title: Should we involve terminally ill patients in teaching medical students? A systematic review of patient's views.
abstract: OBJECTIVE
  To review available published research that has explored how terminally ill patients feel about being involved in undergraduate medical teaching.
  
  
  METHODS
  A systematic review using narrative synthesis. Qualitative or quantitative publications were included if they directly explored the views of adult patients, with a terminal diagnosis, about their involvement in undergraduate clinical teaching.
  
  
  RESULTS
  Seven publications met the inclusion criteria: one case report, one qualitative study and five questionnaire-based studies. A total of 269 patients were included across all studies. Patients were predominantly studied in a hospice or hospice day care setting. Both patients who had, and who had not, previously been involved in student teaching were captured by the included publications. In general, the views of patients were highly positive: overall 85%-100% were in favour of involvement in teaching. There were also some negative aspects, such as: concerns about being physically examined by a student; finding involvement in teaching tiring; feeling unable to decline consent to participate.
  
  
  CONCLUSIONS
  An assumption that clinical undergraduate medical teaching involving terminally ill patients may be too burdensome is not reflected overall in studies that have sought the views of the patients themselves. Understanding the patient's perspective provides a number of practical points in relation to how clinical teaching should be adapted in this patient group; for example, using smaller student group sizes; direct supervision if physical examination performed; short encounters with multiple patients rather than a longer encounter with one patient; adequate informed consent beforehand and without the students automatically being present.
authors.affiliation: Department of Palliative Care, Prince Charles Hospital, Merthyr Tydfil, UK.
authors.forename: Dylan Gareth
authors.initials: DG
authors.lastname: Harris
authors.affiliation: Department of Information Services, Cardiff University, Velindre Hospital, Cardiff, UK.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Coles
authors.affiliation: Department of Postgraduate General Practice Education, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Hannah May
authors.initials: HM
authors.lastname: Willoughby
mesh_terms: D000328:Adult; D004501:Education, Medical / Q000379:methods*; D005260:Female; D017051:Hospice Care / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D036301:Qualitative Research; D013663:Teaching / Q000379:methods*; D019452:Terminally Ill / Q000523:psychology*
keywords: Communication; Education and training; Terminal care