Abstract
Objectives. To examine the impact of active student participation on quality of care in an integrative inpatient setting. Methods. Over a two-year period, we surveyed all patients treated on the Clinical Education Ward for Integrative Medicine (CEWIM), where final-year medical students are integrated into an internal medicine ward complementing conventional medicine with anthroposophic medicine. Patients treated on the regular wards of the same internal medicine department served as the control group (CG). General quality of care was studied with the Picker Inpatient Questionnaire, physician empathy with the Consultation and Relational Empathy measure, and patient enablement with the Patient Enablement Index. ANCOVA was used to control for covariates while examining significant differences between both patient groups. Results. Comparison of the CG wards and the CEWIM revealed no significant differences in medical treatment success. The CEWIM, however, achieved better results for physician-patient interaction, physician empathy, and patient enablement. Eighty Percent of the CEWIM patients rated student participation as positively impacting quality of care. Conclusion. Our results indicate that incorporating students in an integrative healthcare setting may result in greater patient centeredness. Further studies are needed to determine whether this is due to organizational advantages, students' empathic activity, the impact of teaching, or learner-teacher interaction.
Highlights
Over the last two decades, increased attention has been given to the concept of active learner participation in the so-called “community of practice” [1, 2]
Over a two-year period, we surveyed all patients treated on the Clinical Education Ward for Integrative Medicine (CEWIM), where finalyear medical students are integrated into an internal medicine ward complementing conventional medicine with anthroposophic medicine
The aim of our study was to determine whether there is a difference in the quality of care experienced by patients on the CEWIM, where students actively participate in patient care, and wards of the same department where students are not involved in care
Summary
Over the last two decades, increased attention has been given to the concept of active learner participation in the so-called “community of practice” [1, 2]. From different studies, we know that participation in clinical rotations alone does not necessarily automatically result in the professional development of learners. Instead, it is the degree of active participation (as opposed to being involved in primarily passive learning experiences) together with certain qualities of the Evidence-Based Complementary and Alternative Medicine learning environment that determine the success of clinical education [3, 4]. Students tend to be provided with mere passive experiences rather than actively participating in patient care. They are all too often assigned routine tasks, and do not receive sufficient clinical supervision. These shortcomings have been shown to lead to insufficient training of independent patient management and to feelings of uncertainty among medical students [6]
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