J Barr

Developing a patient focussed professional identity: an exploratory investigation of medical students’ encounters with patient partnership in learning

Patient encounters are central to the provision of learning opportunities for medical students and their development as medical professionals. The primary aim of the study reported in this paper was to discover how partnering medical students with patients with chronic illness in undergraduate learning influenced the development of a patient centred professional identity and professionalism. An exploratory interpretive research design was used to address the research aim within a patient partner program (P3). Three qualitative data collection methods were used: (1) focus groups (2) extended response questionnaire and (3) semi-structured interviews. Data were coded and analysed thematically. The professional identity of medical students is constructed along traditional lines in the preclinical years. Patient-partnership offers a disruption to this development by way of an intersection with patients with chronic illness which potentially allows meaningful construction of what a patient-centred identity should be. This point of reflection provides an opportunity to engage at a higher level in medical identity development and professionalism. The findings discussed in this paper further stimulate the patient-centred agenda by understanding the conflict associated with the student–patient nexus in medical education and its potential for building professionalism and a patient-centred professional identity. To continue the drive for a patient-centred professional identity there must be ongoing engagement with patients in medical education, preferably commencing early in a student’s journey so that it becomes the expected norm. This study has highlighted that a true patient-centred emphasis is being encountered too late in their socialisation process.

Committing to patient-centred medical education

Regular encounters of patients and medical students in a managed and structured consultation format, to focus on partnership in health care and chronic illness management, can address the student learning and professional development requirements facing contemporary medical education.

Building the community of patient‐centred care practice across all sectors of health care and health professional education

complications and medication errors. Similar to these two studies, Von Laue et al. describes the majority of adverse events as operative or drug errors. Presumably, nowhere in the literature is misinterpretation of ‘abnormal’ results mentioned as integral to adverse events and medical errors. ‘Incorrect or delayed diagnosis’ and ‘incorrect or delayed therapy’ have been approximated to contribute to 8.1% and 7.5% of medical errors, respectively, but the specifics of these definitions are unclear and poorly defined. Of great concern is that these ill-defined categories (‘Incorrect or delayed diagnosis’ and ‘incorrect or delayed therapy’) are highly preventable and/or associated with negligence (56–94%), and often leave patients with permanent disability (35–47%). Given this enormous burden, more research and education should focus on identifying and reducing mistakes concerning the interpretation of patient data and results. At the very least, high-quality health care is that which does not harm patients, especially through medical errors. On any given day, doctors are incessantly barraged with large quantities of patient data and information. Although most of these results are ‘normal’ and deemed insignificant, a few are flagged as ‘abnormal’ to alert potential deterioration. Reacting hastily to these ‘abnormal’ results without considering the clinical context has enormous potential to harm our patients. To preserve our patients’ health, it is essential that more attention and effort be devoted to treating sick patients than ‘sick’ numbers.