By incorporating the education of medical students and medical trainees in outpatient clinics, is the patient experience enhanced and their quality of care improved?

Slade, Maria

December 2016

Thesis or dissertation

© 2016 Maria Slade. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

There is limited consensus on whether medical trainees in secondary care outpatient departments affect patient care that is delivered, despite the increasing momentum to provide more clinical education in this setting.

The aim of this thesis was to explore the experiences of patients attending local teaching hospitals, before conducting a review of the literature, to ascertain whether medical training impacts on the quality of care delivered in secondary care outpatient clinics.

Twenty-nine patients attending teaching clinics in a local hospital trust were interviewed. Thematic analysis was applied to reports on their experiences and their opinions on the relationship between trainees and quality of care, which provided a base for the search strategy of the scoping review and also a means to triangulate the evidence in the discussion.

A broad range of English-language studies from 1994-2014 were then searched using a variety of electronic databases alongside the hand-searching of key medical education journals. Two researchers made the final decisions on paper inclusion according to predetermined inclusion and exclusion criteria.

Patients who were interviewed were happy to participate in teaching clinics, but none believed that their clinical outcome was altered by having a trainee present.

In the scoping review, fifty-four papers met the inclusion criteria. Patient satisfaction was variable. Issues of concern included consent, quality of the research undertaken, discrepancies regarding whether teaching clinics afforded a higher quality of care and global patient satisfaction scores failing to provide the whole picture on patient experience.

Patients appear less satisfied with their experience of teaching clinics in secondary care compared to other health care settings. Future research should include robust studies on how the patient experience can be improved and clinical outcomes measured to enable safe and effective care for patients and a valuable learning experience for trainees.

Hull York Medical School, The University of Hull and University of York
Pearson, David (David J.)
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