Angela Towle

Framework for teaching and learning informed shared decision making

Patients should be involved in making decisions about their health care. The ethical imperative of autonomy is reflected in legal trends that require a high standard of disclosure for informed consent, amounting to a principle of informed choice.1–3 Outcomes of care and adherence to treatment regimens improve when patients are more involved.4,5 Consumerism is part of the social spirit, and governments exhort citizens to take more responsibility.

Active patient involvement in the education of health professionals

Context  Patients as educators (teaching intimate physical examination) first appeared in the 1960s. Since then, rationales for the active involvement of patients as educators have been well articulated. There is great potential to promote the learning of patient‐centred practice, interprofessional collaboration, community involvement, shared decision making and how to support self‐care.

Putting informed and shared decision making into practice.

Objective  To investigate the practice, experiences and views of motivated and trained family physicians as they attempt to implement informed and shared decision making (ISDM) in routine practice and to identify and understand the barriers they encounter.

Evaluation of the quality of patient information to support informed shared decision-making

Objectives (a) To find out how much patient information material on display in family physicians’ offices refers to management choices, and hence may be useful to support informed and shared decision‐making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians.

Patients as educators: Interprofessional learning for patient-centred care

Background: Patients with chronic conditions have unique expertise that enhances interprofessional education. Although their active involvement in education is increasing, patients have minimal roles in key educational tasks. A model that brings patients and students together for patient-centred learning, with faculty playing a supportive role, has been described in theory but not yet implemented. Aims: To identify issues involved in creating an educational intervention designed and delivered by patients and document outcomes. Method: An advisory group of community members, students and faculty guided development of the intervention (interprofessional workshops). Community educators (CEs) were recruited through community organizations with a healthcare mandate. Workshops were planned by teams of key stakeholders, delivered by CEs, and evaluated by post-workshop student questionnaires. Results: Workshops were delivered by CEs with epilepsy, arthritis, HIV/AIDS and two groups with mental health problems. Roles and responsibilities of planning team members that facilitated control by CEs were identified. Ten workshops attended by 142 students from 15 different disciplines were all highly rated. Workshop objectives defined by CEs and student learning both closely matched dimensions of patient-centredness. Conclusions: Our work demonstrates feasibility and impact of an educational intervention led by patient educators facilitated but not controlled by faculty.

Patient perceptions that limit a community-based intervention to promote participation.

A workshop designed to teach seniors to communicate more effectively with their physicians and enhance patient participation in the consultation was held in a community centre. A grounded theory analysis of follow-up telephone interviews provided examples of effectiveness but also revealed six categories of barriers to changing the pattern of established communication, particularly over the short term.

Developing a medical school: Expansion of medical student capacity in new locations: AMEE Guide No. 55

Background: A concern about an impending shortage of physicians and a worry about the continued maldistribution of physicians to medically underserved areas have encouraged the expansion of medical school training places in many countries, either by the creation of new medical schools or by the creation of regional campuses. Aims: In this Guide, the authors, who have helped create new regional campuses and medical schools in Australia, Canada, UK, USA, and Thailand share their experiences, triumphs, and tribulations, both from the views of the regional campus and from the views of the main Medical School campus. While this Guide is written from the perspective of building new regional campuses of existing medical schools, many of the lessons are applicable to new medical schools in any country of the world. Many countries in all regions of the world are facing rapid expansion of medical training facilities and we hope this Guide provides ideas to all who are contemplating or engaged in expanding medical school training places, no matter where they are. Description: This Guide comprises four sections: planning; getting going; pitfalls to avoid; and maturing and sustaining beyond the first years. While the context of expanding medical schools may vary in terms of infrastructure, resources, and access to technology, many themes, such as developing local support, recruiting local and academic faculty, building relationships, and managing change and conflict in rapidly changing environments are universal themes facing every medical academic development no matter where it is geographically situated. Further information: The full AMEE Guide, printed separately, in addition contains case examples from the authors’ experiences of successes and challenges they have faced.

The patient ' s voice in health and social care professional education: The Vancouver Statement

Purpose – The purpose of this paper is to present a statement about the involvement of patients in the education of health and social care professionals developed at an international conference in November 2015. It aims to describe the current state and identify action items for the next five years. Design/methodology/approach – The paper describes how patient involvement in education has developed as a logical consequence of patient and public participation in health care and health research. It summarizes the current state of patient involvement across the continuum of education and training, including the benefits and barriers. It describes how the conference statement was developed and the outcome. Findings – The conference statement identifies nine priorities for action in the areas of policy, recognition and support, innovation, research and evaluation, and dissemination and knowledge exchange. Originality/value – The conference statement represents the first time that an international and multidisc...

The expert patient as teacher: an interprofessional Health Mentors programme

To meet future health care needs, medical education must increase the emphasis on chronic illness care, interprofessional teamwork, and working in partnership with patients and families. One way to address these needs is to involve patients as teachers in longitudinal interprofessional educational programmes grounded in principles of patient–professional partnerships and shared decision‐making.

A meeting of experts: the emerging roles of non-professionals in the education of health professionals

Most academic programmes that prepare students for the health professions have a long history of involving patients in teaching and learning. Until recently such involvement has been largely passive, but the last 20 years have seen major growth in the number and diversity of educational initiatives in which patients play an active role as educators. This article describes how and why these changes have occurred, identifies some of the challenges of learning from those outside the academy – and professions – and explores some of the questions raised about the nature of ‘professional’ and ‘lay’ knowledge and expertise.