The role of the patient in teaching and learning clinical skills
‘To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all‘
William Osler (1849–1919)
This section gives a brief overview of some of the considerations when teaching with patients. These issues are expanded further in the Involving patients in clinical teaching module in this series.
Traditionally, clinical teaching has involved using real patients in various settings. This is an invaluable part of learning the art of medicine, as it enables students to apply learning to the real world, and also to learn from patients, which is often the most meaningful form of learning. Ensuring patients (and carers) are informed and involved in the learning process is one of the key roles of the clinical teacher.
While using real patients for teaching in clinical areas is often opportunistic (basing the teaching on who is on the ward, or attending the clinic or surgery), newer developments with simulated patients and trained real patients (lay clinical educators or patient educators) are being increasingly used within undergraduate and postgraduate training. The other type of simulated patient often used in medical schools is the well volunteer. These are ‘healthy volunteers’ (such as PhD students) paid to act as patients for clinical skills sessions and examinations. By recruiting and paying people, medical students can participate fully in the sessions and teaching is more predictable and productive. The ‘patients’ can be trained to give feedback similar to that of a lay clinical educator.