A capability approach analysis of student perspectives of a medical consultation quality-improvement process
Background. Research shows that person-centredness declines during medical education. This study examines the underlying assumptions and effects of clinical associate training interventions on person-centred practice.
Objectives. To understand student experiences of a medical consultation quality-improvement (QI) process in terms of a capability approach to learning and the effects of this process on their person-centredness.
Methods. In a randomised controlled trial students from 8 clinical learning centres (CLCs) participated in a qualitative, medical consultation QI process. Qualitative data (focus group discussions and reflective reports) were analysed using a capability approach to the learning framework.
Results. Learning was triggered by disruptions to students’ abilities, knowledge, identity and relationships. Through facilitated review-read-reflectre/action scaffolded by feedback and practical assessment tools they learnt new person-centred consultation skills. The QI process functioned as a learning cycle in which students reviewed disruptions, identified areas for improvement and developed improvement plans. Through it, awareness of themselves developed more deeply, their relationships with peers and patients grew and they improved their knowledge and consultation skills.
Conclusions. Students demonstrated learning through their understanding of the skills and competencies required for person-centred practice. The study found students to be at different points along the directed/self-directed learning continuum, with most of them developing abilities to learn independently, work in groups, give and receive feedback and apply learning across different contexts. Facilitation is particularly important, given the uneven development of the ‘dimensions of a person’ at an individual level. Lastly, the capability approach is useful as an analytical framework and as a way of ‘doing learning’.
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the AJHPE is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The AJHPE does not hold itself responsible for statements made by the authors. The corresponding author should also indicate if the research forms part of a postgraduate short report, dissertation or thesis.
Previously published imagesIf an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.