Patients as teachers and arts-based reflection in surgical clerkship: A preliminary exploration

Abstract

Background

Involving patients in medical education as teachers is not a novel approach, yet it has not been widely adopted by undergraduate surgical curricula in Canada. The Patients as Teachers initiative in surgery (PAT) program, with an arts-based reflection assignment, was developed for surgical clerks with the goals of emphasizing patient-centredness in surgical practice, humanistic aspects of medicine, and to counterbalance the commonplace emphasis on technical competency in surgery.

Methods

Qualitative data was collected exploring the question: What was the experience and impact of the PAT program on patient teachers and students? Patient teachers (n = 5) were invited to participate in one-on-one interviews and students (n = 46) were invited to participate in focus groups at the end of the program.

Results

Findings converged around two main themes: what students/patient teachers valued about the PAT program and what they perceived was learned. While patient teachers felt a sense of emotional healing and appreciated a chance to contribute to medical education, students valued having protected time to learn in depth from the patient teachers. Students also begrudgingly came to appreciate the arts-based reflection assignment.

Conclusion

By bringing patient voice to the forefront and encouraging reflection, the PAT program emphasized to students the compassionate and humanistic side of surgical care. Future studies could examine the mechanisms by which learning occurs and long-term impacts.

Keywords:

• Surgery
• communication skills
• ethics/attitudes
• medical education research
• small group

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

Funding for this program is through an Education Development Fund (EDF) grant from the University of Toronto, An Innovation Grant from St. Michael’s Hospital, and a generous donation from the Viener family of Toronto.

Notes on contributors

Emilia Kangasjarvi

Miss Emilia Kangasjarvi, MSSC, is a research associate who analysed the study's qualitative data and assisted with the development of theoretical framework.

Stella L. Ng

Dr. Stella L. Ng, PhD, is a senior advisor to the program and provided assistance on developing a theoretical framework and evaluative process.

Farah Friesen

Miss Farah Friesen, MI, is the research coordinator who provided research assistance on developing a theoretical framework and evaluative process.

Jory S. Simpson

Dr. Jory S. Simpson, MD, MEd, FRCSC, is a Breast Surgical Oncologist, the PAT course director and creator who implemented of the patient as teacher program.