Cell biology of liver endothelial and Kupffer cells.

Abstract

Objective: To explore the impact of participating in undergraduate teaching in general practice for patients with common mental disorders. Design: Questionnaire survey and qualitative in-depth interviews. Setting: Community based undergraduate teaching programme for fourth year students at a London medical school doing a psychiatry attachment. Participants: Questionnaire survey: all patients involved in the teaching programme over one academic year. In-depth interviews: 20 patients, 14 students, and 12 general practitioner tutors participating in the programme. Results: The questionnaire showed high levels of satisfaction with teaching encounters for participating patients, which were corroborated in the interviews. Many patients and general practitioners reported specific therapeutic benefits for patients from contact with students, including raised self esteem and empowerment; the development of a coherent “illness narrative”; new insights into their problems; and a deeper, more balanced, and understanding doctor-patient relationship. For a few patients the teaching caused some distress, which may relate to a lack of insight into their condition or deficits in students9 interviewing skills. Conclusions: Participation in teaching can have additional positive therapeutic outcomes for selected patients with common mental disorders, although a small minority report negative effects. Testing in a larger sample is needed to determine the characteristics of patients in these two subgroups and establish whether these effects persist.

What is already known on this topic

Patients show high levels of general satisfaction with their participation in teaching Little is known in detail about outcomes for patients who participate in teaching—in particular, patients with common mental disorders in community settings

What this study adds

Patients with common mental disorders respond well to participation in undergraduate teaching in primary care Most patients value time to talk and reflect, and some gained a stronger, more balanced doctor-patient relationship In some patients the process results in higher self esteem and empowerment, a more coherent “illness narrative,” and new insights A few patients find the teaching encounter distressing