Towards a pedagogy for patient and public involvement in medical education

Bere, Sam Regan de; Nunn, Suzanne

doi:10.1111/medu.12880

Cited by 63 publications

(100 citation statements)

References 24 publications

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“…50 Results here suggest International Medical Graduates and BME UK graduates were more likely to be separated from their social support network, causing stress and affecting their learning. This is worthy of further exploration as explaining, and reducing, differential attainment, is a key objective for the NHS and General Medical Council (GMC), among others.…”

Section: Discussionmentioning

confidence: 76%

‘You can't be a person and a doctor’: the work–life balance of doctors in training—a qualitative study

et al. 2016

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ObjectivesInvestigate the work–life balance of doctors in training in the UK from the perspectives of trainers and trainees.DesignQualitative semistructured focus groups and interviews with trainees and trainers.SettingPostgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training.Participants96 trainees and 41 trainers. Trainees comprised UK graduates and International Medical Graduates, across all stages of training in 6 specialties (General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, Surgery) and Foundation.ResultsPostgraduate training was characterised by work–life imbalance. Long hours at work were typically supplemented with revision and completion of the e-portfolio. Trainees regularly moved workplaces which could disrupt their personal lives and sometimes led to separation from friends and family. This made it challenging to cope with personal pressures, the stresses of which could then impinge on learning and training, while also leaving trainees with a lack of social support outside work to buffer against the considerable stresses of training. Low morale and harm to well-being resulted in some trainees feeling dehumanised. Work–life imbalance was particularly severe for those with children and especially women who faced a lack of less-than-full-time positions and discriminatory attitudes. Female trainees frequently talked about having to choose a specialty they felt was more conducive to a work–life balance such as General Practice. The proposed junior doctor contract was felt to exacerbate existing problems.ConclusionsA lack of work–life balance in postgraduate medical training negatively impacted on trainees' learning and well-being. Women with children were particularly affected, suggesting this group would benefit the greatest from changes to improve the work–life balance of trainees.

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Section: Discussionmentioning

confidence: 76%

‘You can't be a person and a doctor’: the work–life balance of doctors in training—a qualitative study

et al. 2016

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“…17–19 Much less is known about the causes of the ethnic attainment gap among UK graduates (UKGs), and it is unclear whether IMGs and BME UKGs have experiences in common. A 2015 GMC-commissioned rapid review of the literature20 highlighted a lack of consensus and research about the causes of the ethnic attainment gap in UKGs. There is however general agreement that examiner bias or overt discrimination is unlikely to be the sole cause in examinations in medicine because differential attainment is seen in written machine-marked multiple choice examinations,21 and research into two postgraduate clinical examinations found no evidence of bias 22…”

Section: Introductionmentioning

confidence: 99%

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

et al. 2016

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ObjectivesExplore trainee doctors’ experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification.DesignQualitative semistructured focus group and interview study.SettingPostgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales.Participants137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad.ResultsMost trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work–life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising.ConclusionsBME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on trainee–trainer relationships at work and organisational changes to improve trainees’ ability to seek social support outside work.

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“…The National Disability Strategy's second implementation plan, released in 2016, directed the need to 'ensure that the expressed views, lived experience and ongoing advice of people with disability are reflected in the development of policies and programs that affect their lives' (Department of Social Services, 2016, p. 16). This shift is evident not only in Australia, but also internationally (Regan de Bere & Nunn, 2016). This shift is evident not only in Australia, but also internationally (Regan de Bere & Nunn, 2016).…”

Section: Introductionmentioning

confidence: 84%

Perspectives of individuals receiving occupational therapy services through the National Disability Insurance Scheme: Implications for occupational therapy educators

Barclay

Callaway

Pope

2019

Aus Occup Therapy J

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Introduction:With the introduction of the National Disability Insurance Scheme (NDIS) in Australia, occupational therapy graduates need to be adequately prepared to support service users in this new policy context. There is, however, limited research informed by service users themselves to inform contemporary occupational therapy curriculum redesign. The aims of this study were: (a) to explore the experience of occupational therapy service provision from the perspective of service users with lived experience of disability; (b) to gain an understanding of the perceptions of people with lived experience of disability regarding the NDIS and whether it will change how they work with occupational therapists; (c) to gain an understanding of the perspectives of people with lived experience of disability regarding the NDIS, and how this influences curriculum content for occupational therapy education. Methods: A pragmatic qualitative design, underpinned by the constructivist paradigm was utilised. Demographic surveys and semi-structured interviews were completed with 10 participants who were purposively recruited. Peer debriefing and use of an audit trail were undertaken to enhance the rigour of the analysis. Results: Three themes were identified: (a) Occupational therapists as gatekeepers for equipment provision; (b) experience of the NDIS (Knowledge and understanding of the NDIS; Uncertainty regarding the NDIS; Choice and control in the NDIS); (c) curriculum content for occupational therapy. Conclusion: The insights provided by the people with lived experience in this studyinform key areas of focus for occupational therapy curriculum to adequately prepare graduates to work in the evolving NDIS environment. Involving service users in an authentic manner in curriculum design, content delivery and student assessment is crucial for "real-world" applicability of student education. K E Y W O R D Sdisability, education, occupational therapy, policy, qualitative research

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Towards a pedagogy for patient and public involvement in medical education

Cited by 63 publications

References 24 publications

‘You can't be a person and a doctor’: the work–life balance of doctors in training—a qualitative study

‘You can't be a person and a doctor’: the work–life balance of doctors in training—a qualitative study

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

Perspectives of individuals receiving occupational therapy services through the National Disability Insurance Scheme: Implications for occupational therapy educators

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