Teaching and mentoring

Helping learners shift from biomedical to person-centred perspectives

• Despite person-centeredness being an aim for medical education, it is often not achieved.

• When learners are taught communication skills without person-centred theory, they can experience dissonance with their biomedical perspective, which can lead to them minimising the importance of the learning.

• Educational interventions that apply person-centred theory to meaningful experiences and include support for sense making can help learners understand the relevance of person-centeredness.

WiseGP Actions

1. Lead a tutorial with your foundation doctor/ registrar during which you could...

   • Discuss a person-centred approach.

   • Share a case you’ve managed where a holistic approach was integral to supporting a patient (e.g. persistent physical symptoms).

   • Role-play a case where a person-centred approach is required to develop a shared understanding and negotiate a management plan (e.g. a person with fatigue & normal blood results). Introduce a challenging communication aspect.

   • Work through/ signpost your trainee to modules 2 and 3 of the WISDOM course for further learning on person-centred care.

2. If you’re involved in communication skills training with undergraduates, consider whether you highlight the value of a person-centred, holistic approach during training.

Read more here:

https://onlinelibrary.wiley.com/doi/full/10.1111/medu.14707

Training in shared decision-making

• A qualitative study explored the perceptions of GPs at a UK Medical school on methods of training in shared decision-making (SDM).

• GPs described role-play, receiving feedback and on-the-job learning as modes of training. They suggested training should reflect the uncertainty present when sharing decisions with patients in everyday practice, supported by realistic cases and reflection on experiences.

• Implementation of SDM by GPs could be facilitated by explaining the benefits on consultation outcomes and targeting the learning needs of individuals.

WiseGP Actions:

• Note down clinical encounters where you had to negotiate uncertainty and share decisions with patients. Consider role-playing these scenarios with your GP registrar, or wider team members during mentoring sessions (e.g., practice pharmacist/ physician associate).

• Involve your GP registrar in team meetings where uncertainty in clinical decision-making is discussed to encourage reflection on shared decision-making.

Read more about the research informing this GEM here: https://bjgp.org/content/73/729/e310