User and carer involvement in the training and education of health professionals: A review of the literature

doi:10.1016/j.ijnurstu.2006.05.013

International Journal of Nursing Studies

Volume 44, Issue 3, March 2007, Pages 511-519

https://doi.org/10.1016/j.ijnurstu.2006.05.013 Get rights and content

Abstract

Background

Health policy requires consumer involvement in services, research and education but little is known about how consumers are being involved in healthcare education, the effect on learning and practice, nor how involvement initiatives are being evaluated.

Objectives

To describe methods of involving consumers in healthcare education, discuss ways in which initiatives have been evaluated, and identify areas for development in education, practice and research.

Design

All papers reporting specific initiatives involving consumers in health care worker training and education were included. Viewpoint articles and studies of consumers training consumers were excluded.

Data sources

Cinahl, Medline, Assia, PsycINFO, British Nursing Index, Social Science Citation Index, citations from reference lists, relevant websites and personal communication with key people known to be working in this area.

Review methods

A narrative approach was taken with categorisation of data to reflect objectives of selected studies; method of involvement; process issues and evaluation.

Results

Thirty-eight papers were included; most provide small-scale qualitative studies of mental health service users and focus on process rather than outcome. Various methods of involvement are described and consumers consistently prioritise the need for training in interpersonal skills over ‘technical’ skills. There is little research into organisational strategies and no studies investigate the effect of consumer involvement on practice. Two studies indicated that students exposed to consumer involvement demonstrate more empathic understanding and better communication skills.

Conclusions

There is tentative evidence that consumer involvement in training enhances workers’ skills in the manner prioritised by consumers. However, if consumer involvement in training and education is to facilitate services that reflect the priorities of the people using them, it must be developed in partnership with service providers; further research is needed to explore the impact of consumer involvement and to track the development of organisational consumer involvement strategies, also systems for supporting consumers need to be established, including training for both consumers and staff.

Section snippets

What is already known about the topic?

•
As health services increasingly focus on patients’ choices, consumer involvement in training and education has been recommended by professional bodies.
•
Guidelines for consumer involvement in training and education have been developed.
•
Small-scale studies of consumer involvement have been published, but these have limited external validity.

What this paper adds

Bringing together the findings of all published studies illustrates

•
different methods of consumer involvement,
•
the areas of healthcare in which they have been tried,
•
their impact on consumers and students,
•
gaps in knowledge, and
•
areas for future development.

Background

The importance of involving consumers in all aspects of health care began to permeate UK government policy in the 1980s and was firmly ensconced by the 1990s. The Community Care Act (1990) clearly placed consumer involvement upon the health care agenda with ‘choice and independence’ as its underlying principles. Subsequent health policy and legislation have confirmed this principle as an essential part of the modernisation agenda. This has resulted in the development of structures for consumer

Search strategy

A variety of search methods were employed to ensure all the relevant literature was identified. The databases searched were: Cinahl, Medline, Assia, PsycINFO, British Nursing Index, Social Science Citation Index with no date or location restrictions. Citations were followed up from reference lists of retrieved articles. Relevant websites were consulted and personal communication with key people known to be working in this area aimed to reveal any ongoing work. A combination of thesaurus and

Gaining consumers’ views and experiences

One way of including the users’ perspective in education is by means of advisory groups; these may constitute existing groups, reference or focus groups set up for the purpose, or conferences with invited representatives from a range of interest groups. Harrison and Beresford (1994) describe the use of a conference as a means of consulting a range of different consumer groups in order to inform social work training for CCETSW. Key points to emerge from this exercise included the need for

Discussion

Out of the 38 papers selected only two papers reported carer involvement in education and training, the remaining focussed on the involvement of service users, and over half of the selected papers reported on the involvement of mental health service users demonstrating the relative interest in this area of health care. The approaches to consumer involvement in education and training included: gaining consumers’ views through surveys, reference groups, conferences and invitation onto existing

Recommendations

If consumer involvement in training and education is to facilitate services that reflect the wishes and priorities of the people using them, then it must be developed in partnership, across education and service delivery.

Further research is needed to explore the impact of both service user and carer involvement in education and training on students’ attitudes, behaviour and practice, and to compare different ways of involving consumers.

Organisational involvement strategies need to be developed

References (49)

J. Costello et al.
Patients as teachers? An evaluative study of patients’ involvement in classroom teaching
Nurse Education in Practice
(2001)
R. Frisby
User involvement in mental health branch education: client review presentations
Nurse Education Today
(2001)
S.M. Greenfield et al.
Community voices: views on the training of future doctors in Birmingham, UK
Patient Education and Counseling
(2001)
B. Hanson et al.
Involving mental health service users in the classroom: a course of preparation
Nurse Education in Practice
(2001)
S. Klein
The effects of the participation of patients with cancer in teaching communication skills to medical undergraduates: a randomised study with follow-up after 2 years
European Journal of Cancer
(1999)
S.F. Twinn
Creating reality or contributing to confusion? An exploratory study of client participation in student learning
Nurse Education Today
(1995)
S. Ah-Mane
Clinical view—learning from psychosis
Nursing Times
(1999)
L. Arnold
Commentary on Patient participants in a physical diagnosis course: a study of motivations and experiences with a comparison to student and faculty perceptions
Teaching and Learning in Medicine
(1992)
D. Barnes et al.
Partnerships with service users in interprofessional education for community mental health: a case study
Journal of Interprofessional Care
(2000)
P. Beresford
Changing the Culture: Involving Service Users in Social Work Education
(1994)

M. Blaxter

Criteria for evaluation of qualitative research

Medical Sociology News

(1996)

V. Chapman

Consumers as faculty: experts in their own lives

Journal of Psychosocial Nursing and Mental Health Services

(1996)

Cole, A., 1994. It was an education Service users assess student social workers. Community Living, January...

K. Coleman et al.

Patients’ views and feelings on the community-based teaching of undergraduate medical students: a qualitative study

Family Practice

(2002)

K. Coupland et al.

Learning from life

Mental Health Care

(2001)

T. Curran

Power, participation and post modernism: user and practitioner participation in mental health social work education

Social Work Education

(1997)

P. Dinsdale

Gain from pain

Nursing Times

(1999)

A First Class Service

(1998)

Patient and Public Involvement in the New NHS

(1999)

Learning From Each Other

(1996)

Evans, C., 1994. The service users who train care managers. Care Plan, December...

A. Felton et al.

Pedagogy, power and service user involvement

Journal of Psychiatric and Mental Health Nursing

(2004)

J. Flanagan

Public participation in the design of educational programmes for cancer nurses: a case report

European Journal of Cancer Care

(1999)

S. Forrest et al.

Mental health service user involvement in nurse education: exploring the issues

Journal of Psychiatric and Mental Health Nursing

(2000)

Cited by (181)

The patient involvement in nursing education: A mixed-methods systematic review
2023, Nurse Education Today
To evaluate the effects patient involvement in nursing education has on students, patients and academic staff using a specific theoretical framework.
Mixed-methods systematic review based on Joanna Briggs Institute methodology (Prospero no. CRD42022327158).
Seven databases (PubMed, Cochrane Library, Cinahl, PsychINFO, Scopus, ERIC, Embase), Google Scholar and reference lists were searched.
Qualitative, quantitative and mixed-method studies published from 2012 to 2022 were included. Two reviewers independently assessed the studies for eligibility and quality; any disagreement was discussed with a third reviewer. Data were extracted and analysed according to the Joanna Briggs Institute converged integrated approach.
Twenty-one qualitative, one quantitative and five mixed-methods studies met the inclusion criteria. Data were provided from three points of view: students, patients and academic staff. Student integrated findings included: (i) students' reactions towards patient involvement in education; (ii) students' views on the learning process and (iii) on ethical issue. From the patient point of view, the integrated findings addressed (i) patients' goals and effects on students' learning; (ii) how patients teach and get involved with students; (iii) how patients perceived their role; the patients' views on facilitators (iv) and barriers (v) in education; (vi) the perceived effects of being involved in education. Four integrated findings were derived from the academic staff's point of view: (i) academics' perceptions on patient vulnerability; (ii) perceived barriers to the efficacy of patient involvement in education; (iii) effects of patient involvement in nursing education; and (iv) methodological aspects of patient involvement in university curriculum.
This systematic review provides useful information from all stakeholders' perspectives on the effects of patient involvement in nursing education. It offers a broader view of the implications for implementation and for developing theoretical frameworks and hypotheses for future research.
“They wanted to know what it was like through my eyes”: Patients and carers views, experiences, and perceptions of active involvement in the delivery of an undergraduate pharmacy curriculum
2022, Currents in Pharmacy Teaching and Learning
There is an increasing policy and practice imperative for involving patients and carers in health-related undergraduate courses. The School of Pharmacy and Life Sciences at Robert Gordon's University, United Kingdom launched a module where patients and carers are actively involved in the delivery of the curriculum by sharing their experiences of their condition and its management with final year student pharmacists. This study aimed to evaluate this initiative by exploring patients' and carers' views and experiences of their active involvement in the delivery and their perceptions of potential future involvement in the design of the pharmacy curriculum.
Face-to-face semi-structured interviews were carried out with patients and carers who were actively involved in the delivery of the pharmacy course. The interview schedule was developed based on the research aim, an extensive literature review, and peer discussion before it was piloted. All interviews were digitally recorded and thematically analysed by two independent researchers.
Seven of eight patients and carers involved in the module agreed to be interviewed. Five themes were identified: reasons for engagement with active teaching, perceived impact of active teaching on students, perceived impact of active teaching on patients and carers themselves, perceived opportunity to improve care of future patients, and challenges and suggestions for improvement.
Overall, patients and carers had a positive view of their active involvement with delivering the undergraduate pharmacy curriculum; they were however unsure about involvement in curriculum design.
A systematic review of patient interactions with student pharmacists in educational settings
2021, Journal of the American Pharmacists Association
Patients may contribute to various aspects of student pharmacists' education within clinical, experiential and educational settings. There is an emerging body of literature describing and evaluating the contribution of patients to health care education; however, little is known about patients' contribution to pharmacy education specifically within educational settings.
To explore the evidence relating to the involvement of patients in the education of student pharmacists, in terms of the nature, extent, and outcomes of their contribution.
A systematic literature search was undertaken within Embase, MEDLINE, Education Resources Information Center, International Pharmaceutical Abstracts, PubMed, PsycINFO, CINAHL, and Scopus databases from inception to April 10, 2020. Inclusion criteria included primary research studies reporting on the active involvement of patients in pharmacy education, within an educational setting. Quality assessment appraisal for the included studies was conducted using the Mixed Methods Appraisal Tool.
Twelve studies were eligible for inclusion in this systematic review. Nine studies explored the use of patients as educators providing valuable insight about their lived experience. Six studies involved patients in question-and-answer sessions, providing students with opportunities to inquire about their lived experience in relation to medicines, health care, and medical conditions. Studies that reported on students’ learning outcomes demonstrated improvements in communication skills, deeper understanding of patients’ lived experience particularly relating to mental illness, and increased confidence in providing care for patients. Among patients, participation in the educational process led to greater satisfaction, empowerment, and knowledge from sharing personal experiences. There were no clinical outcomes measured among patients participating in the included studies. The 5 nonrandomized quantitative studies ranged from low to moderate levels of quality, the 4 mixed-methods studies were of low quality, and the 3 qualitative studies were of high quality.
The involvement of patients in the education of student pharmacists was found to benefit both patients and students. Student-specific outcomes included development of communication skills and new insights about patients’ lived experience. Further research is needed to better understand the long-term impact of patient involvement in pharmacy education, in terms of students' learning outcomes and clinical outcomes among patients.
‘ALL ABOUT MY IDEAL MENTAL HEALTH SERVICE’: Users, family members and experts by experience discussing a co-designed service
2024, Health Expectations
Power to the people? A co-produced critical review of service user involvement in mental health professions education
2024, Advances in Health Sciences Education
Understanding the identity of lived experience researchers and providers: a conceptual framework and systematic narrative review
2023, Research Involvement and Engagement

View all citing articles on Scopus

View full text

User and carer involvement in the training and education of health professionals: A review of the literature

Abstract

Background

Objectives

Design

Data sources

Review methods

Results

Conclusions

Section snippets

What is already known about the topic?

What this paper adds

Background

Search strategy

Gaining consumers’ views and experiences

Discussion

Recommendations

Nurse Education in Practice

Nurse Education Today

Patient Education and Counseling

Nurse Education in Practice

European Journal of Cancer

Nurse Education Today

Clinical view—learning from psychosis

Nursing Times

Commentary on Patient participants in a physical diagnosis course: a study of motivations and experiences with a comparison to student and faculty perceptions

Teaching and Learning in Medicine

Partnerships with service users in interprofessional education for community mental health: a case study

Journal of Interprofessional Care

Changing the Culture: Involving Service Users in Social Work Education

Criteria for evaluation of qualitative research

Medical Sociology News

Consumers as faculty: experts in their own lives

Journal of Psychosocial Nursing and Mental Health Services

Patients’ views and feelings on the community-based teaching of undergraduate medical students: a qualitative study

Family Practice

Learning from life

Mental Health Care

Power, participation and post modernism: user and practitioner participation in mental health social work education

Social Work Education

Gain from pain

Nursing Times

A First Class Service

Patient and Public Involvement in the New NHS

Learning From Each Other

Pedagogy, power and service user involvement

Journal of Psychiatric and Mental Health Nursing

Public participation in the design of educational programmes for cancer nurses: a case report

European Journal of Cancer Care

Mental health service user involvement in nurse education: exploring the issues

Journal of Psychiatric and Mental Health Nursing