By Jennifer O’Neill.

Context

In early February 2022, my colleague and I embarked upon a programme of research examining our shared interest in patient healthcare involvement. As lecturers at the University of Glasgow School of Medicine, we identified a unique opportunity to establish a staff-student research partnership. The underlying rationale was that our student partners may engage with our target demographic – incoming year 1 medical students – more effectively. We also anticipated that the partnership would support the development of our student partners’ graduate attributes in the research context. Our study – examining the attitudes of incoming members of the medical profession towards patient involvement in healthcare – was recently published in the Journal of Medical Ethics.

The Process

We extended an invitation to Year 2 students enrolled on a Student Selected Component (SSC) on ‘Patient Perspectives in Research’, of which four students accepted. We held a preliminary meeting with our four student-partners in which we explained the general research process, expectations and commitments. Once in agreement, we collaborated on the survey content, the active stage of collaboration wound down. Student-partners retained access to all collaborative files and had the opportunity to engage in data analysis and literature reviews as the manuscript was prepared as their study commitments allowed.

Reflections

From the outset, I was enthusiastic about our planned staff-student partnership, however, I remained pragmatic about the potential limitations. Given the intense nature of the medical curriculum, I was aware that there may be barriers to our partners’ ongoing involvement. Furthermore, I was concerned that students may lose interest given the lengthy, and often, disheartening road to publication. However, upon reflection, such concerns were largely unfounded and I found the partnership to be a highly rewarding experience.

Our student partners’ input to the research design was highly valuable – we were able to prove to reviewers and future readers that our questions were developed with the target demographic truly in mind.  In terms of contribution to the literature, we believe this is the first study of its kind in the United Kingdom to look at medical student attitudes to patient involvement in healthcare and research. And, as such, we hope it will serve as the basis for future research in this area.

Whilst there were some instances where communications between parties slowed – such as during the long summer months when students engage with their university email accounts less frequently – such instances had minimal impact upon the overall process. Over the 20 month period from research conception to publication, I adopted a policy of minimal email communications to avoid overwhelming students. As a result, I only corresponded as necessary to facilitate the research process. To offset any potential loss of interest, I sought to use communication points to engage our student-partners by fully explaining each stage of the process. This gave rise to several key teachable moments which are particularly pertinent in ethics education.

By providing a real-time opportunity to take student partners through the research process we were able to examine potential ethical issues relating to:

• Data Protection and UK-GDPR: For example, we discussed the legal and ethical requirements of handling confidential shared documents such as those containing survey results.
• Ethics Committee Applications: Reviewers of an early version of our Ethics Committee Application highlighted concerns that a free-text box on our survey could be used to disclose sensitive. information. We used this as an opportunity to discuss the potential implications – namely disclosure to the relevant authorities – and ultimately agreed to remove the question.
• Pre-print servers: We uploaded our manuscript to the medRXiv pre-print server prior to peer review. This provided an opportunity to discuss the benefits of open-access and dissemination of results versus the benefits of peer review.
• Authorship and Contribution: We agreed upon an Authorship and Contribution Statement which provided an opportunity to discuss the various roles in collaborative research.
• Peer Review: The peer review process offered an opportunity for us to discuss, with the student-partners, what happens when there are differences of academic opinion and when it may be reasonable to rebut a reviewer’s comment.

In addition, several general teachable moments arose such as ‘how to identify appropriate journals’, ‘dealing with rejection’ and ‘how to write letters in support of submissions’. Overall, the staff-student partnerships were highly beneficial for all involved. Our student-partners commented that the overall experience was “valuable” and they would “definitely recommend this to other medical students to understand the ins and outs of paper publication and research”. Whilst I foresaw the development of such graduate attributes, the benefits in terms of teachable ethics moments were an unexpected, but wholly welcome, addition.

Paper title: Medical student attitudes to patient involvement in healthcare decision-making and research

Authors: O’Neill, J.^a*, Docherty Stewart, B.^b, Ng, A., XN.^b, Roy, Y.^b, Yousif, L.^b, McIntyre, K., R.^a

Affiliations:

^a Lecturer, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom; ^b Undergraduate Medical Student, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom.

Competing interests:  No Competing Interests

Social media accounts of post author: @drjenniferoneil