Abstract
Patients are (or should be) at the centre of surgical care. Therefore, it makes sense that patients have a central role in surgical education. In this chapter, we describe ways in which patients have participated and currently contribute to surgical education. We argue for raising the prominence of patients as critical learning resources. We start by outlining changes in service delivery; these inevitably have implications for education, since the practice of surgery has traditionally been learned in the workplace. Recent changes in surgical training are summarised. We explore patients’ experiences of healthcare services and how these may contribute to education. The role of real patients in medical and surgical education is reviewed, with outcomes articulated for patients, trainees and clinicians/educators. Finally, we outline the contributions of simulated patients (SPs). In doing this, we draw on different sources and our own work and put forward ideas about patient involvement in surgical education. Differences in education and healthcare services obviously make uniform conclusions challenging. We invite readers to reflect on this content relative to their own setting.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Adamo, G. (2003). Simulated and standardized patients in OSCEs: Achievements and challenges 1992–2003. Medical Teacher, 25, 262–270.
Aggarwal, R. (2006). Technical-skills training in the 21st century. The New England Journal of Medicine, 355, 2695.
Barnes, H., Alabanese, M., & Schroder, J. (1980). Informed consent: The use of inpatients as teaching-patients for sophomore medical students. Journal of Medical Education, 55, 698–703.
Barrows, H. S. (1968). Simulated patients in medical teaching. Canadian Medical Association Journal, 98, 674–676.
Bell, K., Boshiuzen, H., Scherpbier, A., & Dornan, T. (2009). When only the real thing will do: Junior medical students’ learning from real patients. Medical Education, 43, 1036–1043.
Bideau, M., Guerne, P., Bianchi, M., & Huber, P. (2006). Benefits of a programme taking advantage of patient-instructors to teach and assess musculoskeletal skills in medical students. Annals of the Rheumatic Diseases, 65, 1626–1630.
Black, S., Nestel, D., Horrocks, E., Harrison, R., Jones, N., Wetzel, C., & Kneebone, R. (2006). Evaluation of a framework for case development and simulated patient training for complex procedures. Journal of Simulation in Healthcare, 1, 66–71.
Blasco, P., Kohen, H., & Shapland, C. (2005). Parents as teachers: Design and establishment of a training programme for residents. Medical Education, 33, 695–701.
Bleakley, A., & Bligh, J. (2008). Students learning from patients: Let’s get real in medical education. Advances in Health Sciences Education, 13, 89–107.
Bliss, M. (1999). William osler: A life in medicine. New York: Oxford University Press.
Calman, K. (2007). Medical education, past, present and future. Edinburgh: Churchill Livingstone Elsevier.
Chan, D. K., Gallagher, T. H., Reznick, R., & Levinson, W. (2005). How surgeons disclose medical errors to patients: A study using standardized patients. Surgery, 138, 851–858.
Chipman, J. G., Beilman, G. J., Schmitz, C. C., & Seatter, S. C. (2007). Development and pilot testing of an OSCE for difficult conversations in surgical intensive care. Journal of Surgical Education, 64, 79–87.
Coleman, K., & Murray, E. (2002). Patients’ views and feelings on the community-based teaching of undergraduate medical students: A qualitative study. Family Practice, 19, 183–188.
Coulter, A. (1999). Paternalism or partnership?: Patients have grown up and there’s no going back. BMJ, 319, 719–720.
Cowles, R. A., Moyer, C. A., Sonnad, S. S., Simeone, D. M., Knol, J. A., Eckhauser, F. E., Mulholland, M. W., & Colletti, L. M. (2001). Doctor-patient communication in surgery: Attitudes and expectations of general surgery patients about the involvement and education of surgical residents. Journal of the American College of Surgeons, 193, 73–80.
D’Angelica, M., Hirsch, K., Ross, H., Passik, S., & Brennan, M. F. (1998). Surgeon-patient communication in the treatment of pancreatic cancer. Archives of Surgery, 133, 962–966.
Darzi, A. (2008). High quality care for all. London: TSO
Department of Health. (2000). The NHS plan – Summary. London: Department of Health.
Easter, D. W., & Beach, W. (2004). Competent patient care is dependent upon attending to empathic opportunities presented during interview sessions. Current Surgery, 61, 313–318.
Frank, J. (2005). The CanMEDS 2005 physician competency framework. Better standards. Better physicians. Better care. Ottawa: The Royal College of Physicians and Surgeons of Canada.
Gaver, A., Borkan, J., & Weingarten, M. (2005). Illness in context and families as teachers: A year-long project for medical students. Academic Medicine, 80, 448–451.
Haq, I., Fuller, J., & Dacre, J. (2006). The use of patient partners with back pain to teach undergraduate medical students. Rheumatology, 45, 430–434.
Intercollegiate Surgical Curriculum Project (2010). https://www.iscp.ac.uk/. Last accessed 1 Jan 2010.
Jha, V., Quinton, N., Bekker, H., & Roberts, T. (2009). Strategies and interventions for the invovlement of real patients in medical education: A systematic review. Medical Education, 43, 10–20.
Jones, P. (2005). Doctors as patients. Oxford: Radcliffe.
Kassab, E., King, D., Hull, L., Arora, S., Sevdalis, N., Kneebone, R., & Nestel, D. (2010). Actor training for surgical simulations. Medical Teacher, 32(3), 256–258.
Kennedy, I. (2001). The Inquiry into the management of care of childrenreceiving complex heart surgery at the Bristol Royal Infirmary. London: Crown Publishing.
Ker, J. S., Dowie, A., Dowell, J., Dewar, G., Dent, J., Ramsay, J., Benvie, S., Bracher, L., & Jackson, C. (2005). Twelve tips for developing and maintaining a simulated patient bank. Medical Teacher, 27, 4–9.
Kielmann, T., Huby, G., Powell, A., Sheikh, A., Price, D., Williams, S., & Pinnock, H. (2009). From support to boundary: A qualitative study of the border between self-care and professional care. Patient Education and Counselling, 79(1), 55–61.
Klein, S., Tracy, D., Kitchener, H., & Walker, L. (2000). The effects of the participation of patients with cancer in teaching communication skills to medical undergraduates: A randomised study with follow-up after two years. European Journal of Cancer, 36, 273–281.
Klitzman, R. (2007). When doctors become patients. New York: Oxford University Press.
Kneebone, R., & Nestel, D. (2005). Learning clinical skills - the place of simulation and feedback. The Clinical Teacher, 2, 86–90.
Kneebone, R., & Nestel, D. (2010). Learning and teaching clinical procedures. In S. E. Dornan (Ed.), Medical education: Theory and practice (pp. 172–192). London: Elsevier.
Kneebone, R., Nestel, D., Wetzel, C., Black, S., Jacklin, R., Aggarwal, R., Yadollahi, F., Wolfe, J., Vincent, C., & Darzi, A. (2006a). The human face of simulation: Patient-focused simulation training. Academic Medicine, 81, 919–924.
Kneebone, R. L., Nestel, D., Chrzanowska, J., Barnet, A. E., & Darzi, A. (2006b). Innovative training for new surgical roles–the place of evaluation. Medical Education, 40, 987–994.
Kneebone, R. L., Nestel, D., Vincent, C., & Darzi, A. (2007). Complexity, risk and simulation in learning procedural skills. Medical Education, 41, 808–814.
Kneebone, R., Bello, F., Nestel, D., Mooney, N., Codling, A., Yadollahi, F., Tierney, T., Wilcockson, D., & Darzi, A. (2008). Learner-centred feedback using remote assessment of clinical procedures. Medical Teacher, 30, 795–801.
Lazarus, P. A. (2007). Patients’ experiences and perceptions of medical student candidates sitting a finals examination. Medical Teacher, 29, 478–483.
Leblanc, V. R., Tabak, D., Kneebone, R., Nestel, D., Macrae, H., & Moulton, C. A. (2009). Psychometric properties of an integrated assessment of technical and communication skills. American Journal of Surgery, 197, 96–101.
Lehmann, L., Brancati, F., Chen, M., Roter, D., & Dobbs, A. (1997). The effect of bedside case presentations on patients’ perceptions of their medical care. The New England Journal of Medicine, 336, 1150–1155.
May, W., Park, J., & Lee, J. (2009). A ten-year review of the literature on the use of standardized patients in teaching and learning: 1996–2005. Medical Teacher, 31, 487–492.
Morris, P. (2006). The patient’s voice in doctor’s learning. In J. Thistlethwaite & P. Morris (Eds.), The patient doctor consultation in primary care: Theory and practice. London: Royal College of General Practitioners.
Moulton, C.-A., Tabak, D., Kneebone, R., Nestel, D., Macrae, H., & Leblanc, V. R. (2009). Teaching communication skills using the integrated procedural performance instrument (IPPI): A randomized controlled trial. American Journal of Surgery, 197, 113–118.
Nestel, D., Kneebone, R., & Barnet, A. (2005). Teaching communication skills for handover: Perioperative specialist practitioners. Medical Education, 39, 1157.
Nestel, D., Bello, F., Kneebone, K. A. R., & Darzi, A. (2008a). Remote assessment and learner-centred feedback using the Imperial College Feedback and Assessment System (ICFAS). The Clinical Teacher, 5, 88–92.
Nestel, D., Black, S., Kneebone, R., Wetzel, C., Thomas, P., Wolfe, S., & Darzi, A. (2008b). Simulated anaesthetists in high fidelity simulations for surgical training: Feasibility of a training programme for actors. Medical Teacher, 30, 407–413.
Nestel, D., Cecchini, M., Calandrini, M., Chang, L., Dutta, R., Tierney, T., Brown, R., & Kneebone, R. (2008c). Real patient involvement in role development evaluating patient focused resources for clinical procedural skills. Medical Teacher, 30, 795–801.
Nestel, D., Tierney, T., Muir, E., & Kubacki, A. (2008d). Learning to talk with patients: Feasibility of a volunteer simulated patient programme for first year medical students. International Journal of Clinical Skills, 2, 121–128.
Nestel, D., Clark, S., Ashwell, V., Tabak, D., Muir, E., & Higham, J. (2010a). Defining responsibilites of simulated patients in medical education. Simulation in Healthcare, 5(3), 161–168.
Nestel, D., Kneebone, R., Barnet, A., Tierney, T., & Darzi, A. (2010b). Evaluation of a clinical communication program for peri-operative and surgical care practitioners. Quality and Safety in Healthcare, 19(5), e1. April 21, 1–7.
NHS Modernisation Agency. (2005). Improvement leaders guides: Involving patients and carers. London: Department of Health Publications.
O’Brien, C. (2008). Never say die. Sydney: HarperCollinsPublishing.
Petrusa, E. (2002). Clinical performance assessments. In G. Norman, C. van der Vleuten, & D. Newble (Eds.), International handbook of research in medical education (pp. 673–710). Dordrecht: Kluwer Academic.
Rethans, J., Gorter, S., Bokken, L., & Morrison, L. (2007). Unannounced standardised patients in real practice: A systematic literature review. Medical Education, 41, 537–549.
Reznick, R., & Macrae, H. (2006). Teaching Surgical Skills – Changes in the Wind. The New England Journal of Medicine, 355, 2664–2669.
Richards, N., & Coulter, A. (2007). Is the NHS becoming more patient-centred? Trends from the national surveys of NHS patients in England 2002–07. Oxford: Picker Institute Europe.
Smith, M., Henry-Edwards, S., Shanahan, E., & Ahern, M. (2000). Evaluation of patient partners in the teaching of the musculoskeletal examination. The Journal of Rheumatology, 27, 1533–1537.
Stacy, R., & Spencer, J. (1999). Patients as teachers: A qualitative study of patients’ views on their role in a community-based undergraduate project. Medical Education, 33, 688–694.
Temple, W., Toews, J., Fidler, H., Lockyer, J. M., Taenzer, P., & Parboosingh, E. J. (1998). Concordance in communication between surgeon and patient. Canadian Journal of Surgery, 41, 439–445.
Thistlethwaite, J., & Cockayne, E. (2004). Early student-patient interactions: The views of patients regarding their experiences. Medical Teacher, 26, 420–422.
Thorne, L., Ellamushi, H., Mtandari, S., Mcevoy, A. W., Powell, M., & Kitchen, N. D. (2002). Auditing patient experience and satisfaction with neurosurgical care: Results of a questionnaire survey.[see comment]. British Journal of Neurosurgery, 16, 243–255.
Vail, R., Mahon-Salazar, C., Morrison, A., & Kalet, A. (1996). Patients as teachers: An integrated approach to teaching medical students about the ambulatory care of HIV-infected patients. Patient Education and Counselling, 27, 95–101.
Vu, N., Barrows, H., Marcy, M., Verhulst, S., Colliver, J., & Travis, T. (1992). Six years of comprehensive, clinical performance-based assessment using standardized patients at the Southern Illinois University School of Medicine. Academic Medicine, 67, 43–50.
Wallace, P. (2007). Coaching standardized patients for use in assessment of clinical competence. New York: Springer Publishing Company.
Walters, K., Buszewicz, M., Russell, J., & Humphrey, C. (2003). Teaching as therapy: Cross-sectional and qualitative evaluation of patients’ experiences of undergraduate psychiatry teaching in the community. BMJ, 326, 740–745.
Ware, J., Davies, A., & Connor, E. (1995). Patients assessments of quality. In M. Lipkin, S. M. Putnam, & A. Lazare (Eds.), The medical interview: Clinical care, education, and research. New York: Springer.
Wenger, E. (1998). Communities of practice: Learning, meaning and identity. Cambridge: Cambridge University Press.
Williams, R. G., Silverman, R., Schwind, C., Fortune, J. B., Sutyak, J., Horvath, K. D., Van Eaton, E. G., Azzie, G., Potts, J. R., 3rd, Boehler, M., & Dunnington, G. L. (2007). Surgeon information transfer and communication: Factors affecting quality and efficiency of inpatient care.[see comment]. Annals of Surgery, 245, 159–169.
Ziebland, S., & McPherson, A. (2006). Making sense of qualitative data analysis: An introduction with illustrations from DIPEx (personal experiences of health and illness). Medical Education, 40, 405–414.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media B.V.
About this chapter
Cite this chapter
Nestel, D., Bentley, L. (2011). The Role of Patients in Surgical Education. In: Fry, H., Kneebone, R. (eds) Surgical Education. Advances in Medical Education, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1682-7_9
Download citation
DOI: https://doi.org/10.1007/978-94-007-1682-7_9
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-1681-0
Online ISBN: 978-94-007-1682-7
eBook Packages: MedicineMedicine (R0)