Optimising planned medical education strategies to develop learners' person-centredness: A realist review

被引：19

作者：

Bansal, Aarti ^{[1
]}

Greenley, Sarah ^{[2
]}

Mitchell, Caroline ^{[3
]}

Park, Sophie ^{[4
]}

Shearn, Katie ^{[5
]}

Reeve, Joanne ^{[1
]}

机构：

[1] Univ Hull, Acad Primary Care, Hull York Med Sch, Allam Med Bldg, Kingston Upon Hull HU6 7RX, N Humberside, England

[2] Univ Hull, Inst Clin & Appl Hlth Res, Kingston Upon Hull, N Humberside, England

[3] Acad Unit Med Educ, Sam Fox House, Sheffield, S Yorkshire, England

[4] UCL, Res Dept Primary Care & Populat Hlth, London, England

[5] Sheffield Hallam Univ, Hlth & Wellbeing Res Inst Postgrad, Res Ctr, Sheffield, S Yorkshire, England

来源：

MEDICAL EDUCATION | 2022年 / 56卷 / 05期

基金：

美国国家卫生研究院;

关键词：

PATIENT-CENTEREDNESS; PRIMARY-CARE; STUDENTS PERCEPTIONS; CONSULTATION SKILLS; HEALTH SYSTEMS; SELF-AWARENESS; COMMUNICATION; ATTITUDES; IMPACT; REFLECTIONS;

D O I：

10.1111/medu.14707

中图分类号：

G40 [教育学];

学科分类号：

040101 ; 120403 ;

摘要：

Context Person-centeredness is a stated aim for medical education; however, studies suggest this is not being achieved. There is a gap in our understanding of how, why and in what circumstances medical education interventions that aim to develop person-centredness are successful. Methods A realist review was conducted with a search of Medline, Embase, HMIC and ERIC databases and the grey literature using the terms 'medical education' and 'person-centred' and related synonyms. Studies that involved a planned educational intervention in medical education with data on outcomes related to person-centredness were included. The analysis focused on how and why different educational strategies interact with biomedical learner perspectives to trigger mechanisms that may or may not lead to a change in perspective towards person-centredness. Results Sixty-one papers representing fifty-three interventions were included in the final synthesis. Nine context-intervention-mechanism-outcome configuration (CIMOc) statements generated from the data synthesis make up our refined programme theory. Where educational interventions focused on communication skills learning or experiences without person-centred theory, learners experienced dissonance with their biomedical perspective which they resolved by minimising the importance of the learning, resulting in perspective endurance. Where educational interventions applied person-centred theory to meaningful experiences and included support for sense making, learners understood the relevance of person-centeredness and felt able to process their responses to learning, resulting in perspective transformation towards person-centredness. Conclusion Our findings offer explanations as to why communication skills-based interventions may be insufficient to develop learners' person-centredness. Integrating experiential person-centred learning with theory on why person-centredness matters to clinical practice and enabling learners to make sense of their responses to learning, may support perspective transformation towards person-centredness. Our findings offer programme and policymakers testable theory to inform the development of medical education strategies that aim to support person-centredness.

引用

页码：489 / 503

页数：15

共 126 条

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