"User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users
Open accessAbstract
Despite the General Medical Council emphasising the value of service users to medical students' education, there is scant literature about service user involvement in medical education. Although some research has outlined the effectiveness of service users as teachers, none has explored social issues surrounding how medical students learn 'with' rather than just 'about' service users. Incorporating insights from contemporary socio-cultural learning theory, this study examines the views and experiences of 47 stakeholders (comprising 19 service users, 13 medical students and 15 medical educators) concerning service user involvement in medical education. Eight audiotaped focus group discussions were convened and the audiotapes were transcribed. The transcripts and audiotapes were independently analysed by multiple researchers using Framework analysis. Seven content- and five process-orientated themes emerged from the analysis. Content-related themes included the costs and benefits of service user involvement in medical education and process-related themes included the use and function of humour and metaphor. In this paper, we focus primarily on the content-related themes. We discuss these findings in light of the existing service user involvement literature and contemporary socio-cultural learning theory and provide implications for further research and educational practice. We encourage educators to involve service users in medical education but only in a considered way.
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More generally, patient participation was associated with increased understanding of the importance of communication, building and improving communication skills, empathy, listening skills and respect.
“More generally, patient participation was associated with increased understanding of the importance of communication,27 29 building and improving communication skills,55 71 empathy, listening skills and respect.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Rees et al concluded that this approach helps students to develop a holistic perspective of healthcare.
“Rees et al concluded that this approach helps students to develop a holistic perspective of healthcare.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Experiences with real patient educator encounters could also help in coping with uncertainties, emotions and stress.
“Experiences with real patient educator encounters could also help in coping with uncertainties, emotions and stress.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Students in the study by Rees et al described the encounters with patients as more motivating compared with textbook learning.
“Students in the study by Rees et al described the encounters with patients as more motivating compared with textbook learning.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Students worried about giving incorrect information to patients.
“Students worried about giving incorrect information to patients.”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Some patients felt that they received more time and attention from their healthcare professionals when they were teaching.
“Some patients felt that they received more time and attention from their healthcare professionals when they were teaching.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
In a qualitative study, students felt 'pressured' by service users asking them for information and advice, rather than asking their clinicians, or when service users divulged information to students that they had not told their clinicians.
“In a qualitative study, students felt ‘pressured’ by service users asking them for information and advice, rather than asking their clinicians, or when service users divulged information to students that they had not told their clinicians.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Some faculty educators were concerned that patient stories might be so traumatic that students would require support or debriefings to deal with the resulting emotions.
“Some faculty educators were concerned that patient stories might be so traumatic that students would require support or debriefings to deal with the resulting emotions.66 71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Medical educators suggested that patient involvement was a costly endeavour, both in financial investment as well as staff time.
“Medical educators suggested that patient involvement was a costly endeavour, both in financial investment as well as staff time.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Some patients described it as traumatic for mental health service users to repeatedly tell their stories.
“Some even described it as traumatic for mental health service users to repeatedly tell their stories.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Patients employed terms like 'exposed', 'frightened', 'tired', 'stressed' and 'harrowing' to emphasise service users' feelings within the clinical education environment.
“In addition to the word ‘vulnerable’, patients employed terms like ‘exposed’, ‘frightened’, ‘tired’, ‘stressed’ and ‘harrowing’ to emphasise service users’ feelings within the clinical education environment.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Patients stated that participating in groups gave them support and companionship from their peers.
“Patients stated that participating in groups gave them support and companionship from their peers.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
They did make a decision to include groups of patients to allow multiple voices to be heard in order to prevent criticisms of tokenism.
“They did make a decision to include groups of patients to allow multiple voices to be heard in order to prevent criticisms of tokenism.”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
Some medical educators made the explicit choice not to collaborate with patient organisations, due to a fear of working with politicised groups.
“Some medical educators made the explicit choice not to collaborate with patient organisations, due to a fear of working with politicised groups.71”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [71]
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References 59 · Cited by 99
- Authors
- Rees, C. E., Knight, L. V., & Wilkinson, C. E.
- Affiliations
- University of Exeter (GB)
- University of the West of England (GB)
- Corresponding author
- Rees, C. E.
- Venue
- Advances in Health Sciences Education
- Published
- 2006-07-14
- Volume
- 12
- Issue
- 3
- Pages
- 359-390
- ISSN
- 1382-4996 (ISSN-L)
- 1573-1677
- OpenAlex
- W2081444595
- Cited by
- 99
- References
- 59
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 3 · 2023: 7 · 2022: 6 · 2021: 2 · 2020: 6 · 2019: 5 · 2018: 8 · 2017: 11 · 2016: 9 · 2015: 7 · 2014: 3 · 2013: 8 · 2012: 3
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- green
- eprints.uwe.ac.uk
- Licence
- Locations
- Advances in Health Sciences Education (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion)
- UWE Research Repository (UWE Bristol) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- service user involvement, medical education, medical students, sociocultural theory, stakeholder perspectives
- MeSH terms
- Adult, Aged, Aged, 80 and over, Attitude to Health, Clinical Clerkship, Community Participation, Education, Medical, Faculty, Medical, Female, United Kingdom, Health Policy, Humans, Male, Middle Aged, Preceptorship, Professional-Patient Relations, Psychology, Educational, Social Work, Focus Groups, Qualitative Research, Cultural Competency
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