Attitudes toward patient involvement in healthcare science education among multiple

stakeholder groups

Anvay Deshpande Panagiotis Grigorios KyriazisKearabiloe Mafohla Maria Orellana KehayovaGemma Scott Connor Smith-WarrenVivien Rolfe

University of the West of EnglandSummer Internship Project 2015

This work was presented at the Society for Researchinto Higher Education (SRHE) Newer Researcher Conference

In December 2015.

It was presented by two students from the University of the West of England,Faculty of Health and Applied Sciences.

More details of this patient involvement research can befound on our website:

http://spirit.biologycourses.co.uk

Background• 2013 revised NHS constitution –“patients at the heart of thesystem”.• Professional health courses

are now required to embed ‘patient and public involvement’ (PPI) in learning and teaching.

• This applies to our Healthcare Science Life Science and Physiological Science BSc Honours.

• Where do we start? What is staff awareness? What are their thoughts?

On-line

On-campusOn-placement

or in hospital work

Student study locations

Physiology obviously includes patients….

Cardiac physiology

Respiratory & sleep physiology

But laboratory sciences?

“I work in a lab. I don’tmeet patients”.

This is a new field,so we have littleinformation to go onhow to successfullychange mind-setsand education approachestoward PPI (Rolfe 2015).

Rolfe V. (2015). Advancing Healthcare Sciences through Staff, Student and Service User Partnerships. The Journal of Educational Innovation, Partnership and Change, 1 (2).

Methods

• Ethical approval gained from UWE Faculty Research Ethics Committee.• We used a mixed-methods:

– We drew on initial conversations with the academic team to scope out ideas for enquiry.

– We conducted semi-structured interviews with academic staff and patients (plus some video interview). These were recorded and transcribed verbatim.

– For students who were out on placement and not available for interview, we developed and tested a questionnaire.

– For NHS staff we carried out 4 interviews that were recorded.– We used thematic analysis to distil ideas emerging. Themes were coded, and

notes kept by all researchers during the project were used in discussions as part of the analysis.

Results – participant details

• Interviews took place June-July 2015.• 13 academic staff teaching Healthcare Science

and Biomedical Science.• 31 student questionnaire responses (total

programme group of 59).• 3 patient interviews + 4 patient video

recordings.• 4 audio recordings of NHS staff.

Academic Staff Perceptions

Staff definitions of patient involvement – mixed

• Academic teaching staff had mixed views on what PPI was:

– “Involvement and awareness of the general public in festivals and engagement programmes in both teaching and research.” (This actually is a definition of public engagement in science – something quite different).

– “Having patients for students to understand case studies and as lay people in committee meetings, giving their opinion”.

– “I see as being key in terms of insuring that the way we teach and educate our students is aligned to what is needed within the provision within the healthcare service”.

Positive attitudes toward PPI

– Students need to understand that science is about people “there is a patient at the end of the test tube”.

– “When I did my PhD we had one or two visits from families with cystic fibrosis patients, as part of the research going on in our laboratory was involving bacteria causing cystic fibrosis. It was a helpful exercise and apart from making you more aware, it makes you to try to help”.

Negative perceptions

• Concerns regarding relevance of PPI activities in science.

– “Not to have PPI just for the sake of including PPI in programmes”.

– “Not to involve public and patients, just because they think that it would be important, because they don’t have any experience or knowledge on how to teach”.

Student Perceptions

Awareness of PPI?

“I would define it as involvement of patients at the structure and delivery of health services. Also they could be involved maybe by sharing their experience of their condition”. (Student definition).

Student Perceptions• Students see PPI important for training and communication

(for physiology) but to build empathy and understanding (physiology and lab sciences).

– “The utilisation of 'real-life' case studies of a specific pathology to supplement student learning using patients who suffer with said diseases, to outline their personal experiences and healthcare plan”.

– “Especially when working with samples of patients, you can get dehumanised to what the actual samples are”.

NHS Scientist Perspective

“There are real people at the end of these samples. It is not research. It is diagnostic” (Geneticist).

“We get through an awful lot of samples, we are just churning through and we don’t often stop and think what that means to a patient” (Geneticist).

“You’d go to theatre, harvest a bone marrow, take it back to the lab and process it…you got to meet patients, you got to meet their families” (Haematologist describing bone marrow transplant).

“No patient contact. Your results will impact on the care of that patient” (Microbiologist).

Patient Perspective

“I’m a firm believer in patient participation because the whole system benefits….generally procedures are developed without inputs from people who have to undergo them (Patient 1)”.

“Something they hadn’t been prepared for, is that, when they went to see the patient next time they’d actually died. They hadn’t been prepared, how they might feel about that. We need to be quite clear about what are the training or learning needs of students (Patient 2)”.

“Its not just down to the university or lecturers to decide what the course content should be (Patient 2)”.

Hospital sites are very challenging. Dealing with other medical professionals can be very challenging. It may get you used to dealing with that and something you might face in your future career (Patient 3).

Discussion

• This research has given us a range of stakeholder perspectives regarding how to embed patient and public involvement in our science curricula.

• There is a misconception that lab scientists do not come into patient contact – some do.

• Patients and students more felt that patient involvement was important in science education but teaching teams were more cautious.

• We have a good idea of what activities we can engage PPI in, and the process of recruitment/induction of patients that we need to adopt.

Acknowledgements

Anvay Deshpande Panagiotis Grigorios KyriazisKearabiloe Mafohla Maria Orellana KehayovaGemma Scott Connor Smith-Warren

University of the West of EnglandSummer Internship Project 2015led by Dr Viv Rolfe

Internships funded by UWE and Health Education South West