Learning patient-centredness with simulated/standardized patients
A realist review: Beme Guide No. 68
Dados Bibliográficos
BACKGROUND: Given the positive outcomes of patient-centred care on health outcomes, future doctors should learn how to deliver patient-centred care. The literature describes a wide variety of educational interventions with standardized patients (SPs) that focus on learning patient-centredness. However, it is unclear which mechanisms are responsible for learning patient-centredness when applying educational interventions with SPs. OBJECTIVE: This study aims to clarify how healthcare learners and professionals learn patient-centredness through interventions involving SPs in different healthcare educational contexts. METHODS: A realist approach was used to focus on what works, for whom, in what circumstances, in what respect and why. Databases were searched through 2019. Nineteen papers were included for analysis. Through inductive and deductive coding, CIC'MO configurations were identified to build partial program theories. These CIC'MOs describe how Interventions with SPs change the Context (C→C') such that Mechanisms (M) are triggered that are expected to foster patient-centredness as Outcome. RESULTS: Interventions with SPs create three contexts which are 'a safe learning environment,' 'reflective practice,' and 'enabling people to learn together.' These contexts trigger the following seven mechanisms: feeling confident, feeling a sense of comfort, feeling safe, self-reflection, awareness, comparing & contrasting perspectives, combining and broadening perspectives. A tentative final program theory with mechanisms belonging to three main learning components (cognitive, regulative metacognitive and affective) is proposed: Interventions with SPs create a safe learning environment (C') in which learners gain feelings of confidence, comfort and safety (affective M). This safe learning environment enables two other mutual related contexts in which learners learn together (C'), through comparing & contrasting, combining and broadening their perspectives (cognitive M) and in which reflective practice (C') facilitates self-reflection and awareness (metacognitive M) in order to learn patient-centeredness. CONCLUSION: These insights offer educators ways to deliberately use interventions with SPs that trigger the described mechanisms for learning patient-centredness
Medical education · MEDLINE · Political science · Medicine · Patient Satisfaction in Healthcare · Patient-Provider Communication in Healthcare · Psychology · Simulation-Based Education in Healthcare
Rameses publication standards
Realist review - a new method of systematic review designed for complex policy interventions
Congruence and friction between learning and teaching
Reflection and reflective practice in health professions education
An Integrative Model of Patient-Centeredness – A Systematic Review and Concept Analysis
Cognitive Load Theory
Patient-Centered Care and Outcomes
Experiential Learning Theory
Teaching and Learning Communication Skills in Medicine (2e)
Self-efficacy
Patient-centredness
Unpacking Black Boxes
The craft of interviewing in realist evaluation
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