In my first year at Leicester Medical School, part of our training on consultation and communication skills included the Patients Know Best (PKB) pro bono education programme, set up by Dr. Ron Hsu. In our tutorial groups, we exchanged secure messages with a real patient. This patient shared their health journey and honest experiences with us – both good and bad. Throughout the year, educators assigned us tasks to discuss with our patients, which had overarched links to the wider curriculum. The programme culminated with a group presentation sharing our reflections and learning, presented to an assessor and the patient.
The education programme gave me core foundational pillars of healthcare skills, that I still reflect on today. Some of these are shared below:
Patients as an expert in their condition
Patients are increasingly living longer, and with chronic conditions, often multiple. Patients have a lived experience of these conditions, as they experience them over their lifetime. Coupled with this, everyone presents differently; patients know their own body to determine when something isn’t right.
Healthcare professionals only see snapshots
Healthcare professionals’ interactions with patients are often only snapshots in time; these chronic conditions affect patients long beyond these interactions. The programme allowed follow-up for one year – the longest time scale I have had with a patient. It gave me an insight into the persistent nature of illness, both physical and psychological.
Medical education encourages future doctors to learn not just from theoretical textbooks, but from real patient cases. This programme does give them this from the beginning.
Patient centred care
The patient is at the centre of healthcare; everything we do is with patient benefit in mind. Healthcare consultations are moving away from being paternalist; it’s now about empowering the patient to have all the information they need to make an informed decision about their own care. Only by appreciating the patients’ lived experience and health behaviours will you be able to best engage with them, and deliver personalised medicine.
Improving written communication
During the programme, we initially struggled with written communication, with the patient often requiring clarification of our secure messages or vice-versa. We became mindful that tone cannot be expressed well over message and to limit the number of questions asked at any given time.
Having honed these skills, using secure messages became especially pertinent during the COVID-19 pandemic. Accurx in general practice was used both to send patients informative SMS messages, and receive patient information for triage, diagnosis and management. Its usage is still ongoing e.g. for patients to send in information about a rash.
How PKB could be useful to doctors: centralised data
While working in the care of elderly wards, patients may not always give clear and complete histories. We consulted their next of kin to gather further information about their: symptoms, past medical history and especially baseline (what’s normal for them). Having access to all the relevant information speeds up patient care and means decisions are better informed. Doctors can spend less time on administrative information gathering and more time with patients/relatives. This up-to-date information is especially important overnight, minimising the need to disturb patients while sleeping.
During hospital stays, patients, or their relatives often asked me for their blood tests’ numbers – to monitor their own progress. Access to their blood results via PKB could both empower patients in their own care and free doctors time. Sometimes they’d ask to compare these to GP results, which I often did not have access to. PKB offers this single record. Patients can share it with relatives so they can both view and add to it on their behalf.
You can read more about PKB’s pro bono education programme in our latest annual report published this month.