Learning to become a person-centred healthcare professional: a mixed methods study

Abstract

Background:
Global health care policy and educational standards indicate that nursing students must be prepared to practise in a person-centred way. Despite this, there is little evidence of the efficacy of curricula in preparing students to do so.

Aim:
To examine pre-registration nursing students’ understandings and perceptions of their person-centred practice, and factors that influenced their learning.

Setting:
A UK university where the three-year, pre-registration nursing programme was underpinned by a person-centred curriculum.

Design:
Sequential explanatory mixed methods.

Methods:
The study included three phases:
-Phase 1: Modified Delphi technique to develop an instrument to measure students’ perceptions of their person-centred practice.
-Phase 2: A quantitative survey to test the instrument and measure nursing students’ perceptions of their person-centred practice.
-Phase 3: Focus groups to illuminate students’ understandings of person-centred practice and factors that influenced their learning.

Sample:
All phases of the study involved pre-registration nursing students from each year of study. Phase 1 included focus groups with 13 participants, followed by two Delphi surveys (n=382 and n=144 students respectively). Of those who took part in the Phase 2 survey (n = 532), thirty subsequently participated in Phase 3 focus groups.

Findings: For this study’s population, the Person-centred Practice Inventory - Student instrument, had acceptable psychometric properties. From the end of year one, students rated their person-centred practice positively. However, the aspects of person-centred practice that challenged them most in first year, continued to be the most challenging throughout their programme. Despite this, mean scores for all items were higher in final year students compared with those in first year. Students had well developed understandings of person-centred practice that they believed informed their practice. Factors that enabled their learning included having: ‘a person-centred ethos’, ‘your support systems’, ‘you remember a story or an experience’ and ‘we never had rose-tinted glasses’. However, students also highlighted factors that inhibited their learning: ‘you are almost shocked when someone mentions person-centredness’, ‘bottom of the food chain’, ‘putting it in practice is really different in reality’ and ‘what exactly do you do?’.

Conclusion:
Findings were integrated and the resulting meta-inferences conceptualised as a model of learning to become a person-centred healthcare professional. Good practice principles are proffered to aid the operationalisation of person-centredness in healthcare curricula.

Date of Award	Dec 2021
Original language	English
Supervisor	Sonja McIlfatrick (Supervisor), Tanya McCance (Supervisor) & Brendan Mc Cormack (Supervisor)