‘If you had taken the lead…’ – a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students

Abstract

Objectives To explore what patients with chronic conditions emphasize as important in the patient-medical student conversation, and how the patients’ experiences relate to trust. Methods Twenty-one video-recorded sessions of patients’ feedback in simulation-based communication courses for medical students were observed, transcribed, analyzed inductively and organized into three themes. Results In the patients’ feedback, three aspects were emphasized as important relating to trust: a) when the medical student relates medical information to the patient's lifeworld, b) when the student leads the patient throughout the conversation, and c) when the patient gets emotional support from the student. The patients felt that being met this way by the students grows trust and allows them to lean into the uncertainties they experience while still feeling safe. Discussion The patients emphasize three aspects of importance in conversations with the medical students that grow trust. We argue that these aspects cannot be found in the traditional authority-led practice but can be found in leadership, which imply empathy and willingness to learn from patients. We suggest that students should learn that to effectively communicate with patients infers such leadership. By doing so, medical students can walk alongside their patients to build a relationship and nurture trust.