What motivates patients to become involved in postgraduate medical training in a family planning clinic?

Abstract

Objectives To discover what motivates patients who agree to doctors on postgraduate clinical training attachments being involved in their care; to explore potential negative effects on patients; and to consider how the experience could be improved for the patient.Methods Questionnaire survey of 103 female family planning clinic (FPC) patients. Patients were recruited from the waiting room of a community FPC.Results Motivation could be classified into three categories: 84% of patients gave altruistic reasons for agreeing to see training doctors, 59% indicated the possibility of personal gain and 49% felt some degree of obligation. Potential disadvantages to seeing training doctors included marginalisation of patient care, strain on the doctor-patient relationship, and exposure to potential discomfort or harm. The experience could be 103 IntroductionClinical experience is a vital part of medical training, but we should not assume that all patients are willing to be involved in this. Understanding what motivates patients to agree to play a part in medical education could have a positive influence on the way they are asked, and make the experience more rewarding for the patient.Patient motivation for involvement in medical student education has been described in some detail by Lynöe et al. 1 but there is little research into the experiences of patients with postgraduate medical training. Diploma of the Faculty of Sexual and Reproductive Healthcare (DFSRH) [formerly Diploma of the Faculty of Family Planning and Reproductive Health Care (DFFP)] training doctors are post-registration doctors, mainly general practice registrars or gynaecology senior house officers, who attend family planning clinics (FPCs) to gain clinical experience towards their diploma. This study sought the views and experiences of patients attending a community FPC that frequently has DFSRH training doctors in attendance. Depending on their level of experience, these doctors may observe or lead consultations in the presence of a more senior member of staff, or see patients on their own, under supervision of a Faculty instructing doctor. Practical procedures such as intrauterine device (IUD) and implant insertions would always be performed in the presence of an experienced doctor. MethodsThe study methodology was as described in the first article in this series. Discussion and conclusions Patients were motivated to become involved in training for a variety of reasons, mainly altruism, personal gain or a sense of obligation. There is evidence that patients may not be fully aware of the potential disadvantages of seeing a training doctor. Patients may benefit from being given more choice about their level of involvement to enable them to give informed consent before seeing a training doctor. Patients should feel comfortable about saying no. There is potential to develop the teaching role of some of the most motivated patients. Ethical approvalEthical approval for the study was granted by the Cheshire Local Research Ethics Committee. Results ...