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

À partir des postulats théoriques de l'École de Constance et spécialement de Wolfgang Iser, sur la base de la phénoménologie husserlienne, nous affirmons, à l’inverse des théories littéraires «immanentes» qui ont prédominé durant des décennies, que tout texte littéraire est nécessairement produit par l'auteur dans l'intention d'être lu par un destinataire, en l'occurrence le lecteur. En prenant comme référence le concept de sujet cognitif de W. Iser, nous soutenons que le récepteur, n’approche pas le texte d'une manière neutre et passive, mais qu’il incorpore toujours ses connaissances et ses coordonnées sociales, historiques, culturelles, idéologiques, d'identité et de sexe. Par conséquent, le principal objectif de notre travail est d’expliquer et de démontrer comment, en nous appuyant sur les structures discursives de la narration, une lectrice dotée de savoirs théoriques féministes et forte de sa propre optique en tant que femme dans le monde, peut re-construire certains personnages féminins du roman galdosien depuis une perspective féministe.À partir des postulats théoriques de l'École de Constance et spécialement de Wolfgang Iser, sur la base de la phénoménologie husserlienne, nous affirmons, à l’inverse des théories littéraires «immanentes» qui ont prédominé durant des décennies, que tout texte littéraire est nécessairement produit par l'auteur dans l'intention d'être lu par un destinataire, en l'occurrence le lecteur. En prenant comme référence le concept de sujet cognitif de W. Iser, nous soutenons que le récepteur, n’approche pas le texte d'une manière neutre et passive, mais qu’il incorpore toujours ses connaissances et ses coordonnées sociales, historiques, culturelles, idéologiques, d'identité et de sexe. Par conséquent, le principal objectif de notre travail est d’expliquer et de démontrer comment, en nous appuyant sur les structures discursives de la narration, une lectrice dotée de savoirs théoriques féministes et forte de sa propre optique en tant que femme dans le monde, peut re-construire certains personnages féminins du roman galdosien depuis une perspective féministe. / From the theoretical postulates of the School of Constance and especially of W. Iser, based upon the Husserlian phenomenology, we hold that all literary text is not necessarily produced by the author with the intention of being read by a receptor, in this case the reader. In acoordance with the W. Iser's concept of cognitive subject, we argue that the reader, against the inmanents literary theories that have prevailed for decades, does not read the literary text in a neutral and passive way but that always incorporates their knowledge and social, historical, cultural, ideological, identity and sexual coordinates. Therefore, the aim of our work is to explain and demonstrate how a female reader, substantiated by the discursive structures of the narration and due to her feminist theoretical contents and her woman's point of view in the world, can re-build to certain female characters of the galdosian roman —only to those who have an important narrative unit and a subversive elements— from a feminist perspective. / A partir de los postulados teóricos de la Escuela de Constanza y especialmente de W. Iser, con base en la fenomenología husserliana, sostenemos que todo texto literario es necesariamente producido por el autor en la intención de ser leído por un destinatario, en este caso el lector. Tomando como referencia el concepto de sujeto cognitivo de W. Iser, afirmamos que el receptor, contra las teorías literarias inmanentistas que han predominado durante décadas, no se acerca al texto de una manera neutra y pasiva sino que siempre incorpora sus conocimientos y coordenadas sociales, históricas, culturales, ideológicas, de identidad y de sexo. Por ello, el principal objetivo de nuestro trabajo es explicar y demostrar cómo, apoyada en las estructuras discursivas de la narración, una lectora, por sus contenidos teóricos feministas y su propia óptica como mujer en el mundo, puede re-construir a determinados personajes femeninos de la novela galdosiana —solamente aquellos dotados de una importante entidad narrativa y de elementos subversivos— desde una perspectiva feminista.