Alberta Health Services (AHS) Primary Health Care (PHC) focuses on patient-centered care as part of a medical home model to deliver complete patient care (Canada’s College of Family Physicians, 2014). Patients need to be consulted to provide feedback from a patient lens to ensure that patients remain at the center of the care model, allowing for a variety of perspectives to influence how patient care is delivered. This patient involvement transforms patients into patient advisors who comprehend the scope of the feedback given and do not only see it as a cathartic sounding board.
An option we could use a community of inquiry (COI) to support the health system for patients (Garrison, Anderson, & Archer, 2000). This would have the chosen patient advisors carefully screened and trained to engage in an online setting guided by healthcare professionals as facilitators to provide constructive feedback. Garrison et al. (2000) determined that there are three presences in the effective COI: cognitive, social, and teaching.
Cognitive presence can depend on very simple and straightforward terminology that enables for clear “expectations and understanding for patients, researchers, clinicians and policy-makers” (Manafo, Elizabeth, et al., 2018, p. 8). Singh et al. (2018) researched for AHS and found that appropriate pre-training for patient advisors and physicians aids in critical thinking (p. 59). Grande, Faber, Durand, Thompson, & Elwyn (2014) have launched a three-step process to gain the necessary cognitive patient engagement “information, activation, collaboration” (p. 285).
Plante & Asselin (2014) identified some best practices to create more caring online social presence in an instructional environment. This included popular approaches such as using photographs, videos and biographies, and encouraging teamwork, sharing difficulties, and frequent communication. Plante & Asselin (2014) also cite Gallagher-Lepak et al. (2009), who found that connecting, particularly with patients, on an emotional level helps in creating a caring social setting.
When necessary facilitators need to engage, however, there is a difference between engagement and being engaging. Reupert, Maybery, Patrick, & Chittleborough, (2009) found instructors who were empathic, approachable, patient, passionate, and occasionally humorous, received greater feedback from learners. Patients can go on tangents, which is why facilitators need to re-connect to the materials and be prescriptive when needed (Turpin, 2014). Finally, Turpin (2014) endorsed the efficient use of the three levels of facilitator engagement from lurking (minimum participation), to supporting, to leading (maximum participation).

All graphics and elements are developed by Alastair Linds 2019. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

References

Garrison, D. R., Anderson, T., & Archer, W. (2000). Critical Inquiry in a Text-Based Environment: Computer Conferencing in Higher Education. The Internet and Higher Education, 2(2–3), 87–105. https://doi.org/10.1016/S1096-7516(00)00016-6

Grande, S. W., Faber, M. J., Durand, M. A., Thompson, R., & Elwyn, G. (2014). A classification model of patient engagement methods and assessment of their feasibility in real-world settings. Patient Education and Counseling, 95(2), 281–287. https://doi.org/10.1016/j.pec.2014.01.016

Reupert, A., Maybery, D., Patrick, K., & Chittleborough, P. (2009). The Importance of Being Human: Instructor’s Personal Presence in Distance Programs. International Journal of Teaching and Learning in Higher Education, 21(1), 47–56. Retrieved from http://www.isetl.org/ijtlhe/

Singh, S., Burns, K. K., Rees, J., Picklyk, D., Spence, J., & Marlett, N. (2018). Patient and family engagement in Alberta Health Services: Improving care delivery and research outcomes. Healthcare Management Forum, 31(2), 57–61. https://doi.org/10.1177/0840470417747003

The College of Family Physicians of Canada. (2014). Patient-Centred Care in a Patient ’ s Medical Home, (April).

Turpin, R. L. (2014). State of the Science of Nursing Presence Revisited: Knowledge for Preserving Nursing Presence Capability. International Journal of Human Caring, 18(4), 14–29. https://doi.org/10.20467/1091-5710.18.4.14

Plante, K., & Asselin, M. E. (2014). Best practices for creating social presence and caring behaviors online. Nursing Education Perspectives, 35(4), 219-223.

Manafo, Elizabeth, et al. “Patient engagement in Canada: a scoping review of the ‘how’and ‘what’of patient engagement in health research.” Health research policy and systems 16.1 (2018): 5.