Patients undergoing dialysis as a model for medical students’ longitudinal engagement with chronic illness: Patient perspectives

Abstract

Background: Medical students are predominantly exposed to patients with chronic conditions during acute episodes requiring hospitalisation. Consequently, this limits students’ opportunities to learn about continuity of patient care. Unlike hospitalised patients, patients undergoing haemodialysis attend dialysis clinics in ambulatory/outpatient settings multiple times per week over long time periods. Patients undergoing dialysis would be well placed to share their knowledge of their own chronic illness and their experience of patient-centred care. This study explored the willingness of patients undergoing haemodialysis to interact with the same medical student throughout the academic year. Methods: Twenty-seven patients undergoing dialysis at four dialysis units were interviewed.Results: Twenty-five patients indicated that they would be willing to regularly interact with students. Patients indicated that they would permit students to conduct a range of activities (e.g., taking a medical history). All 25 were willing to provide students with verbal feedback. Twelve were willing to provide written feedback. In terms of interacting with students, there were two predominant groups: 1) those who focus on the students’ needs and are prepared to interact with students frequently and over a long duration and 2) those who have had “enough” after a while and are prepared to interact with students over a shorter duration. Conclusions: Patients undergoing haemodialysis could provide students with opportunities to follow a patient’s journey, provided the length and frequency of the patient–student interaction is matched with patient preferences.