{"id":1563,"date":"2019-01-13T20:00:06","date_gmt":"2019-01-13T20:00:06","guid":{"rendered":"https:\/\/blogs.bmj.com\/ebn\/?p=1563"},"modified":"2019-01-14T09:08:00","modified_gmt":"2019-01-14T09:08:00","slug":"patient-educators-how-important-is-the-patient-in-health-care-professional-education","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/ebn\/2019\/01\/13\/patient-educators-how-important-is-the-patient-in-health-care-professional-education\/","title":{"rendered":"Patient Educators: how important is the patient in health care professional education? Amelia Swift and Jo Etherton"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/ebn\/files\/2018\/10\/Amelia-Swift-003v1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-1510\" src=\"https:\/\/blogs.bmj.com\/ebn\/files\/2018\/10\/Amelia-Swift-003v1-200x300.jpg\" alt=\"\" width=\"200\" height=\"300\" srcset=\"https:\/\/blogs.bmj.com\/ebn\/files\/2018\/10\/Amelia-Swift-003v1-200x300.jpg 200w, https:\/\/blogs.bmj.com\/ebn\/files\/2018\/10\/Amelia-Swift-003v1-768x1151.jpg 768w, https:\/\/blogs.bmj.com\/ebn\/files\/2018\/10\/Amelia-Swift-003v1-683x1024.jpg 683w, https:\/\/blogs.bmj.com\/ebn\/files\/2018\/10\/Amelia-Swift-003v1-640x959.jpg 640w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/p>\n<p>A friend recently posted a link to a video showing a stereotypical conversation of an orthopaedic surgeon asking an anaesthetist for help because he wanted to repair a fracture. It went something like this\u2026<\/p>\n<p>Orthopaedic surgeon (OS): I need to book a case<br \/>\nAnaesthetist (A): what\u2019s the story?<br \/>\nOS: There is a fracture, I need to fix it<br \/>\nA: tell me more<br \/>\nOS: [prolonged and mystified silence] There is a fracture, I need to fix it<br \/>\nA: can you tell me more?<br \/>\nOS: the fracture is very displaced, I need to fix it<br \/>\nA: Ok, let\u2019s start from the basics, where is the fracture<br \/>\nOS: the fracture is in the emergency department<\/p>\n<p>Every profession has its struggles with this type of thing.\u00a0 Phrases like \u2018the appendix in bed 3\u2019 are an often used short-hand that omits as much information as they convey.\u00a0 \u2018Forgetting\u2019 to include the person to whom the appendix belongs is a disrespectful teeter at the top of a slippery slide that most health care professionals would baulk at.\u00a0 We react when people do this, we remind them that it is a person that is being discussed and that person should be respected.<\/p>\n<p>Do we do the same in health care education? How much of our teaching meaningfully includes the patient perspective and experience?\u00a0 We are very good at talking about patient-centred care in education but so little teaching is actually done by patients, or has patients as co-designers, or includes patient stories in an engaging and credible way.\u00a0 The Health and Care Professions Council stipulate that service users and carers must be involved in pre-registration programmes <sup>1<\/sup> but other regulators have not stipulated this.<\/p>\n<p>Common methods of involving patients in education include direct face to face teaching with students and storytelling.<\/p>\n<p>Frank<sup>2<\/sup> describes three types of story; restitution narratives that tell of an illness that has been treated and is resolved, quest narratives that report a patient\u2019s journey and involve them overcoming a variety of obstacles, and chaos narratives that describe complex journeys with multiple, often unresolved issues.\u00a0 These stories have the power to transform a learner\u2019s understanding of illness, treatment, rehabilitation and recovery or readjustment.\u00a0 Stories help us to understand patient priorities, which may be very different than our own.\u00a0 And they help us to reflect on how the patient perceives our efforts to help. Stories can be told in many ways including face to face but often on video or even as a Facebook learning object<sup>3<\/sup>.<\/p>\n<p>&nbsp;<\/p>\n<p>Face to face teaching takes a number of different formats.\u00a0 Patients with training are employed to teach musculoskeletal assessment directly and achieve as good if not better results than their physician colleagues<sup>4<\/sup>.\u00a0 Patients also engage in simulation, which means that students get to practice authentically \u2013 something that is highly valuable in terms of improving learning and helps to bridge the theory-practice gap<sup>5<\/sup>.\u00a0 It has been demonstrated for example that standardised patients with intellectual disability are better able to support medics learning communication skills than actors trying to represent the complex and nuanced challenges the patients have<sup>6<\/sup>.<\/p>\n<p>Patients gain a lot from being teachers.\u00a0 One gentleman with MS who was engaged in classroom teaching with student nurses said \u2018<em>it was nice to get my two penneth in\u2019<\/em><em><sup>7<\/sup><\/em> \u00a0because it wasn\u2019t easy saying what you mean as a patient when you are in a position of dependence on the nurses.<\/p>\n<p>Questions for the twitter chat:<\/p>\n<ol>\n<li>What methods of involving patients in health education do you know of?<\/li>\n<li>What do patients gain from being involved in health education?<\/li>\n<li>What are the risks and costs for patients of their involvement?<\/li>\n<li>What is the added value for students?<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>References<\/p>\n<ol>\n<li>Health and Care Professions Council. Standards and Education and Training. London: HCPC, 2017.<\/li>\n<li>Frank AW. <em>The wounded storyteller: body, illness and ethics<\/em>. Chicago: University of Chicago Press, 1997.<\/li>\n<li>Ryan C, Wilson G, Dismore L, et al. Flo&#8217;s story: the development of a facebook learning object for health and social care students about persistent pain in older people. Pain and Rehabilitation &#8211; the Journal of the Physiotherapy Pain Association 2015;<strong>38<\/strong>:9-17.<\/li>\n<li>Oswald AE, Bell MJ, Wiseman J, et al. The impact of trained patient educators on musculoskeletal clinical skills attainment in pre-clerkship medical students. BMC Medical Education 2011;<strong>11<\/strong>:65.<\/li>\n<li>Rule AC. Editorial: the components of authentic learning. Journal of Authentic Learning 2006;<strong>3<\/strong>(1):1-10.<\/li>\n<li>Thacker A, Crabb N, Perez W, et al. How (and why) to employ simulated patients with intellectual disabilities. Clinical Teacher 2007;<strong>4<\/strong>(1):15-20.<\/li>\n<li>Costello J, Horne M. Patients as teachers? An evaluative study of patients&#8217; involvement in classroom teaching. Nurse Education in Practice 2001;<strong>1<\/strong>(2):94-102.<\/li>\n<\/ol>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A friend recently posted a link to a video showing a stereotypical conversation of an orthopaedic surgeon asking an anaesthetist for help because he wanted to repair a fracture. It went something like this\u2026 Orthopaedic surgeon (OS): I need to book a case Anaesthetist (A): what\u2019s the story? OS: There is a fracture, I need [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/ebn\/2019\/01\/13\/patient-educators-how-important-is-the-patient-in-health-care-professional-education\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":388,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1563","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Patient Educators: how important is the patient in health care professional education? 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OS: There is a fracture, I need [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/ebn\/2019\/01\/13\/patient-educators-how-important-is-the-patient-in-health-care-professional-education\/\" \/>\n<meta property=\"og:site_name\" content=\"Evidence-Based Nursing blog\" \/>\n<meta property=\"article:published_time\" content=\"2019-01-13T20:00:06+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2019-01-14T09:08:00+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/ebn\/files\/2018\/10\/Amelia-Swift-003v1-200x300.jpg\" \/>\n<meta name=\"author\" content=\"EBailey\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"EBailey\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/2019\\\/01\\\/13\\\/patient-educators-how-important-is-the-patient-in-health-care-professional-education\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/2019\\\/01\\\/13\\\/patient-educators-how-important-is-the-patient-in-health-care-professional-education\\\/\"},\"author\":{\"name\":\"EBailey\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/ebn\\\/#\\\/schema\\\/person\\\/09481df158cf72ac0faed7f8ec876625\"},\"headline\":\"Patient Educators: how important is the patient in health care professional education? 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