Meaningful Patient Participation in Health Care Education: A Theoretically Informed Study Exploring Boundaries and Identities.

Abstract

Purpose: After recent policy and practice changes, health care schools are expected to involve patients as partners in the management, design, and delivery of professional curricula. However, what these partnerships mean for academic communities and the processes needed to support them are not yet understood. This study examines what involving patients as partners within an academic community means for key stakeholders.

Method: A qualitative case study design with a social constructivist philosophical stance was used. Communities of practice served as the theoretical framework. Semistructured interviews were conducted with patients and educators from the University of Leicester between November 2021 and May 2022. Focus groups were held with penultimate-year students. Data were analyzed using reflexive thematic analysis informed by communities of practice.

Results: The sample comprised 40 participants. Ten patients and 10 educators participated in 40- to 60-minute interviews. Twenty students participated in 1 of 5 focus group discussions lasting 30 to 50 minutes. Two overarching themes were reported: "boundaries as (permeable) barriers to participation" and "identity as an interpretive lens." Boundaries among patients, educators, and students can hinder patients' meaningful involvement in health care education. Boundaries are marked through differences in knowledge, a lack of shared vision, and a lack of trust in patients. Patients, educators, and students have separate distinct identities. They experience tensions of identity when they meet across boundaries. These tensions reveal insights into the construction of the typical patient identity in health care education.

Conclusions: Applying communities of practice illuminated boundary and identity issues that patients, educators, and students experience when patients are involved in health care education. Health care schools should develop comprehensive training for patients, provide faculty development regarding patient involvement, support students to trust in patient teachers, and embed a distinctive strand of patient involvement across health care curricula.