Patient-centred care is the gold standard of health care, yet in practice, problems prevail. The use of the ‘expert patient’ in health professional education is one form of learning patient-centred care. A gap in the literature regarding how the use of ‘expert patient’ in health professional education promotes patient-centred care was acknowledged in current research. With Queen’s University Health Sciences & Affiliated Teaching Hospitals Research Ethics Board approval, a sample of Queen’s University MScOT students participated in a qualitative study with the following research question: “How does the students’ experience of interacting with the ‘expert patient' (‘XP’) relate to learning regarding client-centred practice (CCP)?” Three objectives were proposed: 1. Describe the OT students’ experience of interacting with the ‘expert patient’, 2. Describe the students’ learning regarding client-centered practice, 3. Identify the conditions particular to the ‘expert patient’ experience that led to learning regarding client-centered practice. In-depth interviews were conducted with the students subsequent to their ‘expert patient’ experience. Analysis revealed three conditions that together provided the foundation for student experiential learning regarding client-centred practice: interaction with particular persons with stable disability known as ‘expert patients’; students’ requirement to evaluate them and thus ‘experience power’; and explicit opportunities for ‘directed reflection and discussion’. Questions were raised for researchers, health care professional educators and health care professionals regarding the potentially transformative nature of engaging in unfamiliar contexts with openness to learning. The thesis allowed insight into the lived experience of OT students learning with ‘expert patients’; and the admiration, discomfort, humility and gratefulness they experienced while gaining a sense of the meaning of collaboration, respect for autonomy and recognition of expertise. Implications of the research impact all stakeholders in health professional education. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-04-15 08:39:19.094

Patient-centred care is the gold standard of health care, yet in practice, problems prevail. The use of the ‘expert patient’ in health professional education is one form of learning patient-centred care. A gap in the literature regarding how the use of ‘expert patient’ in health professional education promotes patient-centred care was acknowledged in current research. With Queen’s University Health Sciences & Affiliated Teaching Hospitals Research Ethics Board approval, a sample of Queen’s University MScOT students participated in a qualitative study with the following research question: “How does the students’ experience of interacting with the ‘expert patient’ (‘XP’) relate to learning regarding client-centred practice (CCP)?” Three objectives were proposed: 1. Describe the OT students’ experience of interacting with the ‘expert patient’, 2. Describe the students’ learning regarding client-centered practice, 3. Identify the conditions particular to the ‘expert patient’ experience that led to learning regarding client-centered practice. In-depth interviews were conducted with the students subsequent to their ‘expert patient’ experience. Analysis revealed three conditions that together provided the foundation for student experiential learning regarding client-centred practice: interaction with particular persons with stable disability known as ‘expert patients’; students’ requirement to evaluate them and thus ‘experience power’; and explicit opportunities for ‘directed reflection and discussion’. Questions were raised for researchers, health care professional educators and health care professionals regarding the potentially transformative nature of engaging in unfamiliar contexts with openness to learning. The thesis allowed insight into the lived experience of OT students learning with ‘expert patients’; the admiration, discomfort, humility and gratefulness they experienced while gaining a sense of the meaning of collaboration, respect for autonomy and recognition of expertise. Implications of the research impact all stakeholders in health professional education. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-04-05 00:18:04.617

Depuis de nombreuses années, le déploiement des TIC dans la prise en charge médicale de pathologies chroniques joue un rôle majeur notamment dans l’évolution des pratiques de santé et l’amélioration du bien-être du patient. Les pathologies chroniques sont de nature longue et évolutive et nécessitent un suivi régulier effectué par une équipe pluridisciplinaire où différents acteurs interviennent auprès du patient. Le patient à son tour, est amené à respecter à domicile, un protocole de soins défini et personnalisé par cette équipe. Cependant, la forme dans la quelle le contenu du protocole est représenté n’est pas forcément complète ni facile à comprendre par les patients. De plus, chaque patient est unique, et la définition du protocole de soins doit être personnalisée et appropriée à ses soins et traitements individuels, parfois même à ses souhaits et contraintes personnelles. L’expertise du patient sur sa maladie chronique est une information précieuse que nous souhaitons intégrer dans un protocole de soins personnalisé afin d’améliorer la prise en charge médicale, le suivi à distance de la maladie chronique et à terme améliorer la connaissance de la pathologie chronique. Pour ce faire,nous avons proposé (i) un langage de représentation informatisée de protocole de soins personnalisé, destiné aux professionnels de santé et aux patients,suffisamment simple,intuitif et facile à comprendre.(ii) une ontologie de l’expertise patient (tirée de son vécu avec la pathologie) permettant de signaler des imprévus dans le déroulement du protocole (actions non prévus ou évènements non prévus). / For several years, the deployment of information and communication technologyintothemanagementofchronicalpathologiesistakingaconsiderableplace, more particularly in the evolution of health’s practices and in the improvement of the well-being of the patient Chronical pathologies are of long duration and they need to be under a regular monitoring of the healthcare professional, composed of multidisciplinary or different actors in charge with the patients. On the other side the patients are alsochargedoffollowingahealthcareprotocolathomepreviouslydefinedbythe health care team. Nevertheless, the different forms of representing the contests of this protocol, it is not always complete and comprehensible for the patients. Furthermore, each one of the patients is unique and a proper definition of the health care protocol must be personalised and conform to his individual treatment and even to his personal wishes or constraints. But this is not the case of information guides or medical references that are supplied in general. With the intent to improve the interaction between the patient and the healthcareprofessionalsrelatedtothehealthcareprotocol,wepropose(i)alanguagefor the computerised representation of the healthcare protocol, sibling the healthcare professionals and the patients, enough simple, intuitive and easy to understand, (ii) an ontology for the patient expertise (based on his experience on the disease) allowingsotheinteractionofthepatientwithhishealthcareprotocolbyreporting all the unexpected behaviours. These behaviours are events that are not defined in the initial health care protocol.

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