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Patient involvement in health professionals’ education: a meta-narrative review

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Abstract

More than 100 years ago, Osler inspired educators to consider health professions education (HPE) as intricately reliant on patients. Since that time, patient involvement in HPE has taken on many different meanings. The result is a disparate body of literature that is challenging to search, making it difficult to determine how to continue to build knowledge in the field. To address this problem, we conducted a review of the literature on patient involvement in HPE using a meta-narrative approach. The aim of the review was to synthesize how questions of patient involvement in HPE have been considered across various research traditions and over time. In this paper, we focus on three scholarly communities concerned with various interpretations of patient involvement in HPE—patient as teachers, real patients as standardized patients, and bedside learning. Focus on these three research communities served as a way to draw out various meta-narratives in which patients are thought of in particular ways, specific rationales for involvement are offered, and different research traditions are put to use in the field. Attending to the intersections between these meta-narratives, we focus on the potentially incommensurate ways in which “active” patient engagement is considered within the broader field and the possible implications. We end by reflecting on these tensions and what they might mean for the future of patient involvement, specifically patient involvement as part of future iterations of competency based education.

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Acknowledgements

The authors would like to thank the Arnold P. Gold Foundation for supporting this project through Mapping the Landscape funding. The authors would also like to acknowledge the assistance of Dr. Nancy McNaugton and Dr. Sophie Soklaridis for their contribution as members of the Advisory Panel, and for SS’s thoughtful commentary on earlier drafts of this paper. The authors would also like to thank Debbie Rolfe for her contributions to earlier aspects of the literature review and her commentary on earlier drafts. Finally, the authors would like to thank Professor Trisha Greenhalgh for advice on methodology, analysis, and reviews of earlier versions of this manuscript.

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This work is supported by the Arnold P. Gold Foundation through a Mapping the Landscape grant.

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Correspondence to Paula Rowland.

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Rowland, P., Anderson, M., Kumagai, A.K. et al. Patient involvement in health professionals’ education: a meta-narrative review. Adv in Health Sci Educ 24, 595–617 (2019). https://doi.org/10.1007/s10459-018-9857-7

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