The Patient-Based Teaching Strategy | Health Professional Education Research Paper

Introduction:

Health professional education, such as nursing and medicine, aimed to enhance the professional skills of students in different circumstances. Student’s experience has a significant impact on their education and professional performance compared to the traditional teaching strategy. Therefore, the development of a new teaching scheme is pivotal to improve the way in which information will be delivered to students to help them in their future practice applications as well as in the expansion of their knowledge. Today,  teaching does not only depend on lectures, but it also improves due to the use of the evidence-based, case-based or human-based learning,  which gives students extensive experience along with the development of their professional skills and abilities . One of the most important teaching methods is the patient-based teaching in medicine education, which is the most effective method compared to other programs1.

  • What is Standardise patient mean? 

A standardized patient (SP) is a patient, who is trained to simulate with others about their medical condition in a standardized way. SPs can be used in several fields of health professional education. Many studies have proved students’ high interest in such learning. 2

  • How patients were used in teaching :

    1. Patient simulation :

The majority of the studies involved patients or standardized patients in the education by the direct communication with the student. In this way, students are able to receive the information directly by talking to patients, who may present either their real medical situation or a given medical condition (SPs).(1,2,4)
Patients as lecturers :

The other way to involve patients is to use them as teachers. This way of the patient-based learning has proved its effectiveness in the nursing education.(3,4)

  • General evaluation of patient-based teaching :

The United Kingdom government policy for training health care professionals highlighted the importance of the evaluation of the clinical teaching5.The effectiveness of patient-based teaching is strongly supported by many studies, which is completely compatible with the accuracies of the outcome-based approach to curriculum planning and delivery(5,7) . The choice of the content of teaching includes three fields of knowledge, skill and attitudes, which are clearly stated by the Calgary-Cambridge Referenced Observation Guides especially in medical education (5,6).  The postgraduate medical education review showed the development of the professional and humanistic skills learnt that would be subjected to workplace assessments, with successful trainees graduating from one level of training to the next2. This way of teaching, in which students have to simulate real world situations with the patients directly, require more communication skills are needed5. The guide formed the basis of complete practical communication programs as starting point for all levels of training6.

The active involvement of patients in the medical education has increased because patients can provide students with more detailed information about their medical cases compared to what students may learn from lectures only. The patient-based teaching expands student’s experience of the real world medicine. Several journals supported the effectiveness of the patient involvement in the medical education because such involvement contributes to the better teaching, assessment or improvement of ability to develop students’ clinical skills.4

Another way to evaluate the effectiveness of this teaching strategy involved a study that performed a comparison between the traditional lecture-based teaching and the patient-based teaching. The study has proved that there was a significant improvement in ways of thinking as well as communication skills of students in the course of their interaction with patients due to the patient-based teaching group compared to the lectures group7. Another study aimed at the evaluation of the difference between computer and patient-based teaching using 54 nursing students, who were divided into two groups: one group dealt with patients and the other group dealt with computers to seek the target information. Researchers have found that the human patient simulation was significantly better than computer-based one in terms of the improvement of student knowledge .8

On the other hand, the medical education used Scholarly Excellence, Leadership Experience, Collaborative Training program (SELECT) to evaluate the patient-based teaching which took one year. The programme included fifteen first year medical training students and a questioning protocol was used to guide the focus group discussion. As a result, students appreciated the significant changes in their attitude to communicate with patients that improved their education and motivation. They also recognised the differences between the patient’s personality and their emotional behaviour that could raise a barrier between patients and health care professions (doctor, nurse or pharmacist). In addition, the impact of the family involvement and social support on the quality of life and health outcomes was acknowledged. Moreover, students reported the importance of their cooperation with other health professionals to achieve better patient care.  They suggested improving the programme by additional simulations and more education involving other health care professions.9

In order to evaluate the effectiveness of teaching strategies, either of case-based teaching or patient-based teaching, a study was performed and involved first year nursing students and hypoglycaemic patients. The study included 96 students of both genders, whose age ranged from 18 to over 45 years old. Participants of the study were divided into two groups: human patient simulation (HPS) group and a single case study group of diabetes education. Objective clinical evaluation methods of students’ performance to evaluate their clinical skills were used along with the pre-test and post-test evaluation to assign the effectiveness of either teaching strategies. The results of the study showed that the pre-test average scores for both groups were identical(55%), while the post-test results for the case study group were slightly higher than the simulation group results(80% and 68% respectively) . On the other hand, the clinical evaluation tool of the simulation group score was significantly higher than the case study group (17/22 , 8/7 points respectively) . The survey of post-lesson showed the higher overall for the (HPS) group on all statements. Thus, all students agreed or strongly agreed that (HPS) teaching was effective. Findings of the study have proved that both teaching strategies are beneficial in nursing education, however, HPS was more effective. Thus, this strategy can be successfully applied to nursing education. 10

Alternatively, patients could be involved in education as teachers in pre-registration nursing classrooms. The active participation of patients allows the students to understand patient’s viewpoints by developing more patient-centred approach to identifying their health problems. Three patients and 23 students, who were finishing their Diploma in Professional Studies in Nursing (DPSN), were involved in patient-focused teaching sessions and questionnaires were used to evaluate student’s experience. As a result, the study has revealed the effectiveness of the involvement of patients in classroom activities, as teachers that expanded nurses learning experience in addition to obtain more realistic information from patients. Hence, this is an effective teaching strategy in nursing education.3

  • Implication of using patients on student:

The medical and nursing education could be applied to the future practical approach that could improve patient care, diagnosis or management. Clinical skills’ development is an essential element of any clinical programme. Thus clinical patient simulation would provide students with opportunities to develop and explore problem solving skills, clinical skills and critical thinking in the safe environment.11

The undergraduate nursing education involving patient simulation as teaching strategy has increased. A study was performed to evaluate the implementation of this teaching strategy to improve first year nursing students’ clinical skills. The study involved about 47 students from the first year Bachelor of Nursing Science; three academic staff to observe and evaluate the students’ performance; in addition to two standardised patients were using unfolded case studies with highly simulation clinical setting. As a result, the study has found that students significantly improved their clinical skills due to the use of the simulated model. A survey was completed to share student’s opinion about the teaching model used. The survey showed the high score that ranged between agree and strongly agree in all sections of benefits of the simulation and its positive impact on their skills, which proved their high satisfaction with all element of the teaching model. An interview with students also supports the finding of students’ desire to participate in more simulation sessions to improve their knowledge, self-confidence, experience and clinical skills. This study provided both qualitative evidence from the interview and quantitative evidence from the survey that assign the implication of the patient-based teaching on students. Thus, researchers suggested introducing the simulation model to train pre-registration nursing students.12

To prove the effectiveness of the involvement of patients in nursing education, another study was performed involving some students, who did not appreciate the importance of communication with patients. They did not believe that simulation could improve their skills, knowledge or that the patient involvement was important to professionalise patient’s care. Thus, a course of nursing and non-nursing sessions were accomplished with a low-tech simulation exercise. The study started by introducing simulation sessions for few hours to maternity unit and it was closely observed and recorded on videotape for five weeks. The study has found that the simulation helps students to recognize that caring is not native and professional caring can be safely learned through simulation. Also they learnt that they could only know another’s subjective world, when another person felt safe in communicating about that person’s world. Students increased their confidence in several manners along with the positive observation of patient communication benefits. Students admitted that communicating with patients would help them into preparation clinical practice regardless of the unit. Moreover, the study has helped to support them to remember the person’s case and how to take care of the patient even after being more complex .13

As the medical education aims at the improvement of the clinical ability of trainees to communicate with patients by several clinical experiences, it is important to rely on patient-based teaching strategy. The involvement of standardized patients, who are trained to represent many clinical cases with students of different levels, was vital to overcome any educational problem associated with real patients’ simulations. It was noticed that significant improvement in student’s clinical skills and knowledge in physical diagnosis course of the second year, clerkships of third-year, final exercise of the fourth-year, and residency training. As a result, the study suggested to introduce of the standardized patients in monitoring and promoting the development of clinical ability .14

To evaluate the impact of the patient-based teaching on students, it was proposed to involve adolescent patients that required special communication skills from students to obtain the information from adolescent patients and to provide better health care for them. The patient-based teaching could either use real patient case, in which the mistake done by the student would not be forgiven, or an actor, who played a role of a patient and, in this case, mistakes done by students would be forgiven. Thus, several courses were run to improve the effectiveness of simulation to improve students’ skill in different fields by means of the involvement of standardised patients. The study aimed at dealing with adolescent patients that required unique communication skills as the simulated-patient-based programmes were used. Professional actors were involved to act as adolescent patients, who had real scenarios from adolescent health unit so students would start the communication that was video recorded. As a result, the study has found that participants proved the effectiveness of the simulation experience to improve their clinical skills and suggest including it in physician’s training programmes.15

When standardized patients (SPs) were used in psychiatric training and education, it allowed student to deal with different psychopathological cases. In addition, such training taught them various complex interpersonal cases different patients may have. Although it was significantly effective to involve patients in psychiatric education, the limitation was psychiatry’s roots in the nature of empathy and the patient-psychiatrist relationship. The study has proved that standardized patients are most appropriate for exposing trainees to a variety of psychopathologies and testing very discrete skills.16

Thus, the patient-based teaching strategy aims to create a solid professional ground based on well-developed professional skills, abilities and extensive professional experience of future doctors, nurses, dentist and pharmacist and other health care professionals. Different studies have revealed a considerable impact of the patient-based teaching strategy on students because this strategy contributes to the improvement of student’s communication skills to make patients feel more comfortable to share their problems and personal issues that may help to make more accurate diagnosis as well as develop more effective treatment programme.7

‘Reflection and a tolerance of uncertainty are important characteristics of professional development for training and practice as well as for developing ongoing, trusting relationships. Thus, in addition to the ways in which our curriculum can promote relationship centeredness and professional development through the institutional changes required to support it’.  14

 

References

  1. Reagans R, Argote L, Brooks D. Individual Experience and Experience Working Together: Predicting Learning Rates from Knowing Who Knows What and Knowing How to Work Together. Management Science. 2005;51(6):869-881.
  2. Barrows H. An overview of the uses of standardized patients for teaching and evaluating clinical skills. AAMC. Academic Medicine. 1993;68(6):443-51.
  3. Costello J, Horne M. Patients as teachers? An evaluative study of patients’ involvement in classroom teaching. Nurse Education in Practice. 2001;1(2):94-102.
  4. Jha V, Quinton N, Bekker H, Roberts T. Strategies and interventions for the involvement of real patients in medical education: a systematic review. Medical Education. 2009;43(1):10-20.
  5. Doshi M. Whys and hows of patient-based teaching. Advances in Psychiatric Treatment. 2005;11(3):223-231.
  6. Kurtz S, Silverman J. The Calgary-Cambridge Referenced Observation Guides: an aid to defining the curriculum and organizing the teaching in communication training programmes. Medical Education. 1996;30(2):83-89.
  7. Christianson C, McBride R, Vari R, Olson L, Wilson H. From Traditional to Patient-Centered Learning: Curriculum Change as an Intervention for Changing Institutional Culture and Promoting Professionalism in Undergraduate Medical Education. Academic Medicine. 2007;82(11):1079-1088.
  8. Wilson R, Klein J, Hagler D. Computer-Based or Human Patient Simulation-Based Case Analysis: Which Works Better for Teaching Diagnostic Reasoning Skills?. Nursing Education Perspectives. 2014;35(1):14-18.
  9. Gallentine A, Salinas-Miranda A, Bradley-Klug K, Shaffer-Hudkins E, Hinojosa S, Monroe A. Student perceptions of a patient- centered medical training curriculum. Int J Med Educ. 2014;5:95-102.
  10. Gibbs J, Trotta D, Overbeck A. Human patient simulation versus case study: Which teaching strategy is more effective in teaching nursing care for the hypoglycemic patient?. Teaching and Learning in Nursing. 2014;9(2):59-63.
  11. McCallum J. The debate in favour of using simulation education in pre-registration adult nursing. Nurse Education Today. 2007;27(8):825-831.
  12. Mills J, West C, Langtree T, Usher K, Henry R, Chamberlain-Salaun J et al. ‘Putting it together’: Unfolding case studies and high-fidelity simulation in the first-year of an undergraduate nursing curriculum. Nurse Education in Practice. 2014;14(1):12-17.
  13. Storr G. Learning How to Effectively Connect with Patients Thorough Low-Tech Simulation Scenarios. University of New Brunswick. 2014;2:36-40.
  14. (Ainsworth M. Standardized patient encounters. A method for teaching and evaluation. JAMA: The Journal of the American Medical Association. 1991;266(10):1390-1396.
  15. Simulated-patient-based programs for teaching communication with adolescents: the link between guidelines and practice. Israel Center for Medical Simulation, Chaim Sheba Medical Center, Tel Hashomer. 2008;3(165).
  16. Brenner A. Uses and Limitations of Simulated Patients in Psychiatric Education. Academic Psychiatry. 2009;33(2):112-119.

 

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"The terms offer and acceptance." freeessays.club, 17 May 2016

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"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: March 29, 2024]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: March 29, 2024]

"The terms offer and acceptance." freeessays.club, 17 May 2016

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