Active Patient Involvement in Healthcare Education in the Global South: Perspectives From Pakistan

Introduction: Direct and active patient involvement in health professions education (HPE) can improve learners' clinical skills and preparedness for patient-centred care. Most research on active patient involvement is from global north (GN) regions where cultural contexts differ from those in the global south (GS). In most GS contexts, patients are not actively engaged in educational activities. Understanding how patients in these regions perceive their potential roles in education is essential to improving HPE not only in the GS but also in culturally diverse GN settings. Methods: This qualitative study explored patient perspectives on active involvement in HPE using a theory-informed inductive approach. We conducted semistructured interviews with 13 patients at a dental teaching hospital in Pakistan. Data were analysed using Braun and Clarke's thematic analysis. Iterative team discussions were held to reach consensus during coding and theme development. Hofstede's cultural dimensions theory was used as a lens to guide conceptualization and mapping of final themes. Results: Six key themes, rooted in cultural values, captured patients' views on active participation in education: contribution to societal good; spiritual and moral obligations; nurturing and supporting students; self-doubts; fear of negative consequences; and balancing responsibilities. Conclusion: Patient perceptions shaped by cultural factors can act as facilitators or barriers to their participation in HPE. Educators should engage with diverse communities and use culturally sensitive approaches to support patient participation. In a globally interconnected educational landscape, understanding and respecting cultural differences when involving patients in education can enable educators to better prepare future healthcare professionals.