Introduction Wykurz and Kelly (BMJ 2002; 325: 818) assert that patients as teachers enhances skill acquisition, builds confidence and generates insights including attitudinal change. During the development of the Psychiatry of Old Age Module (MSc Geriatric Medicine, Salford University) we wished to challenge learners with an expert patient session on dementia.
Methods The “Educators” (a group of expert dementia patients) delivered an interactive 90 minute session. This included their experience of initial diagnosis, subsequent treatment, and perceptions of doctors (and allied professions) throughout their journey.
Learners were asked to reflect on the session immediately afterwards and complete an end-of-course questionnaire. The latter included the statement: “meeting the educators changed my clinical approach when explaining the diagnosis of dementia to a patient for the first time”. Learners were asked to mark their agreement using a Likert scale and then explain their answer.
Results Immediate positive reflections included:
I've never had such a session with real patients and it was quite inspiring and very interesting.
I can honestly say I feel a better doctor from listening.
Wonderful to see people not patients.
However, others were less sure:
For some reason I felt uneasy, maybe because I didn't know their background or what they knew of their progression.
End-of-course questionnaire
20 trainees agreed with the statement, 2 were neutral and 1 disagreed.
Comments included:
Meeting the actual dementia patients and their experiences around the time of diagnosis was helpful and eye-opening.
Very interesting to hear what it's like being on receiving end of diagnosis. Perhaps softened my approach.
Conclusions The comments do indicate that insights and attitudes changed and that the session was both inspiring and valuable. Hints at practice change emerge: follow-up is required to see if there was a reported sustained change. The unease recorded by one participant merits further exploration.