Learning from patients about patient-centredness: A realist review: BEME Guide No. 60

Esther de Groot*, Johanna Schönrock-Adema, Dorien Zwart, Roger Damoiseaux, Kristin Van den Bogerd, Agnes Diemers, Christel Grau Canét-Wittkampf, Debbie Jaarsma, Saskia Mol, Katrien Bombeke

*Bijbehorende auteur voor dit werk

Onderzoeksoutputpeer review

18 Citaten (Scopus)
108 Downloads (Pure)


Background: Patient-centred work is an essential part of contemporary medicine. Literature shows that educational interventions contribute to developing patient-centredness, but there is a lack of insight into the associated learning processes.Objective: Through reviewing articles about educational interventions involving patients, we aspire to develop a program theory that describes the processes through which the educational interventions are expected to result in change. The processes will clarify contextual elements (called contexts) and mechanisms connected to learning patient-centredness.Methods: In our realist review, an initial, rough program theory was generated during the scoping phase, we searched for relevant articles in PubMed, PsycINFO, ERIC, CINAHL and Embase for all years before and through 2016. We included observational studies, case reports, interviews, and experimental studies in which the participants were students, residents, doctors, nurses or dentists. The relevance and rigour of the studies were taken into account during analysis. With deductive as well as inductive coding, we extended the rough program theory.Results: In our review, we classified five different contexts which affect how upcoming professionals learn patient-centredness. These aspects are influenced through components in the intervention(s) related to the learner, the teacher, and the patient. We placed the mechanisms together in four clusters - comparing and combining as well as broadening perspectives, developing narratives and engagement with patients, self-actualisation, and socialisation - to show how the development of (dimensions of) patient-centredness occurs. Three partial-program-theories (that together constituting a whole program theory) were developed, which show how different components of interventions within certain contexts will evoke mechanisms that contribute to patient-centredness.Translation into daily practice: These theories may help us better understand how the roles of patients, learners and teachers interact with contexts such as the kind of knowledge that is considered legitimate or insight in the whole illness trajectory. Our partial program theories open up potential areas for future research and interventions that may benefit learners, teachers, and patients.

Originele taal-2English
Pagina's (van-tot)380-392
Aantal pagina's13
TijdschriftMedical Teacher
Nummer van het tijdschrift4
Vroegere onlinedatum18-dec.-2019
StatusPublished - 2020

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