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Cited by 208Innovations in Medical EducationMental Health and Patient InvolvementEmpathy and Medical Education

Role of active patient involvement in undergraduate medical education: a systematic review

Open access
Dijk, Stijntje Willemijn, Duijzer, Edwin Johan, Wienold, Matthias·2020·BMJ Open
DOI 10.1136/bmjopen-2020-037217PMC PMC7389514
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Abstract

Objectives: To identify the scope of active patient involvement in medical education, addressing the current knowledge gaps relating to rationale and motivation for involvement, recruitment and preparation, roles, learning outcomes and key procedural contributors. Methods: The authors performed a systematic search of the PubMed database of publications between 2003 and 2018. Original studies in which patients take on active roles in the development, delivery or evaluation of undergraduate medical education and written in English were eligible for inclusion. Included studies’ references were searched for additional articles. Quality of papers was assessed using the Mixed Methods Appraisal Tool. Results: 49 articles were included in the review. Drivers for patient involvement included policy requirements and patients’ own motivations to contribute to society and learning. Patients were engaged in a variety of educational settings in and outside of the hospital. The vast majority of studies describe patients taking on the role of a patient teacher and formative assessor. More recent studies suggest that patients are increasingly involved in course and curriculum development, student selection and summative assessment. The new body of empirical evidence shows the wide range of learning objectives was pursued through patient participation, including competencies as professional, communicator, collaborator, leader and health advocate, but not scholar. Measures to support sustainable patient involvement included longitudinal institutional incorporation, patient recruitment and/or training, resource support and clear commitment by faculty. The importance and advantages of patient involvement were highlighted by students, faculty and patients themselves; however, organisations must continue to consider, monitor and take steps to mitigate any potential harms to patients and students. Discussion: This systematic review provides new knowledge and practical insights to physicians and faculty on how to incorporate active patient involvement in their institutions and daily practice, and provides suggested action points to patient organisations wishing to engage in medical education.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review synthesizes 49 primary empirical studies on active patient involvement in undergraduate medical education, mapping rationales, recruitment/preparation, roles, learning outcomes, concerns, finances, and sustainability. It finds patients most often serve as teachers and formative assessors, with newer involvement in curriculum development, selection, and summative assessment, while evidence on long-term outcomes and cost-effectiveness remains limited.

Key findings

  • From 769 initial records, 95 were reviewed in full, 11 additional articles were found through references, and 49 studies met inclusion criteria; reviewer consensus was 91.2%.
  • Drivers included policy requirements (e.g., UK Department of Health, UK General Medical Council, Australian Medical Council, WHO) and patients’ motivations to contribute to society and learning; the vast majority of studies described patients as patient teachers and formative assessors, with more recent studies involving them in course/curriculum development, student selection, and summative assessment.
  • Learning objectives spanned CanMEDS roles including professional, communicator, collaborator, leader, health advocate, and medical expert, but no paper explicitly described developing the scholar role.
  • Sustainability measures included longitudinal institutional incorporation, patient recruitment and/or training, resource support, and clear faculty commitment; financial reporting was limited, with examples such as $800 for a disability skills workshop, £800 for physical examination training, £2640 for the overall Patient Partners programme, and honoraria from €8 per hour to £350 per day, but no cost-effectiveness or cost-benefit analysis.

Methods

  • Systematic review with a PubMed search on 12 July 2018 for English-language original empirical studies published between 1 January 2003 and 12 July 2018 addressing active patient participation in undergraduate medical education; simulated patients/actors, patients solely undergoing examinations, and patients only observed in wards were excluded.
  • Title/abstract screening followed by full-text review, reference searching of included articles and relevant reviews, and inclusion of 49 studies; quality was assessed with the Mixed Methods Appraisal Tool, and studies were not excluded based on methodological quality.
  • Data were extracted using a prepiloted standardized form, checked by a second author, and synthesized thematically; intended learning outcomes were categorized using the CanMEDS framework.

Limitations

  • Stated: lack of common terminology risked missing relevant articles; only original peer-reviewed English-language literature was included, so patient-authored grey literature such as blogs, conference statements, and patient organization newsletters may have been missed; most included papers were from North America (n=23), Europe (n=17), and Australia/New Zealand (n=7).
  • Stated: most included studies were qualitative, few used control groups (n=7), participation was often voluntary, and many studies could not be anonymized or were part of student assessments, introducing possible social desirability bias; no paper performed an economic evaluation, and long-term effects for patients, students, and the healthcare system remain under-researched.
  • Evident from the text: financial data were not reported in a systematically comparable way, and the predominance of qualitative/observational designs with few controls limits causal conclusions about patient involvement’s effects.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1136/bmjopen-2020-037217

Cites

63 of 63 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 224 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    More recent studies suggest that patients are increasingly involved in course and curriculum development, student selection and summative assessment.

    “More recent studies suggest that patients are increasingly involved in course and curriculum development, student selection and summative assessment.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The vast majority of studies describe patients taking on the role of a patient teacher and formative assessor.

    “The vast majority of studies describe patients taking on the role of a patient teacher and formative assessor.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Patients were engaged in a variety of educational settings in and outside of the hospital.

    “Patients were engaged in a variety of educational settings in and outside of the hospital.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The importance and advantages of patient involvement were highlighted by students, faculty and patients themselves.

    “The importance and advantages of patient involvement were highlighted by students, faculty and patients themselves; however, organisations must continue to consider, monitor and take steps to mitigate any potential harms to patients and students.”
    • Also stated in: § Levels of patient involvement in medical education as defined by Towle et al2 · plain
      “The importance and advantages of patient involvement were highlighted by students, faculty and patients themselves; however, organisations must continue to consider, monitor and take steps to mitigate any potential harms to patients and students.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Several authors referred to government policy mandating patient participation in medical education, namely the UK Department of Health and the UK General Medical Council, the Australian Medical Council and the WHO as a rationale for their patient involvement initiatives.

    “Several authors referred to government policy mandating patient participation in medical education, namely the UK Department of Health and the UK General Medical Council,16 23 24 the Australian Medical Council25 and the WHO5 as a rationale for their patient involvement initiatives.”
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    • cites 16 23 24

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    • cites [25] Australian Medical Council . Assessment and accreditation of medical schools. Standards and procedures, 2002.

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    • cites [5] Boelen C , Heck JE , World Health O . Defining and measuring the social accountability of medical schools. Geneva: World Health Organization, 1995.

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  • May combine two claims. 61
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    The new body of empirical evidence shows the wide range of learning objectives was pursued through patient participation, including competencies as professional, communicator, collaborator, leader and health advocate, but not scholar.

    “The new body of empirical evidence shows the wide range of learning objectives was pursued through patient participation, including competencies as professional, communicator, collaborator, leader and health advocate, but not scholar.”
    Quote in the paperSubstantial claim

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    Drivers for patient involvement included policy requirements and patients' own motivations to contribute to society and learning.

    “Drivers for patient involvement included policy requirements and patients’ own motivations to contribute to society and learning.”
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    49 articles were included in the review.

    “49 articles were included in the review.”
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    Measures to support sustainable patient involvement included longitudinal institutional incorporation, patient recruitment and/or training, resource support and clear commitment by faculty.

    “Measures to support sustainable patient involvement included longitudinal institutional incorporation, patient recruitment and/or training, resource support and clear commitment by faculty.”
    • Also stated in: § Levels of patient involvement in medical education as defined by Towle et al2 · plain
      “Measures to support sustainable patient involvement included longitudinal institutional incorporation, patient recruitment and/or training, resource support and clear commitment by faculty.”
    Quote in the paperSubstantial claim

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    Cited rationale was to create a multicultural learning environment.

    “to create a multicultural learning environment;”
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    The review of references resulted in 11 additional articles for inclusion.

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    Cited rationale was to practise social accountability and an inclusion agenda.

    “to practise social accountability and an inclusion agenda32–37;”
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    • cites [32] Stagg, 2012, Why community members want to participate in the selection of students into medical school, Rural Remote Health

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    • cites [33] Hudson, 2014, Faculty analysis of distributed medical education in northern Canadian Aboriginal communities, Rural Remote Health

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    • cites [34] Nestel, 2014, Community perceptions of a rural medical school: a pilot qualitative study, Adv Med Educ Pract source

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    • cites [35] Fritz, 2015, Are we missing the mark? the implementation of community based participatory education in cancer disparities curriculum development, J Racial Ethn Health Disparities source

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    • cites [36] Noonan, 2018, Engaging the transgender community to improve medical education and prioritize healthcare initiatives, Teach Learn Med source

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    • cites [37] Kamaka, 2010, Designing a cultural competency curriculum: asking the stakeholders, Hawaii Med J

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    Cited rationale was to introduce students to chronic illness care.

    “to introduce students to chronic illness care29–31;”
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    • cites [29] Towle, 2014, The expert patient as teacher: an interprofessional health mentors programme, Clin Teach source

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    • cites [30] Ivory, 2013, A clinical approach to population medicine, Clin Teach source

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    The initial search resulted in 769 articles.

    “The initial search resulted in 769 articles, of which 95 were selected for further review based on the title and/or abstract.”
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    Of 769 articles, 95 were selected for further review based on title and/or abstract.

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    Main reasons for exclusion were wrong article type (conference abstracts or commentaries) and studies that did not concern active participation of patients.

    “Main reasons for exclusion where wrong article type (conference abstracts or commentaries) and studies that did not concern active participation of patients.”
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    The most frequently reported methods to recruit patients were through existing university partnerships and existing programmes, advertisements through press or social media or posted in health facilities, through community and patient organisations, through personal connections and previous participants, and through health professionals.

    “The most frequently reported methods to recruit patients were through existing university partnerships and existing programmes,28 33 41–46 advertisements through press or social media or posted in health facilities,26 34–36 47 48 through community and patient organisations, through personal connections and previous participants,32 38 49–51 and through health professionals.52–55”
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    General criteria for patient educators included good communication skills, affinity for teaching, aptitude for further learning, enthusiasm, time to commit to the study, as well as being fully mobile and being able to cope with repeated physical examinations.

    “General criteria for patient educators included good communication skills, affinity for teaching, aptitude for further learning, enthusiasm, time to commit to the study, as well as being fully mobile and being able to cope with repeated physical examinations.48 54 56”
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    Selection criteria were generally set up broadly, inviting any patient or community member.

    “Selection criteria were generally set up broadly, inviting any patient or community member.”
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    Cited rationale was to empower patients.

    “and to empower patients.39”
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    • cites [39] Muir, 2012, Experts by experience; the views of service user educators providing feedback on medical students' work based assessments, Nurse Educ Today source

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    Training programmes for patients in teaching musculoskeletal (MSK) skills were the most extensive and were delivered by medical or educational experts.

    “Training programmes for patients in teaching musculoskeletal (MSK) skills were the most extensive and were delivered by medical or educational experts.42 47 54 56 58 59”
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    One study underscored the importance of patient educators being aware of the course goals in order to safeguard student learning outcomes.

    “One study underscored the importance of patient educators being aware of the course goals in order to safeguard student learning outcomes.53”
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    Patients mentioned that they felt a sense of responsibility to the broader community in shaping the future health workforce and improving the healthcare system.

    “Patients mentioned that they felt a sense of responsibility to the broader community in shaping the future health workforce24 32 and improving the healthcare system.24 33 40”
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    Cited rationale was to make education more engaging, powerful and transformative.

    “to make education more engaging, powerful and transformative38;”
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    • cites [38] Cheng, 2017, How patient educators help students to learn: an exploratory study, Med Teach source

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    In some cases patients were required to have representative physical signs of their disease.

    “In some cases patients were required to have representative physical signs of their disease.53 54 56 57”
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    In one project, where students shadowed a patient with a chronic condition, students were asked to recruit patients themselves.

    “In one project, where students shadowed a patient with a chronic condition, students were asked to recruit patients themselves.30”
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    • cites [30] Ivory, 2013, A clinical approach to population medicine, Clin Teach source

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    Another article described that the collaboration between patients and educators allows for mutual learning without an authentic patient perspective being lost.

    “Another article described that the collaboration between patients and educators allows for mutual learning without an authentic patient perspective being lost.39”
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    • cites [39] Muir, 2012, Experts by experience; the views of service user educators providing feedback on medical students' work based assessments, Nurse Educ Today source

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    Another article describes the use of a post-training satisfaction questionnaire to help ensure that patient educators felt ready to teach.

    “Another article describes the use of a post-training satisfaction questionnaire to help ensure that patient educators felt ready to teach.47”
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    In addition to clinical skills, patients taught students about their experiences of overall management of care, and the personal aspects of their lives.

    “In addition to clinical skills, patients taught students about their experiences of overall management of care, and the personal aspects of their lives.”
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    Others mentioned aiming to serve the needs of patients in building their confidence, providing skills training and providing knowledge related to the educational process.

    “Others mentioned aiming to serve the needs of patients in building their confidence, providing skills training57 and providing knowledge related to the educational process.23 39 48 60”
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    • cites [57] Jain, 2013, Patients with disabilities as teachers, Fam Med

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    They were trained to teach students skills and deliver immediate feedback, which stimulated further learning.

    “They were trained to teach students skills and deliver immediate feedback, which stimulated further learning.56”
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    They highlight the critical role of the community organisation representatives who can be brokers between the two cultures of academia and community.

    “They highlight the critical role of the community organisation representatives who can be brokers between the two cultures of academia and community.”
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    • cites [49] Towle, 2013, Patients as educators: interprofessional learning for patient-centred care, Med Teach source

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    Patient teachers with chronic conditions acted as mentors, and met regularly with students.

    “Patient teachers with chronic conditions acted as mentors, and met regularly with students.27 29”
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    These sessions addressed approaches such as problem-based learning, how to deliver a presentation, cofacilitation methods and how to provide effective feedback.

    “These sessions addressed approaches such as problem-based learning, how to deliver a presentation, cofacilitation methods and how to provide effective feedback.”
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    Teaching was done through panel discussions and small group sessions as well as visits to the community and patients' homes.

    “Teaching was done through panel discussions and small group sessions24 43 63 as well as visits to the community and patients’ homes.31 52”
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    One article mentions finishing the preparation of patient educators with a short quiz as an assessment tool and having a graduation session before starting to teach.

    “One article mentions finishing the preparation of patient educators with a short quiz as an assessment tool and having a graduation session before starting to teach.28”
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    • cites [28] Owen, 2004, Consumers as tutors - legitimate teachers?, BMC Med Educ source

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    One article describes an intervention in which the patient educators explicitly have not received training, so the student-patient encounters would be as authentic as possible.

    “One article describes an intervention in which the patient educators explicitly have not received training, so the student–patient encounters would be as authentic as possible.53”
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    Patients taught students patient-centredness and interprofessionalism, community-centredness, cultural competence and ethics.

    “Patients taught students patient-centredness and interprofessionalism,23 24 31 38 49 community-centredness, cultural competence and ethics.33 64”
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    Towle et al discussed the tension between preparedness of patient educators and authenticity of education in both form and content.

    “Towle et al discussed the tension between preparedness of patient educators and authenticity of education in both form and content.49”
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    • cites [49] Towle, 2013, Patients as educators: interprofessional learning for patient-centred care, Med Teach source

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    Several patients were members of the steering committee for the psychiatry curriculum and the interprofessional education curriculum.

    “Several patients were members of the steering committee for the psychiatry curriculum28 and the interprofessional education curriculum.49”
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    • cites [49] Towle, 2013, Patients as educators: interprofessional learning for patient-centred care, Med Teach source

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    While they were not seen as medical experts, they did have an interest in ensuring optimal healthcare for themselves and their families.

    “While they were not seen as medical experts, they did have an interest in ensuring optimal healthcare for themselves and their families.26”
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    • cites [26] O'Keefe, 2007, Promoting lay participation in medical school curriculum development: lay and faculty perceptions, Med Educ source

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    Medical educators interviewed by Jha et al believed there was a role for patients in assessing whether students made them feel at ease and whether students asked the right questions.

    “Medical educators interviewed by Jha et al believed there was a role for patients in assessing whether students made them feel at ease and whether students asked the right questions.66”
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    A world café discussion was similarly held to inform the curriculum on transgender health.

    “A world café discussion was similarly held to inform the curriculum on transgender health.36”
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    • cites [36] Noonan, 2018, Engaging the transgender community to improve medical education and prioritize healthcare initiatives, Teach Learn Med source

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    While patients and medical educators in the study by Raj et al praised patients' assessments, students expressed their concerns whether patients could reliably assess clinical skills or whether they were likely to be too lenient.

    “While patients and medical educators in the study by Raj et al54 praised patients’ assessments, students expressed their concerns whether patients could reliably assess clinical skills or whether they were likely to be too lenient.54”
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    Patients also provided written feedback to student essays, which were used for formal assessment.

    “Patients also provided written feedback to student essays, which were used for formal assessment.39”
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    • cites [39] Muir, 2012, Experts by experience; the views of service user educators providing feedback on medical students' work based assessments, Nurse Educ Today source

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    Some faculty members expressed their experiences of working with patient assessors and course developers as tokenistic.

    “Some faculty members expressed their experiences of working with patient assessors and course developers as tokenistic.66”
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    Workshops were led by patient teachers and facilitated, but not controlled, by faculty.

    “Workshops were led by patient teachers and facilitated, but not controlled, by faculty.”
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    Patient teachers stated that programme support was essential for participation, allowing them to transform from teaching individual messages to teaching universal lessons.

    “Patient teachers stated that programme support was essential for participation, allowing them to transform from teaching individual messages to teaching universal lessons.43”
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    • cites [43] Hatem, 2003, Challenges and opportunities for patients with HIV who educate health professionals, Teach Learn Med source

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    Lay participants of one study regarded sharing of curriculum ownership as necessary to acknowledge the importance of lay perspectives, whereas faculty participants presumed ownership of curriculum development.

    “Lay participants of one study regarded sharing of curriculum ownership as necessary to acknowledge the importance of lay perspectives, whereas faculty participants presumed ownership of curriculum development.26”
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    • cites [26] O'Keefe, 2007, Promoting lay participation in medical school curriculum development: lay and faculty perceptions, Med Educ source

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    Faculty was not always present in meetings but could provide background support, such as setting broad topics for discussions.

    “Faculty was not always present in meetings but could provide background support, such as setting broad topics for discussions.46”
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    • cites [46] Baral, 2016, Development of community based learning and education system within undergraduate medical curriculum of Patan Academy of health sciences, J Nepal Health Res Counc

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    Students regarded real patients as more authentic and the encounters more useful in practising physical examination.

    “Students regarded real patients as more authentic and the encounters more useful in practising physical examination.”
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    • cites [53] source

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    Faculty in the study by Jha et al were not clear on how to involve patients more fully in assessments or course development, nor were they convinced of the appropriateness of doing so.

    “Faculty in the study by Jha et al were not clear on how to involve patients more fully in assessments or course development, nor were they convinced of the appropriateness of doing so.”
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    Reflecting on role models some authors referred to broadening understanding of the role of the healthcare provider, qualities of remarkable clinicians that inform personal ideals, creating a future professional model and professional identity.

    “Reflecting on role models some authors referred to broadening understanding of the role of the healthcare provider,27 qualities of remarkable clinicians that inform personal ideals,64 creating a future professional model55 and professional identity.71”
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    • cites [27] Collins, 2011, Transforming chronic illness care education: a longitudinal interprofessional mentorship curriculum, J Interprof Care source

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    • cites [64] Langlois, 2016, Learning professional ethics: student experiences in a health mentor program, Educ Health source

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    • cites [55] source

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    Various qualitative studies suggested that patient involvement can attribute to dealing with ethical complexity in clinical practice and patients' perspectives on clinician error and developing reflective skills.

    “Various qualitative studies suggested that patient involvement can attribute to dealing with ethical complexity in clinical practice and patients’ perspectives on clinician error64 and developing reflective skills.29 48 55”
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    • cites [64] Langlois, 2016, Learning professional ethics: student experiences in a health mentor program, Educ Health source

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    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”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Jha et al pointed out that active patient involvement by itself demonstrates an equal partnership.

    “Jha et al pointed out that active patient involvement by itself demonstrates an equal partnership66”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Patient-centredness included the ability to see patient mentors as individuals, the importance of patient autonomy and expertise in care, adopting a non-patronising and non-judgemental attitude, recognising patients' needs and seeing the patient as a capable part of the team.

    “Patient-centredness included the ability to see patient mentors as individuals,27 the importance of patient autonomy and expertise in care,64 adopting a non-patronising and non-judgemental attitude,55 recognising patients’ needs41 and seeing the patient as a capable part of the team.41”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [27] Collins, 2011, Transforming chronic illness care education: a longitudinal interprofessional mentorship curriculum, J Interprof Care source

      Not checked in the free run.

    • cites [64] Langlois, 2016, Learning professional ethics: student experiences in a health mentor program, Educ Health source

      Not checked in the free run.

    • cites [55] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    McKinlay et al described an education programme in which students undertake a home visit to a patient with a chronic condition, where students demonstrated increased understanding of interdisciplinary teams in management of chronic conditions in their reflective assays.

    “McKinlay et al described an education programme in which students undertake a home visit to a patient with a chronic condition,31 where students demonstrated increased understanding of interdisciplinary teams in management of chronic conditions in their reflective assays.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    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”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites 27 29

      Not checked in the free run.

    • cites 55 71

      Not checked in the free run.

    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Students in intervention studies with patient teachers living with physical or mental disabilities demonstrated an improved attitude, increased levels of comfort in communication, increased levels of self-efficacy and confidence, and higher mean performance scores across all interview stations when compared with a control group.

    “Similarly, students in intervention studies with patient teachers living with physical or mental disabilities demonstrated an improved attitude,28 increased levels of comfort in communication,57 increased levels of self-efficacy and confidence,63 65 and higher mean performance scores across all interview stations when compared with a control group.65”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [28] Owen, 2004, Consumers as tutors - legitimate teachers?, BMC Med Educ source

      Not checked in the free run.

    • cites [57] Jain, 2013, Patients with disabilities as teachers, Fam Med

      Not checked in the free run.

    • cites 63 65

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Students worried about giving incorrect information to patients.

    “Students worried about giving incorrect information to patients.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Hatem et al reported that patients had increased knowledge of their medical condition as a practical benefit.

    “and increased knowledge of their medical condition.43”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Hatem, 2003, Challenges and opportunities for patients with HIV who educate health professionals, Teach Learn Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Patients described fulfilling their responsibility to the broader community.

    “fulfilling their responsibility to the broader community24 32”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [24] Doucet S , Lauckner H , Wells S . Patients’ messages as educators in an interprofessional health education program. J Res Interprof Pract Educ 2013;3.doi:10.22230/jripe.2013v3n1a98 source

      Not checked in the free run.

    • cites [32] Stagg, 2012, Why community members want to participate in the selection of students into medical school, Rural Remote Health

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Patient educators with back pain involved in teaching medical students stated their participation improved the management of their own back pain.

    “Patient educators with back pain involved in teaching medical students stated their participation improved the management of their own back pain, and improved confidence in voicing their needs in consultations with physicians.47”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Students in the study by Henriksen and Ringsted expressed concerns about unstructured experiential learning in a context where patients had autonomy in both planning and delivering the teaching encounter.

    “expressed concerns about unstructured experiential learning in a context where patients had autonomy in both planning and delivering the teaching encounter.67”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Henriksen, 2014, Medical students' learning from patient-led teaching: experiential versus biomedical knowledge, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Patients described receiving tangible rewards such as gifts as a material benefit.

    “Material benefits included receiving tangible rewards such as gifts43”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Hatem, 2003, Challenges and opportunities for patients with HIV who educate health professionals, Teach Learn Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    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”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [66] source

      Not checked in the free run.

    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Students in the study by Henriksen and Ringsted expressed scepticism about patients' knowledge.

    “Students in the study by Henriksen and Ringsted67 expressed scepticism about patients’ knowledge67”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Henriksen, 2014, Medical students' learning from patient-led teaching: experiential versus biomedical knowledge, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Patients described that they were teaching patient-centredness.

    “because they were teaching patient-centredness,24 72”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [24] Doucet S , Lauckner H , Wells S . Patients’ messages as educators in an interprofessional health education program. J Res Interprof Pract Educ 2013;3.doi:10.22230/jripe.2013v3n1a98 source

      Not checked in the free run.

    • cites [72] Lucas, 2012, Patient perceptions of their role in undergraduate medical education within a primary care teaching practice, Educ Prim Care source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Patients drew attention to the fact that unanticipated disease progression had an impact on their ability to teach.

    “Patients also drew attention to the fact that unanticipated disease progression had an impact on their ability to teach.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    In some cases, unanticipated disease progression resulted in patients pulling out of their commitment as teachers, an inevitable loss among patient educators.

    “In some cases, this resulted in them pulling out of their commitment as teachers, an inevitable loss among patient educators.43”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Hatem, 2003, Challenges and opportunities for patients with HIV who educate health professionals, Teach Learn Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    A patient educator teaching on the subject of HIV described the experience of being very frustrated with one man's lack of knowledge and ignorance about the disease.

    “A patient educator teaching on the subject of HIV, for example, described the experience of being very frustrated with one man’s lack of knowledge and ignorance about the disease.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    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”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    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”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Patients described bolstering students' confidence.

    “bolstering students’ confidence,72”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [72] Lucas, 2012, Patient perceptions of their role in undergraduate medical education within a primary care teaching practice, Educ Prim Care source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Students were concerned that patients might have difficulty discriminating between poor and good performance, and are likely to be too lenient in feedback or assessment.

    “Students were also concerned that patients might have difficulty discriminating between poor and good performance, and are likely to be too lenient in feedback or assessment.54”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Students expressed reservations that they were only getting the view of one person, which could lead to a biased perspective.

    “Students expressed reservations that they were only getting the view of one person, which could lead to a biased perspective.23”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The drawbacks and risks associated with patient involvement in medical education included being confronted with stigmatising assumptions, vulnerability of self-disclosure and spontaneous question-answer exchanges.

    “The drawbacks and risks associated with patient involvement in medical education included being confronted with stigmatising assumptions, vulnerability of self-disclosure and spontaneous question-answer exchanges.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Staff members expressed the concern that the impact of the patient experience might be reduced if the same patient was involved in the same programme too often.

    “In a different study, staff members expressed the concern that the impact of the patient experience might be reduced if the same patient was involved in the same programme too often.66”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Jha et al described the patient as providing an illustration of the theory in practice, thus enhancing students' understanding and recall.

    “Jha et al described the patient as providing an illustration of the theory in practice, thus enhancing students’ understanding and recall.66”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Hatem et al reported that patients got better at finding healthcare providers as a practical benefit.

    “Hatem et al reported practical benefits for patients including getting better at finding healthcare providers and increased knowledge of their medical condition.43”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Hatem, 2003, Challenges and opportunities for patients with HIV who educate health professionals, Teach Learn Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Patient educators with back pain involved in teaching medical students stated their participation improved their confidence in voicing their needs in consultations with physicians.

    “and improved confidence in voicing their needs in consultations with physicians.47”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Patients described professional growth and personal fulfilment from being involved in the selection process of students.

    “Patients described professional growth and personal fulfilment from being involved in the selection process of students.32”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Stagg, 2012, Why community members want to participate in the selection of students into medical school, Rural Remote Health

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Patients described receiving a full medical check-up as a material benefit.

    “and receiving a full medical check-up.40”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Lauckner, 2012, Patients as educators: the challenges and benefits of sharing experiences with students, Med Educ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Patients described improving the healthcare system.

    “and improving the healthcare system.24 33 40”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [24] Doucet S , Lauckner H , Wells S . Patients’ messages as educators in an interprofessional health education program. J Res Interprof Pract Educ 2013;3.doi:10.22230/jripe.2013v3n1a98 source

      Not checked in the free run.

    • cites [33] Hudson, 2014, Faculty analysis of distributed medical education in northern Canadian Aboriginal communities, Rural Remote Health

      Not checked in the free run.

    • cites [40] Lauckner, 2012, Patients as educators: the challenges and benefits of sharing experiences with students, Med Educ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Some staff feared that cash patients needed to spend on refreshments or public transport would be a barrier for their participation.

    “Some staff feared that cash patients needed to spend on refreshments or public transport would be a barrier for their participation.73”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [73] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Reported financial cost of £2640 for the overall Patient Partners programme.

    “and £2640 for the overall Patient Partners programme.47”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Half of the patients involved in the community-based intervention in a socioeconomic-deprived area expressed feelings of anxiety, apprehension or nervousness prior to the interview, although in all cases patients felt that this was normal.

    “Half of the patients involved in the community-based intervention in a socioeconomic-deprived area expressed feelings of anxiety, apprehension or nervousness prior to the interview, although in all cases patients felt that this was normal.52”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [52] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    In the paper by Baral et al, representatives from rural communities and consumer groups were consulted by the medical school steering committee for the development of the Academy of Health Sciences curriculum.

    “In the paper by Baral et al, representatives from rural communities and consumer groups were consulted by the medical school steering committee for the development of the Academy of Health Sciences curriculum.45”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] Baral, 2016, Rural community as context and teacher for health professions education, Cureus

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    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”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The University of Leeds worked with a dedicated internal patient group named 'The Patient Voice Group', consisting of lay people who use their experiences to inform their roles as teachers and researchers.

    “The University of Leeds worked with a dedicated internal patient group named ‘The Patient Voice Group’, consisting of lay people who use their experiences to inform their roles as teachers and researchers.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Muir, 2012, Experts by experience; the views of service user educators providing feedback on medical students' work based assessments, Nurse Educ Today source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Reported financial cost of £800 for a physical examination training.

    “£800 for a physical examination training54”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Reported financial cost of $800 for a disability skills workshop.

    “Reported financial costs included $800 for a disability skills workshop,63”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] Saketkoo, 2004, Effects of a disability awareness and skills training workshop on senior medical students as assessed with self ratings and performance on a standardized patient case, Teach Learn Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Initially, mentors were commonly anxious and unsure about whether what they shared was of benefit to students.

    “Initially, mentors were commonly anxious and unsure about whether what they shared was of benefit to students.29”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Towle, 2014, The expert patient as teacher: an interprofessional health mentors programme, Clin Teach source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    That article did not provide an economic evaluation.

    “but did not provide an economic evaluation.54”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    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”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    Not all of these representatives of patient organisations were patients themselves.

    “Not all of these representatives of patient organisations were patients themselves.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    That article noted that patient-led teaching is a cost-effective method compared with physician-led teaching.

    “noting that patient-led teaching is a cost-effective method compared with physician-led teaching”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    They were described as brokers between two cultures of academia and community.

    “They were described as brokers between two cultures of academia and community.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    The majority of included studies were qualitative (n=38), others were mixed methods (n=5) or qualitative (n=6).

    “The majority of included studies were qualitative (n=38), others were mixed methods (n=5) or qualitative (n=6).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    A patient and public involvement manager who provided ongoing support was assigned within the school.

    “Additionally, a patient and public involvement manager who provided ongoing support was assigned within the school.39”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Muir, 2012, Experts by experience; the views of service user educators providing feedback on medical students' work based assessments, Nurse Educ Today source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The majority of included papers were from North America (n=23), Europe (n=17) and Australia and New Zealand (n=7).

    “The majority of included papers were from North America (n=23), Europe (n=17) and Australia and New Zealand (n=7).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing). May combine two claims.

    Findingcitation

    Medical educators commented that if patient educators were paid and seen as an employee of the medical school, they might take on the role more seriously and become more reliable, as well as being seen as a respected part of the educational team.

    “Medical educators commented that if patient educators were paid and seen as an employee of the medical school, they might take on the role more seriously and become more reliable, as well as being seen as a respected part of the educational team.66”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In another role, patients were consulted in institution-level topics and curriculum development beyond specific courses, but rather than being equal partners, they were consulted in a faculty-driven initiative, displaying partial elements of Towle's levels 4, 5 and 6.

    “In another role, patients were consulted in institution-level topics and curriculum development beyond specific courses, but rather than being equal partners, they were consulted in a faculty-driven initiative, displaying partial elements of Towle’s levels 4, 5 and 6.2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    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.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Included papers described various types of roles for patients, but the vast majority of papers cited the role of a patient teacher, similarly to previous reviews.

    “Included papers described various types of roles for patients, but the vast majority of papers cited the role of a patient teacher, similarly to previous reviews.1 17–19”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [1] source

      Not checked in the free run.

    • cites [17] Jha, 2010, Patient involvement in teaching and assessing intimate examination skills: a systematic review, Med Educ source

      Not checked in the free run.

    • cites [18] source

      Not checked in the free run.

    • cites [19] Gordon, 2020, Patient/service user involvement in medical education: a best evidence medical education (BEME) systematic review: BEME guide No. 58, Med Teach source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The institution appointed a patient and public involvement manager to provide ongoing support.

    “The institution appointed a patient and public involvement manager to provide ongoing support.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Muir, 2012, Experts by experience; the views of service user educators providing feedback on medical students' work based assessments, Nurse Educ Today source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    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”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Rees, 2007, "User involvement is a sine qua non, almost, in medical education": learning with rather than just about health and social care service users, Adv Health Sci Educ Theory Pract source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Some initiatives chose to work in partnership with existing institutions, implemented at a school-wide level or focused on one condition such as arthritis.

    “Some initiatives chose to work in partnership with existing institutions, implemented at a school-wide level45 or focused on one condition such as arthritis.58”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [45] Baral, 2016, Rural community as context and teacher for health professions education, Cureus

      Not checked in the free run.

    • cites [58] Oswald, 2011, Musculoskeletal examination teaching by patients versus physicians: how are they different? neither better nor worse, but complementary, Med Teach source

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    In one role, patients did take on roles as equal in curriculum development, but only to specific courses rather than the curriculum as a whole, falling between Towle's levels 4 and 5.

    “In one role, patients did take on roles as equal in curriculum development, but only to specific courses rather than the curriculum as a whole, falling between Towle’s levels 4 and 5.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    More recent papers suggest that patients are increasingly involved in curriculum development.

    “More recent papers suggest that patients are increasingly involved in curriculum development.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Most of these initiatives were incidental and were lacking institutional incorporation and longitudinal involvement.

    “Most of these initiatives were incidental and were lacking institutional incorporation and longitudinal involvement.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Gaver et al identified the process of establishing commitment among volunteering organisations and families as a key challenge to the sustainability of patient involvement.

    “Gaver et al55 identified the process of establishing commitment among volunteering organisations and families as a key challenge to the sustainability of patient involvement.55”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [55] source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The key factors identified in sustaining patient involvement were the provision of adequate resource support, formal acknowledgement of the value of lay contributions and a clear faculty commitment to change following lay input.

    “The key factors identified in sustaining patient involvement were the provision of adequate resource support, formal acknowledgement of the value of lay contributions and a clear faculty commitment to change following lay input.26”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] O'Keefe, 2007, Promoting lay participation in medical school curriculum development: lay and faculty perceptions, Med Educ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    It has been over 40 years since the first article on patient involvement in medical education was published.

    “It has been over 40 years since the first article on patient involvement in medical education was published.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Findingreasoning

    This gap in research limits recommendations that can be made based on current literature.

    “This gap in research limits recommendations that can be made based on current literature.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    No paper performed an economic evaluation of patient involvement, which may be a critical factor for decision makers in educational policy.

    “Additionally, no paper performed an economic evaluation of patient involvement, which may be a critical factor for decision makers in educational policy.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    As many articles written by patients on their experiences in involvement in medical education may only be found in grey literature, including blog posts, conference statements and patient organisation newsletters, this review may have missed their viewpoints.

    “As many articles written by patients on their experiences in involvement in medical education may only be found in grey literature, including blog posts, conference statements and patient organisation newsletters, this review may have missed their viewpoints.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    This systematic review is the first of its kind focused specifically on undergraduate medical education.

    “This systematic review is the first of its kind focused specifically on undergraduate medical education, providing practical guidance to educators, students and patients with ambition to improve work in healthcare professionals’ education.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In recent decades, the involvement of patients in medical education has been advocated for increasingly and has become common practice adopted by reformers of medical education.

    “In recent decades, the involvement of patients in medical education has been advocated for increasingly and has become common practice adopted by reformers of medical education.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Premisecitation

    Despite an increasingly collaborative role of patients in medical education, there is much to be learnt about how to embed it, and how to develop systematic, institution-wide approaches to planning patient involvement in all levels of medical education.

    “Despite an increasingly collaborative role of patients in medical education, there is much to be learnt about how to embed it, and how to develop systematic, institution-wide approaches to planning patient involvement in all levels of medical education.3 7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 3 7

      Not checked in the free run.

    • Rests on an assumption: Previous studies have identified major gaps in the knowledge base relating to short and long-term learning outcomes, ethical issues, psychological impact and key procedural contributors like recruitment, selection and preparation.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    The drive towards a more equal partnership in clinical decision-making and patient-centred care, fuelled by national and international guidelines, promotes the expansion of the efforts towards developing a culture where partnership in medical education becomes the norm.

    “The drive towards a more equal partnership in clinical decision-making and patient-centred care, fuelled by national and international guidelines, promotes the expansion of the efforts towards developing a culture where partnership in medical education becomes the norm.3 5–15”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 3 5–15

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    A recent systematic review provided a comprehensive overview of the involvement, outcome and reason behind involvement mainly from learner's perspective.

    “A recent systematic review provided a comprehensive overview of the involvement, outcome and reason behind involvement mainly from learner’s perspective.19”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] Gordon, 2020, Patient/service user involvement in medical education: a best evidence medical education (BEME) systematic review: BEME guide No. 58, Med Teach source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Medical educators are now seeing the value of linking medical students with patients and their families and communities to foster awareness of the importance of longitudinal relationships, to improve students' social interaction skills and to facilitate learning of coping with illness in the real world.

    “Medical educators are now seeing the value of linking medical students with patients and their families and communities to foster awareness of the importance of longitudinal relationships, to improve students’ social interaction skills and to facilitate learning of coping with illness in the real world.5 6”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 5 6

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    This has resulted in overlap of included papers, and limited the generation of a common theoretical framework and terminology.

    “This has resulted in overlap of included papers, and limited the generation of a common theoretical framework and terminology.3 16”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 3 16

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The remaining articles were included based on consensus after a short discussion.

    “The remaining articles were included based on consensus after a short discussion.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All authors (SWD, ED, MW) used a prepiloted standardised form to extract data from included studies.

    “All authors (SWD, ED, MW) used a prepiloted standardised form to extract data from included studies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two authors (SWD and ED) applied the Mixed Methods Appraisal Tool to assess the methodological quality of studies.

    “As our review included papers of qualitative, quantitative and mixed methods designs, two authors (SWD and ED) applied the Mixed Methods Appraisal Tool to assess the methodological quality of studies (online supplementary file 2).21”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    These 95 articles were independently read by two authors (SWD and ED) and included based on the specified criteria.

    “These 95 articles were independently read by two authors (SWD and ED) and included based on the specified criteria.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The initial draft of this paper was presented and discussed at the European Patient Forum 2019 in a plenary session with 300 patient representatives present, feedback from which has been incorporated into the final paper.

    “The initial draft of this paper was presented and discussed at the European Patient Forum 2019 in a plenary session with 300 patient representatives present, feedback from which has been incorporated into the final paper.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Studies were not excluded based on assessed methodological quality.

    “Studies were not excluded based on assessed methodological quality.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    A second author checked if the extracted data were accurate, and discrepancies were resolved through discussion.

    “A second author checked if the extracted data were accurate, and discrepancies were resolved through discussion.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    MW, patient representative and co-author, was involved as an equal partner in all stages of the research project including project initiation, study design, data analysis, discussion and writing of the paper.

    “MW, patient representative and co-author, was involved as an equal partner in all stages of the research project including project initiation, study design, data analysis, discussion and writing of the paper.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Consensus between reviewers was 91.2%.

    “Consensus between reviewers was 91.2%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Search criteria were reviewed by a hospital information specialist.

    “Search criteria were reviewed by a hospital information specialist.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    Only studies written in English were included, which may have led to bias in selected papers.

    “Additionally, only studies written in English were included, which may have led to bias in selected papers.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Most studies were not (possible to be) anonymised, or were part of student assessments, which introduces a risk of responses being subject to social desirability bias.

    “Another important factor that may have introduced bias is that most studies were not (possible to be) anonymised, or were part of student assessments, which introduces a risk of responses being subject to social desirability bias.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    In most cases, students and patients participated in interventions on a voluntary basis, which may limit the generalisability of findings to the wider population.

    “In most cases, students and patients participated in interventions on a voluntary basis, which may limit the generalisability of findings to the wider population.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Both the medical education community and the patient community have joined together in the movement to promote patient-centredness.

    “Today, both the medical education community and the patient community have joined together in the movement to promote patient-centredness.”
    Quote in the paperNot a substantial claim
134 of 134

  • The paper relies on this without support.

    Previous studies have identified major gaps in the knowledge base relating to short and long-term learning outcomes, ethical issues, psychological impact and key procedural contributors like recruitment, selection and preparation.

    “Previous studies have identified major gaps in the knowledge base relating to short and long-term learning outcomes, ethical issues, psychological impact and key procedural contributors like recruitment, selection and preparation.”

  • The paper relies on this without support.

    There is limited information on the cost-effectiveness of active patient involvement.

    “There is also limited information of the cost-effectiveness of active patient involvement.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Qualitative studies are counted in two separate categories

    Minor

    The paper reports 38 qualitative studies, then describes another 6 studies as qualitative while calling them "others." The study-design categories therefore contradict each other as written.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Dijk, 2017, Meaningful patient involvement in medical education, Academic medicine-philadelphia, 92, 575
  2. IAPO . What is patient-centered healthcare? A review of definitions and principles. London, United Kingdom: IAPO, 2007.

Cited by

Sorted by citations

Related

Authors
Dijk, S. W., Duijzer, E. J., & Wienold, M.
Affiliations
  • Erasmus MC (NL)
  • University Medical Center Groningen (NL)
  • Wissenschaftliche Dienste und Projektberatung, Berlin, Germany
Corresponding author
Dijk, Stijntje Willemijn
ORCID
Dijk, Stijntje Willemijn
Venue
BMJ Open
Publisher
BMJ
Published
2020-07
Volume
10
Issue
7
Pages
e037217
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2020-037217
PMC
PMC7389514
OpenAlex
W3045860071
Cited by
208
References
63
Citations by year
2026: 27 · 2025: 46 · 2024: 54 · 2023: 48 · 2022: 18 · 2021: 14 · 2020: 1
FWCI
3.38
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • HighWire Press Open Archive (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (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
patient involvement in medical education, undergraduate medical education, patient assessment, curriculum development, student selection, summative assessment, learning outcomes, professional competence, patient recruitment, patient associations, health advocacy
MeSH terms
Education, Medical, Undergraduate, Faculty, Humans, Learning, Patient Participation

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

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