Accepted Type
Oral
Code
OG3-2-3
Acceptance Declaration
Decline
Was this work accepted for CCME 2020?
yes
Category
General Call (Workshop, Oral Presentation, Poster Presentation)
Type
Oral
Sub Type
Education Research
Will the presenter be a:
Student
Affiliation
Considered for Poster
yes
Title
Placing the Patient at the Centre of the Learning Environment: Effect on Agency for the Learner, the Attending Physician and the Patient
Length of Presentation
Background/Purpose
Although much has been written about the medical learning environment, the patient, who is the
focus of our care, has been systematically excluded from this discourse. The purpose of this study
was to explore the role of the patient as an active participant with agency in an authentic medical
learning environment from the standpoint of the learner, the faculty and most importantly the
patient. We hoped to gain insight into the reinforcement of positive professional values such as
patient-centred behaviours and a respectful environment.
Methods
The study recruited participants to adopt a "patient-centered" clinic approach where case presentations were conducted in examination rooms with the patient. After each visit, participants took part in semi-structured interviews to explore the impact of the patient-present learning environment. We recruited 34 participants; 10 attending physicians, 12 learners, 10 patients and 2 family members. We analyzed the data deductively using a conceptual framework of agency.
Results
Results revealed three themes: 1. The teaching model allowed for a more patient-centered and
inclusive health care environment from the patient perspective; 2. Attending physicians and medical trainees reported that presenting cases with the patient present challenged normal teaching practices and were differed on whether it supported a more inclusive health care environment; 3. There was a hidden curriculum of performance-based view of professional behaviour.
Conclusion
Patient-present teaching engaged patients and enhanced their agency by recasting the patient as the central focus within the healthcare encounter. We identified a tension between performing and learning. This study adds new insights to the concept of patient centredness and professionalism in the medical learning environment.
Keyword 1
Patient-Centered
Keyword 2
Learning Environment
Keyword 3
Professionalism
Level of Training
Undergraduate
Abstract Themes
Other
Additional Theme (First choice)
Professionalism
Additional Theme (Second Choice)
Undergraduate
Additional Theme (Third Choice)
Authors
Presenter
Bavenjit Cheema
Term 1
Yes
Term 2
Yes
Term 3
Yes
Term 4
Yes
Term 5
Yes
