Utrecht University Medical Center, Utrecht University, Heidelberglaan 100, Huispost Nr. Stratenum 6.131, P.O. Box 85500, Utrecht, GA, 3508, Netherlands.
User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, Niels Bohrs Alle 1, Odense, 5230, Denmark.
BMC Med Educ. 2024 Sep 15;24(1):1008. doi: 10.1186/s12909-024-05987-x.
It has been advocated that the development of medical school curricula must be informed by students, doctors in training, educators, employers, other health and social care professionals and patients, families and carers. Patients are widely employed to teach clinical and interpersonal skills, and while recognised as crucial in health education, they have mostly been offered a passive role. We assessed the impact of patients contributing personal illness narratives in the master curriculum of allied health care professionals on students' learning experiences.
We designed a module (Patient and Society) for a master's degree programme in Health Sciences at the University of Southern Denmark in collaboration with six patients. The patients contributed to the teaching by sharing and discussing their personal illness narrative. At the end of the module, as part of the exam, we asked the students to reflect on the patients' contribution to the module and how this affected their learning experiences. The 500-word exam responses of 29 students were analysed, in collaboration with six patients, using thematic analysis.
Including patients' illness narratives lifted students' academic learning, and their personal and professional development. The stories brought theoretical concepts to life; it helped the students to obtain, retain, and apply academic knowledge. Actively and uninterrupted listening to patients' illness experiences promoted empathy and critical reflection on clinical practice. Faced with the impact of a disease on a person's life, seeing the healthcare system through a patient's lens made students reflect critically on the medical positivist model ruling the health care system focused on just fixing the medical problem with very little room for the illness experience.
Our analyses support previous findings indicating that patient narratives are a powerful tool to achieve academic and professional development. Working with patients in health education has the potential to work towards a more inclusive epistemological stance in the health care system and health research.
医学课程的发展必须以学生、受训医生、教育工作者、雇主、其他卫生和社会保健专业人员以及患者、家属和照护者为依据。患者广泛被用于教授临床和人际交往技能,虽然他们在健康教育中被认为是至关重要的,但他们大多被赋予了被动的角色。我们评估了让患者在辅助医疗保健专业人员的硕士课程中分享个人疾病叙述对学生学习体验的影响。
我们与六名患者合作,为丹麦南部大学的健康科学硕士课程设计了一个模块(患者与社会)。患者通过分享和讨论他们的个人疾病叙述来参与教学。在课程结束时,作为考试的一部分,我们要求学生反思患者对课程的贡献以及这如何影响他们的学习体验。我们与六名患者合作,对 29 名学生的 500 字考试答卷进行了主题分析。
纳入患者的疾病叙述提高了学生的学术学习和个人及专业发展。这些故事使理论概念生动化;它帮助学生获得、保留和应用学术知识。积极而不间断地倾听患者的疾病经历促进了同理心和对临床实践的批判性反思。面对疾病对个人生活的影响,通过患者的视角看待医疗体系,使学生批判性地反思主导医疗体系的医学实证主义模式,该模式仅关注解决医学问题,几乎没有考虑疾病体验。
我们的分析支持了先前的发现,即患者叙述是实现学术和专业发展的有力工具。在健康教育中与患者合作有可能朝着医疗体系和健康研究中更具包容性的认识论立场发展。