How can medical education be optimised to support the development of person-centredness? A realist review.
The Problem
Person-centred care (PCC) is considered central to the delivery of high-quality care. Yet current evidence points to an erosion of person-centredness in medical students as they progress through training. This is despite the long-established delivery of person-centred consultation skills training in medical schools. We query whether there are gaps in our educational strategy in developing person-centredness.
Your Approach
Education is as a complex intervention with multiple component parts and a variety of potential outcomes depending on the interactions between multiple factors. A realist review, which focuses on explanation (how, why and in what circumstances does an intervention lead to desired outcomes) is particularly suited to investigating complex interventions. The output of realist research is a programme theory with explanations in the form of Context-Mechanism-Outcome (CMO) configurations. These CMO configurations, which are a form of generalisable knowledge, seek to explain in what contexts, certain mechanisms trigger to generate outcomes of interest.
The Findings
At this interim stage of analysis, we have identified three key themes which suggest that person-centred values, beliefs and attitudes may be supported by:
1. Critical engagement with the knowledge, concepts and evidence that underpin the theory of person-centred care.
2. Critical reflection on clinical practice that supports self-awareness and transformative learning.
3. Clinical experiences which allow for the development of relationships with patients and preceptors.
Why it matters
It is imperative for patient care that we understand how we can optimise medical education to support a person-centred approach. We are particularly keen to involve undergraduate and postgraduate medical educators, medical students and GP trainees as stakeholders in this research to test emerging theory with lived experience. Come and find out how these finding can be used to inform, develop and evaluate existing educational strategies.
Presenter:
Dr Aarti Bansal, Academy of Primary Care, Hull York Medical School.
Email: aarti.bansal@hyms.ac.uk
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Co-authors:
Professor Joanne Reeve, Academy of Primary Care, HYMS. joanne.reeve@hyms.ac.uk
Dr Caroline Mitchell, Academy of Primary Medical Care, Sheffield Medical School, University of Sheffield. c.mitchell@sheffield.ac.uk
Dr Sophie Park, Primacy Care and Community, UCL Medical School. Sophie.park@ucl.ac.uk
Dr Katie Shearn, Sheffield Hallam University. K.shearn@shu.ac.uk
Ms. Sarah Greenley, Hull York Medical School. Sarah.greenley@hyms.ac.uk