Catch 22s and Escape Hatches: Practical Problems and Conceptual Musings on Patient Engagement in Health Professions Education

By: Paula Rowland, OT Reg (Ont.), PhD P. Rowland is assistant professor and scientist, Department of Occupational Science and Occupational Therapy, University of Toronto (UT) Faculty of Medicine, Toronto, Ontario, Canada. She is also cross-appointed researcher, Wilson Centre, UT, Toronto, Ontario, Canada. It was the idea of the “Catch 22” that caught my attention. I first saw the explanation in an article by Learmonth and colleagues in 2009.1 In their article, they talked about a persistent dilemma in patient engagement programs. These are the kinds of programs where patients are asked to use their experiences to help shape decisions about health policy or organizational priorities. However, the authors described a dilemma: Patients that were articulate, well-reasoned, and well-read provided convincing arguments for change, but there would always be someone who would argue, “But these articulate, well-reasoned, and well-read people can’t possibly represent the ‘average’ patient.” And so—in being so skilled at being convincing—these patients became less convincing as credible representatives of the average patient. It was a Catch 22 of patient engagement: One could not be both convincing and credible. I saw the same dilemma in my own studies of patient engagement. The collective sigh from many of my participants seemed to mean something to the effect of: “The organization just has so many escape hatches! So many ways they can discount what a patient says....
Source: Academic Medicine Blog - Category: Universities & Medical Training Authors: Tags: Featured Guest Perspective patient engagement patient representation patients Source Type: blogs