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The learners’ perspective
Students and trainees also express huge benefits in learning with and from patients. Learners value working with patients immensely in the context of structured learning events, supported and supervised by more senior clinicians. To develop effective clinical reasoning, learners need to see a wide range of many cases in different contexts (Eva, 2005), but they also need support in making sense of what they see through discussion with and challenge from clinical teachers.
Doshi and Brown (2005, p. 224) identify the advantages of patient-based teaching as:
- learning in context
- opportunity for role modelling
- teaches transferable skills
- increased learner motivation
- increased professional thinking
- integration of clinical skills, communication skills, problem solving, decision making and ethical challenges.
And the disadvantages as:
- its ad hoc nature
- decline in availability of patients/clinical cases
- cannot cover the whole curriculum
- poorly supervised and variable delivery
- conflicting pressures of teaching and service delivery.
Guidance for learners who are working with patients should include ‘advice on appropriate dress and behaviour, how to implement good practice and how to deal with problems and difficult situations’ (Howe and Anderson, 2003).
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