“The patient trainers have experienced the events they tell us about. It’s very different from a simulation between students, or with actors, like during the session we had this morning. The actors are very talented, but there is not necessarily the same affect. We find ourselves faced with situations that we may face during our practice, it’s good to have been exposed to them before,” says Ninon, a student at theUniversity of Western Brittany (UBO), in the fifth year of medicine, in Brest.
Filmed consultations
On that day, at the end of December 2022, in the meeting room linked by video to the simulation consultation room of the Faculty of Medicine, there were about ten around two general practitioners trainers and two expert patients to debrief the four sessions which just stood. These students are confronted for the first time with a patient who has experienced the scenario.
The two expert patients of this session, Danièle Himily and Yvon Abautret, presented several situations. “I presented a scenario on somatic pain, due to the illness of my son, who is schizophrenic. The other scenario was about domestic violence. The consultation is filmed, the other students see what is happening in the office. It lasts five minutes and then we all debrief together, ”explains Danielle Himily. “I take this opportunity to tell them about my association, Unafamwhich brings together friends and families of mentally ill people, often little known to doctors”.
All expert patients have enough distance with regard to their history or their disease. They are trained and elements of their real life are adapted into scenarios for the training objectives.
As for Yvon Abautret, the other expert patient, he took up a scenario around diabetes and alcohol, which may have made the students uncomfortable. “When I asked a question focusing on alcohol, a student went on diabetes,” notes Yvon Abautret.
Real life for training
“All expert patients have enough distance with regard to their history or their disease. They are trained and we adapt the elements of their real life in scenarios for the training objectives”, specifies Doctor Estelle Michelet, general practitioner in Fouesnant, who led this training day with her colleague Doctor Florence Hémon, general practitioner who practices in the hospital on questions of the health of women and couples.
Expert patients also intervene at the physiotherapy training institute, in dentistry and at the midwifery school with scenarios adapted to each specialty.
The status of the expert patient still remains to be established. Financial support from the faculty of medicine to remunerate the patients made it possible to launch the adventure, even if some wish to remain volunteers. L’Association for the formation of partnership of care chaired by Dr Estelle Michelet took over in 2019.
“Used with care”
“These experts sometimes come from our patient base or referred by our colleagues, or via France health association, an association of healthcare users. It has a playful side but it is very standardized and it has a strong emotional impact for the students. They are placed in a situation and are judged by their peers. Simulation should be used with caution. The patients are professional and aware of the impact of the scenarios”, emphasizes Dr Estelle Michelet.
Brest – When the treated train the caregivers at the Faculty of Medicine of Brest