在医学教育的发展和实施中的参与。首先，我回顾并总结了有关患者参与医学教育的文献。随后，我强调了后殖民框架如何更广泛地应用于医学教育，从文献中推断出后殖民视角在患者参与医学教育领域的应用。
后殖民理论的概念可以帮助医学教育工作者以有意义和非象征性的方式思考如何让患者以有意义的方式参与医学教育项目。具体来说，将患者定位为“底层”可以为对抗传统权力不对称提供抵抗的渠道。这对患者参与医学教育领域的医学教育研究具有课程和方法学上的意义。
