Professional Experience Placement

This study by Manninen et al (2014) explored patient-student encounters in relation to student learning in a patient-centred health-care setting. The authors used an ethnographic approach to study the encounters between patients and students. Observation, reflective notes, interview and transcription were undertaken by the an observer. The authors describe the detailed analysis undertaken.

The findings of the study showed that patients took different approaches to their encounters with students. The authors use narrative to demonstrate that when students managed to create a good atmosphere and rapport with patients tha patients were active participants in the students’ learning. The patients were willing to help the students even though the students sometimes need to do procedures that could be painful for patients. Alternatively, if students do not manage to create a good atmosphere, the relationship became one-way and the patients became passive participants, letting the students practice on their bodies but did not engage in dialogues with the students.

When students and patients work together they also engaged in meaning-making processes that could result in transformative learning and knowledge construction. This patient-centred and holistic approach enables students to learn from, through and with the patients. When the relationship between the student and patient has not developed patients a still willing to let students practice, but as objects rather than subjects. Students that focus on skills, get pieces of information without seeing how they are linked together. This means learning from the patient, rather than with the patient. Supervisors are important for students learning and these authors indicate that further research into their role and and patient-centred care in relation to learning outcomes.

In conclusion, the employment of a patient-centred pedagogical approach can develop into a learning or an attending relationship. A mutual relationship between patients and students results in active participation in the student learning by patients where they both experience it as a partnership. A one-way or attending relations develops patients let students practice on their bodies but do not engage in learning dialogue with the students.

It is important for clinical supervisors to model patient-centred care to facilitate opportunities for students to enter into learning partnerships with patients. The development of a mutual relationship can be enabled by clinical supervisors who actively engage in learning with both their patients and students. Clinical supervisors need to identify those students that are focused on learning skills and reorientate them to understanding the value in developing participatory relationships where holistic care and learning can be undertaken.

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