Interventions aimed towards the development of patient-centredness in undergraduate medical curricula : a scoping review
CITATION: Archer, E. & Meyer, I. 2018. Interventions aimed towards the development of patient-centredness in undergraduate medical curricula : a scoping review. African Journal of Health Professions Education, 10(3):171-175, doi:10.7196/AJHPE.2018.v10i3.1040.
The original publication is available at http://www.ajhpe.org.za
Background. Patient-centredness has been identified by most medical schools worldwide as a desired core graduate competence. Patient-centredness positions the patient at the centre of the consultation and, therefore, focuses on the patient instead of on the disease. The concept of patient-centredness is, however, multifaceted. The choice and development of approaches and interventions that can enhance or sustain the various dimensions of patient-centredness are challenges for undergraduate medical curriculum developers. Objectives. To determine what the extent and nature of published scientific literature on implemented interventions are and how these could assist in fostering the various constructs of patient-centredness in undergraduate medical curricula. Furthermore, to determine which of these interventions could potentially be applied and incorporated in the context of the undergraduate medical curriculum at the Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. Methods. The study followed the 6-step scoping review methodology framework. Four electronic databases were searched. Two independent reviewers screened citations for inclusion and performed the data abstraction. Results. Articles (N=581) were eligible for inclusion in this study. Information captured in the Excel spreadsheets resulted in 9 categories of teaching interventions, which could lead to the various constructs of patient-centredness. These included didactic sessions and workshops, simulated patients, reflection, small-group discussions, e-learning, peer role-play/drama/surrogate, narratives/storytelling/art, clinical experiences and mindfulness training. Conclusions. It is important to acknowledge that the development of patient-centredness in medical students is more than just a set of communication skills. Curricula need to provide learning opportunities for students to enhance knowledge, skills and attitudes related to patient-centredness to develop it as a strong competence. Furthermore, students need to be placed in clinical learning environments that foster a patient-centred approach, providing various opportunities where they can reflect on their learning, be more mindful of the needs of their patients and build caring relationships with them.