Follow the patient: process and outcome evaluation of medical students' educational experiences accompanying outpatients

BACKGROUND To instil patient-centred attitudes in medical students, several medical schools in Japan have recently started to offer educational experiences in which medical students accompany outpatients throughout entire visits to hospitals. OBJECTIVE To evaluate the processes and outcomes of the educational experience of Year 5 medical students accompanying outpatients at Nagoya University Hospital. METHODS An integrated, multimethod approach was adopted using a written survey with open-ended questions for students, focus groups with students, and a written evaluation survey for patients. In all, 99 students completed the survey, 19 students participated in 3 focus groups, and 46 patients participated in the evaluation. RESULTS Many students were sceptical about the objectives of the exercise. We were able to gain insight into student perceptions about facets of the exercise such as the ratio of students to patients and whether or not students should wear white coats. In particular, there was consensus among students about the importance of the debriefing session after the experience. Students achieved different learning outcomes depending on their particular individual experiences. In the student survey, 49% were satisfied with this experience, 6% were dissatisfied, and 43% were neither. In contrast, patients were highly satisfied with the experience (mean score 4.2 out of 5.0 on a Likert scale). Some students expressed concern about being a burden to patients, while many patients reported feeling emotionally supported by being accompanied by students. CONCLUSION An integrated approach to programme evaluation, using quantitative and qualitative methods, was useful in the process and outcome evaluation of this new educational experience. The results have been taken into consideration for quality improvement of this curricular element.