Seeing the patient as a person in interprofessional health professions education

Bosveld, Matthijs H.; Romme, Sjim; Nooijer, Jascha de; Smeets, Hester Wilhelmina Henrica; Dongen, Jerôme Jean Jacques van; Bokhoven, Marloes Amantia van

doi:10.1080/13561820.2022.2093843

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…Person-centeredness has long been a central concern across health professions education and practice. 1,2 Indeed, current Western mental healthcare system reforms prioritise person-centred approaches and personal recovery for clients, which require clinicians to reconceptualise their professional approaches in the provision of care. 3,4 Yet mental healthcare systems continue to be critiqued for privileging biomedical views of recovery and not aligning with reform priorities.…”

Section: Introductionmentioning

confidence: 99%

Fragilising clients: A positioning analysis of identity construction during clinical psychology trainees' supervision

Schubert,

Monrouxe,

Buus

et al. 2023

Medical Education

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ContextWestern mental healthcare system reforms prioritise person‐centred care and require clinicians to adjust their professional positions. Realising these reforms will necessitate clinicians—including clinical psychologists—acquiring professional identities that align with them. Learners develop professional identities through socialisation activities: within interactional spaces such as supervision learners come to understand the self (clinician) and, by extension, the other (client). A clinician's understanding of who I am is intertwined with an understanding of who they are. Our study offers a moment‐by‐moment examination of supervision interactions of clinical psychology trainees to illuminate processes through which the identities of therapists and clients are constructed.AimWe examined how clinical psychology trainees and supervisors construct identities for themselves and clients in supervision.MethodsWe used positioning analysis to explore identity construction during interactions between supervisors (n = 4) and trainees (n = 12) in a clinical psychology training clinic. Positioning analysis focuses on the linguistic choices participants make as they position themselves (and others) in certain social spaces during everyday interactions. Twelve supervision sessions were audio recorded and transcribed. We found that clients were frequently positioned as fragile and subsequently analysed these sequences (n = 12).ResultsClients' identities were constructed as fragile, which co‐occurred with clinical psychologists' claiming positions as responsible for managing their distress. Supervisors played an active role in linguistically positioning clients and trainees in this way. Trainees rarely contested the identities made available to them by supervisors.Discussion and ConclusionWe suggest that linguistically positioning clients as fragile perpetuates paternalistic clinical discourses that do not align with mental healthcare reform priorities. We make visible how this is achieved interactionally through language and influenced by organisational power relations. Intentional efforts are required to support the professional identity construction of clinical psychologists in ways that do not perpetuate paternalism. We offer recommendations for education and clinical practice to support these efforts.

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Section: Introductionmentioning

confidence: 99%

Fragilising clients: A positioning analysis of identity construction during clinical psychology trainees' supervision

Schubert,

Monrouxe,

Buus

et al. 2023

Medical Education

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“…Interviewed participants. Patient consultants from the Patient as a Person Foundation [26][27][28]. Patient as a Person Foundation is a non-profit organisation that wants to realise person-centred care through personcentred education.…”

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confidence: 99%

Challenges in engaging patients in feedback conversations for health care professionals' workplace learning

Sehlbach,

Bosveld,

Romme

et al. 2024

Medical Education

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IntroductionPatient feedback is relevant information for improvement of health care professionals' performance. Engaging patients in feedback conversations can help to harness patient feedback as a powerful tool for learning. However, health care settings may prevent patients and health care professionals to effectively engage in a feedback dialogue. To advance our understanding of how feedback conversations may support learning in and from practice, we sought to explore patients' and health care providers' perspectives on engaging patients in feedback conversations as informal learning opportunities.MethodsFor this qualitative study, we used a pragmatic approach and conducted semi‐structured interviews with 12 health care providers and 10 patient consultants. We applied an inductive approach to thematic analysis to understand interviewees' perceptions regarding patient feedback for workplace learning.ResultsParticipants attributed importance to patient feedback and described how the feedback may improve treatment relationships, professionals' performance and care processes on the team level and the organisational level. Participants experienced conflicting roles as patient and educator or expert and learner, respectively. Changing relationships, feelings of vulnerability and perceived power dynamics in treatment relationships would affect participants' engagement in feedback conversations. Patients and professionals alike saw a role for themselves in giving or inviting feedback but often missed the tools for engaging in feedback conversations.DiscussionPatient feedback can contribute to professionals' practice‐based learning but requires navigating tensions around conflicting roles and power dynamics in the treatment relationship. Both patients and health care professionals need to embrace vulnerability and may need facilitation and guidance to use patient feedback effectively. Attention to power dynamics, if not a shift towards collaborative relationships, is however crucial to engage patients in feedback conversations, thereby capitalising the power patients posses.

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Twelve tips for patient involvement in health professions education

Eijkelboom

Brouwers

Frenkel

et al. 2023

Patient Education and Counseling

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Seeing the patient as a person in interprofessional health professions education

Cited by 6 publications

References 24 publications

Fragilising clients: A positioning analysis of identity construction during clinical psychology trainees' supervision

Fragilising clients: A positioning analysis of identity construction during clinical psychology trainees' supervision

Challenges in engaging patients in feedback conversations for health care professionals' workplace learning

Twelve tips for patient involvement in health professions education

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