Past Projects

Workshops to help patients and the public improve communication with health professionals

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The Community and Patient Fair was an annual, one-day interprofessional event that connected about 40 community-based organizations, patient support groups and individuals involved in these agencies with students and faculty at UBC. It was held on UBC campus between 2009 and 2013 as part of Celebrate Learning Week. The Fair recognized the unique expertise and role of people in the community in the education of health professionals and promoted meaningful partnerships between UBC and the communities it serves. Each community organization had a booth to display information. One‐hour ‘patient panels’ were held on a variety of topics throughout the day.

Funding for the Fair came from the UBC Teaching and Learning Enhancement Fund, Office of the Provost & Associate Vice President Academic, Faculty of Medicine Social Accountability & Community Engagement Initiative, College of Health Disciplines, and donations from community organizations and local businesses.

Link:

• Article: Towle A., Godolphin W., & Kline C. The community comes to campus: The patient and community Fair. The Clinical Teacher 2015; 12(4): 260-266.

International Conferences held in Vancouver in 2005 and 2015

The first conference brought together 240 pioneers in the field from a wide range of backgrounds to ‘map the territory’. The conference report documented the state of patient involvement in education, and identified emerging issues and future directions. Conference sponsors included the Social Sciences & Humanities Research Council (Canada), Primary Health Care Transition Fund (Health Canada), and British Columbia Medical Services Foundation

Links:

• Farrell C, Towle A, Godolphin W. Where's the Patient's Voice in Health Professional Education? Vancouver, Division of Health Care Communication, University of British Columbia. 2006. ISBN 0-9782028-0-5.
• Towle A, Weston W. Patient's Voice in Health Professional Education. Patient Education and Counseling 2006; 63: 1-2.

The second conference in November 2015 looked at progress since the first. It was attended by 250 delegates from 16 countries, representing all the major health disciplines. Most were educational leaders or practitioners; just over 20% identified themselves as patients or community members and 13% as students. The conference resulted in the production of a consensus statement, the Vancouver Statement, to set the agenda for the next five years, and serve as a resource for participants in their own institutions and organizations.

Links:

• Towle A, Farrell C, Gaines M, Godolphin W, John G, Kline C, Lown B, Morris P, Symons J, Thistlethwaite J. The patient's voice in health and social care professional education: The Vancouver Statement. International Journal of Health Governance 2016; 21(1): 18-25.

This community-based participatory action research project funded by the Vancouver Foundation (2012-2016) informed the development of a mechanism for communities to engage with the university.  The vision is that diverse end-users of the health care system have the power and a mechanism to have sustained influence and participation in the education of health professionals. The project included key informant interviews and dialogues with university and community leaders, resulting in four reports and a literature review. The project led to a monthly newsletter Patient & Community Voices: A monthly newsletter to promote patient and community involvement at UBC and laid the ground work for the development of Patients in Education. Project partners included Cheryl Hewitt from PeerNet BC and Scott Graham from the Social Planning and Research Council of BC.

Reports:

• Research Report No. 1: Community Key Informant Interviews
• Research Report No. 2: Community Dialogue
• Research Report No. 3: University Key Informant Interviews
• Research Report No. 4: University Dialogue
• Community-University Partnership Literature Review

Engaging Patients as Teachers in a Clinical Setting is an instructional video and worksheet to help preceptors to involve patients as active teachers in the clinical setting. The materials were developed with a grant from the UBC Teaching and Learning Enhancement Fund (2007).

Aboriginal people in Canada have poorer health than the rest of the population. Reasons for health disparities include problems in communication between doctor and patient. The study aimed to understand doctor–patient communication in Aboriginal communities in order to design educational interventions for medical students based on the needs and experiences of patients.  

Interviews or focus groups were held with 22 Aboriginal community members, 2 community health representatives and 2 Aboriginal trainee physicians. Positive and negative experiences of communicating with physicians fell into three broad and interrelated themes: their histories as First Nations citizens; the extent to which the physician was trusted; time in the medical interview. The findings laid the ground work for the Community and Teacher Cultural Camps. The project was funded by the UBC Faculty of Medicine Special Populations Fund.

Link:

• Towle A, Godolphin W, Alexander, T. Doctor-Patient Communication in the Aboriginal Community: Development of Educational Programs. Patient Education and Counseling 2006; 62: 340-346.

Cross-Cultural Communication in Health Care Education: A Course Manual for Students and Teachers is a curriculum designed to provide health care professionals with the knowledge and skills they need to provide care to a culturally diverse society. The curriculum consists of four modules, each split into three-hour blocks. Each block is further divided into sections for maximum flexibility. We recommend that instructors teach the modules in order, but each one can stand alone.

• Introduction: Program Introduction
• Module 1: Introduction to Cultural Competence
• Module 1: Materials
• Module 2: Culture in Health Care: Expectations and Beliefs
• Module 2: Materials
• Module 3: Role of Family and Community in Health Care
• Module 3: Materials
• Module 4: Role of the Interpreter in Health Care 
• Module 4: Materials
• Video: Working with Interpreters in the Health Care Setting

The curriculum was developed with grants from the UBC Teaching and Learning Enhancement Fund and Faculty of Medicine Special Populations Fund.

Patients as Educators Research Collaborative (PERC) met between 2008 and 2010 to review the current state of research and identify major research gaps in this area, including effectiveness, outcomes and sustainability of 'patients as educator' programs. Outputs from PERC included a ‘state of the science’ paper in Medical Education, a bibliography and preliminary work for a report to the UK Health Foundation.  

PERC activities were funded by a Social Science and Humanities Research Council International Opportunities Fund grant

Links:

• Patient Involvement in Health Professional Education - A Bibliography 1975 - November 2016
• Towle A, Bainbridge L, Godolphin W, Katz A, Kline C, Lown B, Madularu I, Solomon P, Thistlethwaite J. "Active patient involvement in education of health professionals". Medical Education 2010: 44: 64-74.
• Spencer J, Godolphin W, Karpenko N, Towle, A. Can patients be teachers? The Health Foundation 2011(October): 1-78.

Summer Student Research and Other Student Projects 

Informed Shared Decision Making (ISDM) has been called the crux of patient-centred care. It occurs when a decision about management options for a healthcare problem is made jointly by health professional and a patient. The patient, helped by the health professional to assess the evidence, evaluates the choices available and becomes informed of the risks and benefits. The patient is then able to exercise reasonable autonomy and share in the decisions for medical treatment and health care.

• ISDM merges two trends in health care: patient-centred care and evidence-based decision making.
• Ethical and legal trends demand that doctor-patient communications involve informed choice.
• Improved health care outcomes can result when patients are involved in decisions about their health care.
• There are many barriers to ISDM including habitual patterns of communication shaped during medical training, perceived lack of time and fear of jeopardizing rapport

Our projects included foundational research and educational interventions for family physicians, residents and medical students as well as for patients [link]. The work was funded by grants from the Max Bell Foundation, BC Medical Services Foundation, Bayer Institute for Health Care Communication, Vancouver Foundation and the UBC Teaching and Learning Enhancement Fund.

Links to publications:

• Towle A, Godolphin W. Framework for teaching and learning informed shared decision making. BMJ 1999; 319: 766-69.
• Godolphin W, Towle A, McKendry R. Challenges in family practice related to informed and shared decision-making: a survey of preceptors of medical students. CMAJ 2001; 165 (4); 434-35.
• Godolphin W, Towle A, McKendry R. Evaluation of the quality of patient information to support informed shared decision-making. Health Expectations 2001; 4, 235-42.
• Godolphin, W. The role of risk communication in shared decision making: first let's get to choices. BMJ 2003; 327: 692-3.
• Towle A, Godolphin W, Grams G, LaMarre A. Putting Informed and Shared Decision Making into Practice. Health Expectations 2006; 9: 321-32.
• Godolphin W. Shared decision-making. Healthcare Quarterly 2009;12 Spec:e186-90.

Links to ISDM workshop:

• Godolphin W, Towle A. Informed and Shared Decision Making Workshop. The College of Family Physicians of Canada MAINPRO-C Accreditation (4 credits), accredited 2001, re-accredited 2003.

Links to ISDM workshop videos:

• Medicine – Beth Miller; Bob Smith; Simone Price; Sara Clark, Sarah Reilly, Thomas Jorgensen
• Physical Therapy – Don Jamieson
• Occupational Therapy – Patricia Varone
• Pharmacy – Ginger Vincent