PURPOSE:Mentorship programs in health professional education are often characterized as a mutually beneficial relationship between mentor and mentee, but little is known about benefits for mentors. Mentors can be health professionals, academic faculty, other students (peers), and patients (health mentors). We studied the benefits that health mentors (people with chronic health conditions or disabilities, or a caregiver) get from mentoring students, and the contextual factors that contribute to, or explain these benefits. METHODS:We surveyed 72 health mentors who had mentored between one and eight cohorts of students from different health professions in the health mentors program at the University of British Columbia. Using a contextual-developmental framework of mentorship, we analyzed mentors' responses to open-ended questions about how they benefit from the program. RESULTS:Benefits fit into three categories: generativity (guiding the next generation), transformation (personal growth and reflection), and 'career' development (new activities resulting from increased self-efficacy). Contextual factors that contributed to benefits included the non-clinical setting, informality of meetings and reciprocal learning, and feeling valued by the program and students. CONCLUSIONS:Health mentors perceive benefits in passing on their lived experiences to students, leading to personal growth and new activities. Their perspectives offer unique insights into the workings of effective mentorship relationships. There is much to be learned about how benefits of mentoring are linked to program design.

Purpose Medical education should foster professional identity formation, but there is much to be learned about how to support learners in developing their professional identity. This study examined the role that patients can play in supporting professional identity development during the University of British Columbia Interprofessional Health Mentors Program (HMP), a longitudinal preclinical elective in which patients, or their caregivers, act as mentors and educate students about their lived experience of a chronic condition or disability. Method The authors interviewed 18 medical residents in 2016, 3 to 4 years after they completed the HMP. Professional identity was explored by asking participants how the HMP had influenced their ideas about the ideal physician and the kind of doctor they aspire to become. The authors analyzed the data using the identify status paradigm as a conceptual framework. Results The authors identified 7 themes: patient as more than disease, patient as autonomous, patient as expert, doctor as partner, doctor as collaborator, self-aware doctor, and empathic doctor. They found firm commitments to patient partnership, interprofessional collaboration, and holistic care for patients rooted in the exploration of professional values that was prompted by patient mentors during HMP. Conclusions Patient mentors can help medical students begin to construct their professional identity during the preclinical period by supporting exploration of and commitment to the professional values that society expects of physicians.

SummaryBackgroundHealth professional students are provided with a wealth of online learning resources recommended by curriculum developers or instructors, the majority of which focus on biological and clinical science. Our goal was to develop a database of learning resources to help students and faculty members understand chronic health conditions from a patient's perspective. Resources were recommended by patients and evaluated by students.Our goal was to develop a database of learning resources … recommended by patients and evaluated by studentsMethodsPatients and caregivers who recommend resources to their students in an interprofessional health mentors programme, and participants in a Disability Learning Resource planning session, provided 68 different resources, ranging from community organisation websites to personal biographies. Resources were organised into eight categories and rated by 10 senior health professional students.Patients … provided 68 different resources, ranging from community organisation websites to personal biographiesResultsPatients recommended resources so that students could learn what it is like to live with a particular condition, and also learn about useful patient information resources and community‐based advocacy organisations. Students identified 40% of the rated resources as useful or exceptionally useful, and identified the characteristics of useful and not useful resources.Students identified 40% of the rated resources as useful or exceptionally useful …ConclusionsStudents want resources that are easy to navigate and are well organised. They want a ‘one‐stop shop’ to access information about a particular condition or disease, and value resources that they can recommend to their patients as well as use to expand their own knowledge. Students value information about local organisations for specific conditions that they can connect their patients to, and from which they may learn more about existing support initiatives in their communities. Clinical educators could better prepare students for practice by making available patient‐recommended resources.Students … value resources that they can recommend to their patients as well as use to expand their own knowledgeStudents value information about local organisations for specific conditions that they can connect their patients to …Clinical educators could better prepare students for practice by making available patient‐recommended resources

Health professional education (HPE) has taken a problem-based approach to community service-learning with good intentions to sensitize future health care professionals to community needs and serve the underserved. However, a growing emphasis on social responsibility and accountability has educators rethinking community engagement. Many institutions now seek to improve community participation in educational programs. Likewise, many Canadians are enthusiastic about their health care system and patients, who are “experts by lived experience,” value opportunities to “give back” and improve health care by taking an active role in the education of health professionals. We describe a community-based participatory action research project to develop a mechanism for community engagement in HPE at the University of British Columbia (UBC). In-depth interviews and a community dialogue with leaders from 18 community-based organizations working with vulnerable populations revealed the shared common interest of the community and university in the education of health professionals. Patients and community organizations have a range of expertise that can help to prepare health practitioners to work in partnership with patients, communities, and other professionals. Recommendations are presented to enhance the inclusion of community expertise in HPE by changing the way the community and university engage with each other.

Purpose – The purpose of this paper is to present a statement about the involvement of patients in the education of health and social care professionals developed at an international conference in November 2015. It aims to describe the current state and identify action items for the next five years. Design/methodology/approach – The paper describes how patient involvement in education has developed as a logical consequence of patient and public participation in health care and health research. It summarizes the current state of patient involvement across the continuum of education and training, including the benefits and barriers. It describes how the conference statement was developed and the outcome. Findings – The conference statement identifies nine priorities for action in the areas of policy, recognition and support, innovation, research and evaluation, and dissemination and knowledge exchange. Originality/value – The conference statement represents the first time that an international and multidisc...

Purpose – The purpose of this paper is to present a statement about the involvement of patients in the education of health and social care professionals developed at an international conference in November 2015. It aims to describe the current state and identify action items for the next five years. Design/methodology/approach – The paper describes how patient involvement in education has developed as a logical consequence of patient and public participation in health care and health research. It summarizes the current state of patient involvement across the continuum of education and training, including the benefits and barriers. It describes how the conference statement was developed and the outcome. Findings – The conference statement identifies nine priorities for action in the areas of policy, recognition and support, innovation, research and evaluation, and dissemination and knowledge exchange. Originality/value – The conference statement represents the first time that an international and multidisciplinary group has worked together to assemble in a single document specific priorities for action to embed the patient’s voice in health professional education.

Partnering with patients is an urgent imperative for transforming the health care system to one that is focused on building a culture of health. Data supports this call by demonstrating positive impacts of patient engagement on health outcomes in different settings (CFHI, 2014; IOM, 2014). To respond to this growing trend, health care providers (HCP) need to be trained and educated to become proficient collaborators and nurture collaborative partnerships with patients. However, to date, integrating patients in education and training is considerably less common, and data to support programme development are scarce. A paradigm shift in the health care systems from a paternalist to a patient-as-partner approach is needed (Karazivan et al., 2015; Richards, Montori, Godlee, Lapsley & Paul, 2013). In this chapter, Canadian and American authors from four different universities—leaders in involving patients as educators for health care students—will present their experiences in interprofessional education (IPE). They will examine the processes of integrating partnership with patients in IPE and present how the leadership takes form and is actualised, and discuss evaluation issues.

The Clinical TeacherVolume 12, Issue 3 p. 149-154 The Clinical Teacher's Toolbox Patients as teachers: promoting their authentic and autonomous voices Angela Towle, Corresponding Author Angela Towle Division of Health Care Communication, College of Health Disciplines, University of British Columbia, Vancouver, British Columbia, CanadaCorresponding author's contact details: Angela Towle, Division of Health Care Communication, College of Health Disciplines, University of British Columbia, 400-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada. E-mail: [email protected]Search for more papers by this authorWilliam Godolphin, William Godolphin Division of Health Care Communication, College of Health Disciplines, University of British Columbia, Vancouver, British Columbia, CanadaSearch for more papers by this author Angela Towle, Corresponding Author Angela Towle Division of Health Care Communication, College of Health Disciplines, University of British Columbia, Vancouver, British Columbia, CanadaCorresponding author's contact details: Angela Towle, Division of Health Care Communication, College of Health Disciplines, University of British Columbia, 400-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada. E-mail: [email protected]Search for more papers by this authorWilliam Godolphin, William Godolphin Division of Health Care Communication, College of Health Disciplines, University of British Columbia, Vancouver, British Columbia, CanadaSearch for more papers by this author First published: 25 May 2015 https://doi.org/10.1111/tct.12400Citations: 35 Funding: None. Conflict of interest: None. Acknowledgements: We would like to acknowledge the perspectives provided by our community partners over many years, and especially Cheryl Hewitt, R Paul Kerston and Sue Macdonald. Ethical approval: Not required. 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References 1Towle A, Bainbridge L, Godolphin W, Katz A, Kline C, Lown B, Madularu I, Solomon P, Thistlethwaite J. Active patient involvement in the education of health professionals. Med Educ 2010; 44: 64–74. 10.1111/j.1365-2923.2009.03530.x CASPubMedWeb of Science®Google Scholar 2Jha V, Quinton ND, Bekker HL, Roberts TE. Strategies and interventions for the involvement of real patients in medical education: a systematic review. Med Educ 2009; 43: 10–20. 10.1111/j.1365-2923.2008.03244.x CASPubMedWeb of Science®Google Scholar 3Morgan A, Jones D. Perceptions of service user and carer involvement in healthcare education and impact on students’ knowledge and practice: a literature review. Med Teach 2009; 31: 82–95. 10.1080/01421590802526946 PubMedWeb of Science®Google Scholar 4Terry J. Service user involvement in pre-registration mental health nurse education classroom settings: a review of the literature. J Psychiatr Ment Health Nurs 2012; 19: 816–829. 10.1111/j.1365-2850.2011.01858.x CASPubMedWeb of Science®Google Scholar 5Anderson J. Involving service users and carers in education: the development worker role. Guidelines for Higher Education Institutions. Higher Education Academy/Mental Health in Higher Education; 2009. Available at eprints.lancs.ac.uk/69396. Accessed on 2 April 2015. Google Scholar 6Williamson C. ‘How do we find the right patients to consult?‘ Qual Prim Care 2007; 15: 195–199. Web of Science®Google Scholar 7 PeerNetBC. Principles of peer support. Available at: http://www.peernetbc.com/principles-of-peer-support. Accessed on 2 April 2015. Google Scholar 8Bleakley A, Bligh J. Students learning from patients: let's get real in medical education. Adv Health Sci Educ Theory Pract 2008; 13: 89–107. 10.1007/s10459-006-9028-0 PubMedWeb of Science®Google Scholar 9Haidet P, Stein HF. The role of the student–teacher relationship in the formation of physicians. J Gen Intern Med 2006; 21 Suppl: S16–S20. 10.1111/j.1525-1497.2006.00304.x PubMedWeb of Science®Google Scholar 10Coulehan J, Granek IA. “I hope I'll continue to grow”: rubrics and reflective writing in medical education. Acad Med 2012; 87: 8–10. 10.1097/ACM.0b013e31823a98ba PubMedWeb of Science®Google Scholar 11Smith E. Teaching critical reflection. Teach High Educ 2011; 16: 211–223. 10.1080/13562517.2010.515022 PubMedWeb of Science®Google Scholar 12 British Medical Association. Role of the patient in medical education; 2008. Available at http://bma.org.uk/developing-your-career/medical-student/the-role-of-the-doctor/role-of-the-patient. Accessed on 2 April 2015. Google Scholar 13Spencer J, Godolphin W, Karpenko N, Towle A. Can patients be teachers? Involving patients and service users in healthcare professionals’ education. A report of The Health Foundation, London, UK; October 2011. http://www.health.org.uk/publications/can-patients-be-teachers/. Accessed on 2 April 2015. Google Scholar 14Vogel AL, Seifer SD, Gelmon SB. What influences long-term sustainability of service-learning? Lessons from early adopters. Michigan Journal of Community Service Learning 2010; 17: 59–74. Google Scholar Citing Literature Volume12, Issue3June 2015Pages 149-154 ReferencesRelatedInformation

Community‐based learning connects students with local communities so that they learn about the broad context in which health and social care is provided; however, students usually interact with only one or a few organisations that serve a particular population. One example of a community‐based learning activity is the health fair in which students provide health promotion and screening for local communities.

PARTICIPATING SOCIETIES/SOCIETES PARTICIPANTES Canadian Neurosurgical Society Societe canadienne de neurochirurgie Canadian Neurological Society Societe canadienne de neurologie Canadian Society of Electroencephalographers, Electromyographers and Clinical Neurophysiologists Societe canadienne des electroencephalographistes, electromyographistes et neurophysiologistes cliniques Canadian Association of Neurological and Neurosurgical Nurses Association canadienne des infirmieres en neurologie et neurochirurge

Patients have always been important in medical education, but their role has usually been as passive aids to learning. Active involvement of patients as educators has increased over the past 20 years as a consequence of government and professional policy directives relating to public and patient involvement in healthcare, moral imperatives related to social accountability, and the desire to broaden curricula to include the psychosocial aspects of health, promote patient-centred care and include the voices of those who are experts by experience. Patients are mainly involved in curriculum delivery and, to a much lesser extent, curriculum development and student assessment. In other professional programmes such as nursing and social work, a greater range of educational roles is found. Examples of active involvement occur throughout the continuum of medical education and include patients telling their stories; patients teaching clinical and communication skills; co-teaching with faculty; family attachment schemes; mentoring programmes; and community-based placements. Various classification schemes have been developed to assist the study and comparison of patient-as-teacher initiatives, especially focused on the degree of involvement in educational decision making. Patient involvement in education is viewed positively by learners, patients and professional educators. Evidence of short-term benefits has been demonstrated. However, educational initiatives involving patients are rarely informed by learning theory and rigorous studies of long term outcomes are lacking. Medical educators wishing to increase active patient involvement in their programmes need to attend to a variety of practical matters, including patient recruitment, preparation, support, and recognition. At the institutional level coordinated and sustained programmes of patient involvement in education require engagement with patient groups and community organizations in a non-tokenistic way to develop authentic partnerships.

Communication between health care professionals and Aboriginal patients is complicated by cultural differences and the enduring effects of colonization. Health care providers need better training to meet the needs of Aboriginal patients and communities. We describe the development and outcomes of a community-driven service-learning program in which health professional students learn with, from, and about the community through brief immersion in summer camps put on by an Aboriginal agency to teach their own youth about their culture. Outcomes were assessed by semi-structured interviews with students and community members. Health profession students learn about important cultural differences, become more aware of their own values, beliefs and stereotypes, and consider ways to overcome communication barriers that interfere with developing trust with Aboriginal patients. These outcomes are retained long-term and influence relationships with patients in practice as well as career paths. Students are seen by the community as good role models. The opportunity to educate university students enhances the community’s sense of pride in their culture.

An estimated 133 million Americans and 16 million Canadians (roughly half the population of both countries) live with at least one chronic illness; about one in four suffers limitations to daily activities as a consequence. As the population ages and people live longer, we can expect to see an increase in the prevalence and complexity of chronic illness. Chronic disease management will become a major part of the work of health professionals, both as individuals and as members of interprofessional teams. The need to align medical education with changes in health care delivery will require more emphasis on chronic disease management as well as on the related topics of behavioral and social sciences and interprofessional teamwork.1 Yet medical education is still focused on, and in, acute care. A PubMed search of all issues of two top medical education journals for the term “chronic disease management” yielded four papers in Academic Medicine and nine in Medical Education. In chronic disease, the patient/family is the chief provider of care. Patient chronic disease self-management (CDSM) and self-management support by clinicians have been identified as essential components of chronic care programs. The need for health professionals to be trained in the core competencies required in CDSM support has been identified. Yet there appears to be a wide gap between health professionals' understanding of CDSM and the wider concerns and realities of patients. Whereas health professionals identify self-management primarily as structured patient education, patients identify self-management as a process initiated to bring about order in their lives that involves recognizing and monitoring the boundaries, mobilizing resources, managing the shift in self-identity, and balancing, pacing, planning, and prioritizing. A seminal study identified three lines of work that people managing chronic illnesses at home must undertake: illness work, referred to as trajectory management (symptom management, diagnostic-related work, crisis prevention and management); everyday life work (house work, looking after family, paid work, eating, etc.); and biographical work (reconstruction of the patient's biography).2 These tasks may compete or conflict with medical management, especially in patients with multiple chronic conditions. Since this research, more recent studies of patients' experiences have identified further forms of work including information work, moral work, and time work. Through doing this work, many patients living with chronic illness become “experts by experience.” There is strong evidence in the literature that many physicians are unaware of the scope of work involved in CDSM, do not recognize the expertise that patients acquire, and do not provide appropriate support. These problems are hardly surprising given the lack of, or narrow (biomedical) focus on, chronic disease management in medical education. Learning about chronic disease has a low profile, and the few educational programs described have been defined by professionals within a biomedical model, the goal being primarily to influence patients' behavior so they can better control their disease and improve their health status. It is important that medical students and trainees learn about chronic disease from the patients' perspective and explore more fully their roles in supporting the many tasks of self-management. We believe that this is best done through the active involvement of patients as teachers. Examples of such initiatives in North America and the United Kingdom include longitudinal programs in which learners are mentored by an individual or family, taught by parents of children with disabilities, or learn from users of mental health services.3 Our own work, in which interprofessional workshops are designed and delivered by patients (community educators) with chronic conditions, has demonstrated the acceptability and impact of this patient-led and patient-centered model of education. These and other examples demonstrate the increasing recognition that patients and community members have important experiences that can enrich medical education at all levels, from basic education through residency and continuing professional development. However, currently these are sporadic, often single, educational experiences that rely on a small group of enthusiasts and external funding. We need to move to a systemic approach which includes institutional commitment and an infrastructure that supports and values patients as educators. If medical education is truly to address the pressing health problem of chronic disease management, it needs to embrace the concept that patients with chronic disease and their families should be partners in education so that students and trainees can learn directly from “experts by experience” about the work involved in living with and managing chronic disease. This will lead to better support for CDSM within the context of a partnership relationship between professionals and patients, and ultimately better health outcomes.

Most academic programmes that prepare students for the health professions have a long history of involving patients in teaching and learning. Until recently such involvement has been largely passive, but the last 20 years have seen major growth in the number and diversity of educational initiatives in which patients play an active role as educators. This article describes how and why these changes have occurred, identifies some of the challenges of learning from those outside the academy - and professions - and explores some of the questions raised about the nature of 'professional' and 'lay' knowledge and expertise.

Context  Patients as educators (teaching intimate physical examination) first appeared in the 1960s. Since then, rationales for the active involvement of patients as educators have been well articulated. There is great potential to promote the learning of patient‐centred practice, interprofessional collaboration, community involvement, shared decision making and how to support self‐care.

Abstract The education of health professionals for shared decision-making (SDM) or Evidence Based Patient Choice (EBPC) has received increasing attention over the past decade. The knowledge, skills, and attitudes required for SDM, the gap between this ideal and current practice, and the types of training and education that are needed to bridge the gap were reviewed in the first edition (Towle and Godolphin 2001). We suggested approaches to teaching and assessment of SDM competencies, barriers to implementation, and strategies to overcome them. This chapter is an overview of how education and training of health professionals for SDM has developed since and how it has informed further understanding of the barriers and possible future directions.

Context Tutors report difficult incidents and distressing conflicts that adversely affect learning in their problem-based learning (PBL) groups. Faculty development (training) and peer support should help them to manage this. Yet our understanding of these problems and how to deal with them often seems inadequate to help tutors. Objectives The aim of this study was to categorise difficult incidents and the interventions that skilled tutors used in response, and to determine the effectiveness of those responses. Methods Thirty experienced and highly rated tutors in our Year 1 and 2 medical curriculum took part in semi-structured interviews to: identify and describe difficult incidents; describe how they responded, and assess the success of each response. Recorded and transcribed data were analysed thematically to develop typologies of difficult incidents and interventions and compare reported success or failure. Results The 94 reported difficult incidents belonged to the broad categories 'individual student' or 'group dynamics'. Tutors described 142 interventions in response to these difficult incidents, categorised as: (i) tutor intervenes during tutorial; (ii) tutor gives feedback outside tutorial, or (iii) student or group intervenes. Incidents in the 'individual student' category were addressed relatively unsuccessfully (effective < 50% of the time) by response (i), but with moderate success by response (ii) and successfully (> 75% of the time) by response (iii). None of the interventions worked well when used in response to problems related to 'group dynamics'. Overall, 59% of the difficult incidents were dealt with successfully. Conclusions Dysfunctional PBL groups can be highly challenging, even for experienced and skilled tutors. Within-tutorial feedback, the treatment that tutors are most frequently advised to apply, was often not effective. Our study suggests that the collective responsibility of the group, rather than of the tutor, to deal with these difficulties should be emphasised.