Optimising planned medical education strategies to develop learners' person-centredness: A realist review

BANSAL, Aarti, GREENLEY, Sarah, MITCHELL, Caroline, PARK, Sophie, SHEARN, Katie and REEVE, Joanne (2021). Optimising planned medical education strategies to develop learners' person-centredness: A realist review. Medical Education.

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Link to published version:: https://doi.org/10.1111/medu.14707
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    Abstract

    CONTEXT: Person-centeredness is a stated aim for medical education; however, studies suggest this is not being achieved. There is a gap in our understanding of how, why and in what circumstances medical education interventions that aim to develop person-centredness are successful. METHODS: A realist review was conducted with a search of Medline, Embase, HMIC and ERIC databases and the grey literature using the terms 'medical education' and 'person-centred' and related synonyms. Studies that involved a planned educational intervention in medical education with data on outcomes related to person-centredness were included. The analysis focused on how and why different educational strategies interact with biomedical learner perspectives to trigger mechanisms that may or may not lead to a change in perspective towards person-centredness. RESULTS: Sixty-one papers representing fifty-three interventions were included in the final synthesis. Nine context-intervention-mechanism-outcome configuration (CIMOc) statements generated from the data synthesis make up our refined programme theory. Where educational interventions focused on communication skills learning or experiences without person-centred theory, learners experienced dissonance with their biomedical perspective which they resolved by minimising the importance of the learning, resulting in perspective endurance. Where educational interventions applied person-centred theory to meaningful experiences and included support for sense making, learners understood the relevance of person-centeredness and felt able to process their responses to learning, resulting in perspective transformation towards person-centredness. CONCLUSION: Our findings offer explanations as to why communication skills-based interventions may be insufficient to develop learners' person-centredness. Integrating experiential person-centred learning with theory on why person-centredness matters to clinical practice and enabling learners to make sense of their responses to learning, may support perspective transformation towards person-centredness. Our findings offer programme and policymakers testable theory to inform the development of medical education strategies that aim to support person-centredness.

    Item Type: Article
    Uncontrolled Keywords: 11 Medical and Health Sciences; 13 Education; 17 Psychology and Cognitive Sciences; Medical Informatics
    Identification Number: https://doi.org/10.1111/medu.14707
    SWORD Depositor: Symplectic Elements
    Depositing User: Symplectic Elements
    Date Deposited: 06 Jan 2022 16:01
    Last Modified: 06 Jan 2022 16:15
    URI: http://shura.shu.ac.uk/id/eprint/29565

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