건강 및 사회적 돌봄 전문직 교육에서 환자의 목소리: 밴쿠버 성명(International Journal of Health Governance, 2016)

건강 및 사회적 돌봄 전문직 교육에서 환자의 목소리: 밴쿠버 성명(International Journal of Health Governance, 2016)
The patient’s voice in health and social care professional education: The Vancouver Statement
Angela Towle, Christine Farrell, Martha E. Gaines, William Godolphin, Gabrielle John, Cathy Kline, Beth Lown, Penny Morris, Jools Symons and Jill Thistlethwaite 

 

환자 참여의 역사
History of patient involvement

의료 및 사회복지 서비스를 이용하는 사람들이 치료를 제공하는 전문가 교육에 적극적으로 참여하는 것은 지난 20년 동안 크게 확대되었습니다(Towle et al., 2010). 이러한 성장은 의료 서비스의 여러 측면에서 대중과 환자의 적극적인 참여를 강조하는 의료 서비스 전달, 정책 및 연구 동향이 융합된 결과입니다. 

Active involvement of people who use health and social services in the education of professionals who provide the care has expanded greatly over the past 20 years (Towle et al., 2010). Its growth is the consequence of the convergence of trends in health care delivery, policy and research that have emphasized active participation of the public and patients in many aspects of their care.

환자의 의료 참여는 부분적으로는 [전통적인 가부장주의]에서 벗어나 [환자를 치료의 파트너로 포용]하려는 [자율성의 윤리적 의무]에서 비롯되며, [정보에 입각한 선택을 요구하는 법적 추세]에 따라 명문화되었습니다. 또한, 특히 영국, 미국, 캐나다, 호주의 정부와 영향력 있는 기관은 의료 서비스에 대한 직접적인 혜택으로 인해 더 많은 환자와 대중의 참여가 필요하다는 점을 명확히 했습니다. 환자 참여는 환자 안전(의학 연구소, 2000; 보건부, 2001), 환자 중심의 결과, 공동 의사 결정 및 공동 관리 결정 준수, 인구 고령화 및 만성 질환 증가에 따른 환자들의 보다 적극적인 치료 참여 등 환자 중심 치료 및 품질 보증의 다양한 측면과 연관되어 있습니다(Nasmith et al., 2010).
Involvement of patients in health care arises, in part, from the ethical imperative of autonomy that moves us away from traditional paternalism toward inclusion of patients as partners in care and has been codified in legal trends that require informed choice. In addition, governments and influential institutions, especially in the UK, USA, Canada and Australia, have articulated the need for more patient and public involvement because of perceived direct benefits to health care. Patient involvement has been linked to various aspects of patient-centered care and quality assurance, including

• patient safety (Institute of Medicine, 2000; Department of Health, 2001), patient-centered outcomes, shared decision-making and adherence to joint management decisions, and involving people more actively in their care as the population ages and chronic disease increases (Nasmith et al., 2010).

보건 연구에 대한 환자 및 대중의 참여가 절실해지면서 영국의 국립보건연구원, 미국의 환자 중심 성과 연구소, 캐나다의 환자 중심 연구 전략, 호주의 뉴사우스웨일스 임상 혁신 기관에서 대중의 적극적인 참여를 지원하는 INVOLVE와 같은 이니셔티브가 만들어졌습니다.
The imperative for patient and public involvement in health research has resulted in the creation of

• initiatives such as INVOLVE that supports active public involvement in the National Institute for Health Research in the UK (www.invo.org.uk),
• the Patient-Centered Outcomes Research Institute in the USA (www.pcori.org),
• Canada’s Strategy for Patient-Oriented Research (www.cihr-irsc.gc.ca/e/documents/P-O_Research_Strategy-eng.pdf), and
• the New South Wales Agency for Clinical Innovation in Australia (www.aci.health.nsw.gov.au).

환자와 대중의 참여를 포용할 수 있는 인력을 양성하기 위해 교육에 환자를 참여시키는 것(정의는 학회 성명서 각주 참조)은 이러한 움직임에서 논리적으로 발전한 것입니다. 이는 현재 의료 전문가를 교육하는 방식에 [내재된 몇 가지 장벽] 때문에 특히 중요합니다. 예를 들어, 오플린과 브리튼(2006)의 연구에 따르면 [공유 의사 결정]의 채택은 현재 의사가 권력과 책임의 상당한 공유를 포함하지 않는 의료 정체성을 달성해야 할 필요성과, [의료 교육 중 공감과 환자 중심주의의 침식]을 보여주는 많은 연구로 인해 제한됩니다(Neumann et al., 2011). 
The involvement of patients in education (see footnote in conference statement for definition) to develop a workforce that is able to embrace patient and public participation is a logical development from these movements. This is particularly important because of some barriers inherent in the way we currently educate health professionals. For example, the work of O’Flynn and Britten (2006) suggests that the adoption of shared decision-making is limited by the need for practitioners to achieve a medical identity that currently does not involve significant sharing of power and responsibility, and the many studies that demonstrate an erosion of empathy and patient centredness during medical training (Neumann et al., 2011). 

교육에 대한 환자 참여는 의학(Wykurz and Kelly, 2002; Jha 외, 2009; Towle 외, 2010), 간호학(Warne and McAndrew, 2005; Repper and Breeze, 2007; Terry, 2012), 사회사업학(Cairney 외, 2006; Robinson and Webber, 2013), 다양한 분야의 정신건강 전문가 교육(Livingston and Cooper, 2004; Happell 외, 2014)에서 시작되었습니다. 최근에는 물리치료(Jones 외, 2009), 작업치료(Cleminson and Moesby, 2013), 약국(Grimes 외, 2013), 치과(Renard 외, 2015)와 같은 다른 의료 전문직으로 확산되고 있습니다. 

Patient involvement in education began in

• medicine (Wykurz and Kelly, 2002; Jha et al., 2009; Towle et al., 2010), 
• nursing (Warne and McAndrew, 2005; Repper and Breeze, 2007; Terry, 2012) and
• social work (Cairney et al., 2006; Robinson and Webber, 2013), and in
• the education of mental health professionals from a variety of disciplines (Livingston and Cooper, 2004; Happell et al., 2014). 
• It has more recently spread to other health professions such as
  • physical therapy (Jones et al., 2009), 
  • occupational therapy (Cleminson and Moesby, 2013), 
  • pharmacy (Grimes et al., 2013) and
  • dentistry (Renard et al., 2015).

그러나 교육에 대한 환자 참여는 아직 교육 실무의 주류에서 잘 확립되지 않았습니다. 환자 참여는 

• 삶의 경험의 다양성을 반영하기보다는 특정 환자 집단으로 제한되는 경우가 많고, 
• 교육 기관에 통합되어 있지 않고 파편화되어 있으며, 
• 적절한 인프라와 지속적인 리더십 및 자원이 부족합니다. 

혜택에 대한 증거가 나타나고 있지만 여전히 고르지 않습니다. 교육자로서의 환자 이니셔티브가 가장 광범위하고 제도적으로 지원되는 국가는 영국으로, "환자 주도형" 국가보건서비스(하원 보건위원회, 2007) 개발에 대한 정부의 노력과 최근에는 보건 및 사회 서비스 개발에 대한 접근 방식으로서 공동 생산 개념(Loeffler et al., 2013)이 교육 정책 지침으로 확장되었습니다. 따라서 교육에 대한 서비스 사용자 및 보호자의 참여는 간호 및 조산사(간호 및 조산사 위원회, 2010), 16개 기타 보건 및 사회복지 전문직(보건 및 사회복지 전문직 위원회, 2014), 최근에는 의학(일반 의학 위원회, 2016)의 교육 프로그램 인증을 담당하는 법정 기관의 [표준에 명시]되어 있습니다.
However, patient involvement in education is still not well established in the mainstream of educational practice. Involvement

• is often limited to a specific population of patients rather than reflecting the diversity of lived experiences,
• is fragmented and not embedded in the educational institution, and
• lacks appropriate infrastructure and sustained leadership and resources.

Evidence of benefit is emerging but still patchy. The most wide-ranging and institutionally supported patient-as-educator initiatives are in the UK (Towle and Godolphin, 2011) where government commitment to the development of a “patient-led” National Health Service (House of Commons Health Committee, 2007) and, more recently, to the concept of co-production as an approach to the development of health and social services (Loeffler et al., 2013) has extended to policy directives in education. Thus, service user and carer involvement in education has become enshrined in the standards of the statutory bodies responsible for the accreditation of educational programs in nursing and midwifery (Nursing and Midwifery Council, 2010), 16 other health and social care professions (Health and Care Professions Council, 2014) and more recently, medicine (General Medical Council, 2016).

문헌에서 말하는 것
What the literature says

환자 참여의 예는 이제 기본 교육부터 대학원 및 지속적인 전문성 개발에 이르기까지 교육의 연속체에서 찾을 수 있으며, 학생 선발, 다양한 교수 역할, 피드백 및 평가, 커리큘럼 개발 및 기관 차원의 의사 결정을 포함한 [광범위한 교육 활동]을 포함합니다(유형론은 Towle 외., 2010 참조). 
Examples of patient involvement can now be found across the continuum of education from basic training through postgraduate and continuing professional development, and include a wide spectrum of educational activities including selection of students, a variety of teaching roles, feedback and assessment, curriculum development and decision-making at an institutional level (for a typology see Towle et al., 2010).

문헌에 따르면 환자로부터의 학습은 임상적 추론, 의사소통 기술, 전문적 태도, 공감적 이해 및 환자에 대한 개별화된 접근법을 개발하는 데 중요한 역할을 하며, 관련성과 맥락을 제공함으로써 학생들에게 동기를 부여합니다(Towle 외., 2010).

• 교육에 참여하는 환자에게는 지역사회에 환원하는 것에 대한 만족감, 미래의 전문가 교육에 대한 영향력, 자존감 및 권한 부여 증가 등의 [이점]이 있습니다(McKeown 외., 2012).
• 또한 문헌에서는 제도적 지원 및 자금 부족(Happell 외., 2015), 전문 지식과 권력에 대한 도전(Felton and Stickley, 2004), 대표성 및 토큰주의 문제(Forrest 외., 2000) 등 환자의 교육 참여에 대한 [장벽]을 파악하고 있습니다.
• 그러나 대부분의 연구는 설명적이며 교육 전략에 정보를 제공할 수 있는 [이론적 이해나 비판적 설명]이 부족합니다(Regan de Bere와 Nunn, 2016).
• 좋은 [평가 연구]는 거의 없으며, 진료에 대한 장기적인 영향과 의료 수혜자에게 미치는 혜택에 대한 [증거가 부족]합니다(Morgan and Jones, 2009; Robinson and Webber, 2013).

The literature provides evidence that learning from patients plays a role in the development of clinical reasoning, communication skills, professional attitudes, empathic understanding and an individualized approach to the patient; it also motivates students by providing relevance and context (Towle et al., 2010). 

• Benefits to patients involved in education include satisfaction in giving back to the community, having an influence on the education of future professionals, and increased self-esteem and empowerment (McKeown et al., 2012). 
• The literature also identifies barriers to patient involvement in education including lack of institutional support and funding (Happell et al., 2015), challenges to professional knowledge and power (Felton and Stickley, 2004), and issues of representativeness and tokenism (Forrest et al., 2000). 
• However, most of the research is descriptive and lacks theoretical understanding or critical explanation that might inform educational strategies (Regan de Bere and Nunn, 2016). 
• There are few good evaluation studies, and there is a lack of evidence of the long-term impact on practice and benefits to the recipients of care (Morgan and Jones, 2009; Robinson and Webber, 2013).

"환자의 목소리는 어디에 있는가?" 컨퍼런스
“Where’s the Patient’s Voice?” Conference

2005년 캐나다 밴쿠버에서 "의료 전문가 교육에서 환자의 목소리는 어디에 있는가?"라는 주제로 첫 번째 국제 컨퍼런스가 열렸습니다. 이 컨퍼런스의 목적은 이 분야의 선구자들을 한자리에 모아 다양한 배경을 가진 240명의 참석자가 발표와 토론을 통해 '영역의 지도'를 그리는 것이었습니다. 컨퍼런스 보고서는 교육에 대한 환자 참여 현황을 문서화하고 새로운 문제와 향후 방향을 파악했습니다(Farrell et al., 2006).
In 2005, the first international conference on the topic, “Where’s the Patient’s Voice in Health Professional Education?” was held in Vancouver, Canada. The aim was to bring together pioneers in the field and “map the territory” through the presentations and discussions of 240 attendees with a wide range of backgrounds. The conference report documented the state of patient involvement in education, and identified emerging issues and future directions (Farrell et al., 2006).

10년 후인 2015년 11월에 2005년 이후의 진전 상황을 살펴보기 위한 두 번째 컨퍼런스가 열렸습니다. 컨퍼런스 위원회(이 백서의 저자)는 향후 5년간의 의제를 설정하고 각 기관 및 단체의 참가자들을 위한 자료로 사용될 성명서를 작성하기 위해 노력했습니다. 이 컨퍼런스에는 16개국에서 온 250명의 대표단이 참석했으며 모든 주요 보건 분야를 대표했습니다. 대부분은 교육 리더 또는 실무자였으며, 환자 또는 지역사회 구성원이라고 밝힌 비율은 20%가 조금 넘었고 학생은 13%였습니다.
A second conference was held ten years later in November 2015 to look at progress since 2005. The conference committee (authors of this paper) worked toward production of a statement that would set the agenda for the next five years, and serve as a resource for participants in their own institutions and organizations. The conference was attended by 250 delegates from 16 countries and representing all of the major health disciplines. Most were educational leaders or practitioners; just over 20 percent identified themselves as patients or community members and 13 percent as students.

컨퍼런스 성명서 개발
Development of the conference statement

컨퍼런스 위원회는 [성명서 초안]을 작성하여 사전에 컨퍼런스 등록자에게 소개했습니다. 대표자들은 서면, 초안 자체 또는 학회 웹사이트의 전자 버전, 학회 위원회와의 공개 회의, 학회 마지막 날 오전 중 한 가지 이상의 방법으로 초안에 대한 피드백을 제공하여 향후 성명서 개발에 참여하도록 초대되었습니다.
The conference committee prepared a draft statement that was introduced to the conference registrants in advance. Delegates were invited to participate in its future development by providing feedback on the draft in one or more of the following ways:

• in writing,
• on the draft itself or an electronic version on the conference website,
• during an open meeting with the conference committee, and
• on the final morning of the conference.

약 90명의 컨퍼런스 대표단이 최종 세션에 참석하여 컨퍼런스 위원회 위원 또는 퍼실리테이터로 지정된 사람들과 함께 [원탁 토론 그룹]을 구성했습니다. 원탁 토론 그룹은 성명서에 대한 일반적인 의견을 제시한 후 보다 구체적으로 실행 항목에 집중하도록 요청받았습니다. 그룹은 성명서 및 권고사항에 대한 실질적인 변경 사항을 보고했습니다. 모든 의견과 메모는 회의가 끝난 후 수집되어 필사되었습니다. [회의 위원회의 소그룹]이 피드백에서 주요 주제를 파악하여 회의 후 성명서 버전에 변경 사항을 반영했습니다. 이 성명서는 모든 대표자에게 이메일로 배포되어 추가 의견을 보내달라는 초대장과 함께 전달되었습니다. 추가 수정 사항은 거의 제안되지 않았으며 성명서에 대한 강력한 지지가 있었습니다. 성명서는 아래에서 확인할 수 있습니다.
About 90 conference delegates attended the final session and formed round table discussion groups with members of the conference committee or designates as facilitators. The round table groups were asked to provide general comments about the statement and to then focus more specifically on action items. The groups reported any substantive changes to the statement and recommendations. All comments and notes were collected and transcribed after the conference. A subgroup of the conference committee identified major themes from the feedback and incorporated changes into the post-conference version of the statement. This was circulated by e-mail to all delegates with an invitation to send further comments. Very few further amendments were suggested and there was strong support for the statement. The statement can be seen below.

---

보건 및 사회복지 전문가 교육에서 환자의 목소리는 어디에 있나요? 2015 밴쿠버 성명서 
Where’s the patient voice in health and social care professional education? The Vancouver Statement 2015 

이 성명서는 향후 5년 동안 [교육에 대한 환자 참여의 방향을 설정]하는 것을 목표로 합니다[1]. 2015년 11월 12일부터 14일까지 밴쿠버에서 개최된 제2회 "보건의료 전문가 교육에서 환자의 목소리는 어디에 있는가?" 국제 컨퍼런스에서 참석자들과 협력하여 개발되었습니다. 우리는 환자를 교육에 적극적으로 참여시키기 위해 이미 이루어지고 있는 훌륭한 작업과 10년 전 첫 번째 컨퍼런스 이후 이루어진 진전을 인정합니다.
This statement aims to set the direction for patient involvement in education for the next five years[1]. It was developed in collaboration with attendees at the 2nd “Where’s the Patient’s Voice in Health Professional Education?” international conference, held in Vancouver from 12 to 14 November 2015. We acknowledge the excellent work that is already taking place to actively involve patients in education and the advances that have been made since the first conference ten years ago.

이 성명서는 보건 및 사회복지 전문가 교육을 담당하는 [의사결정권자를 대상]으로 하며, 개별 교육자 및 환자, 지역사회 조직과도 관련이 있습니다.
This statement is targeted at decision-makers responsible for the education of health and social care professionals, and is also relevant to individual educators and patients, and community organizations.

1. 목표 
1. Aim 

1.1 현재와 미래의 보건 및 사회복지 전문가 교육에 [환자의 자율적이고 진정성 있는 목소리]와 [환자의 생생한 경험]이 포함되도록 촉진하고 보장하여 [진정으로 환자 중심적인 치료가 제공]되도록 합니다.
1.1 To promote and ensure that the education of current and future health and social care professionals includes the autonomous and authentic voices of patients and their lived experiences so that the care delivered is genuinely patient-centred.

2. 보건의료 전문가 교육에 대한 환자 참여 - 정의 
2. Patient involvement in the education of health professionals – what it is 

2.1 환자가 [교사, 평가자, 커리큘럼 개발자 및 교육 의사 결정자]로서 [적극적이고 협력적인 교육적 역할을 수행]하는 것을 의미합니다.
2.1 We mean that patients play an active and collaborative educational role, as teachers, assessors, curriculum developers and educational decision makers.

3. 이 선언문이 중요한 이유 
3. Why this statement is important 

3.1 보건 및 사회복지 분야는 환자를 [의사 결정, 서비스 제공 및 연구의 파트너로 참여]시켜야 합니다.
3.1 Health and social care should engage patients as partners in decision-making, service delivery and research.

3.2 교육에서 환자와의 협력은 현재 및 미래의 의료인이 환자와 협력하여 다음과 같은 목적으로 일할 수 있도록 준비시키는 데 필수적입니다:

• i) 사람 중심의 관계 기반 치료 제공;
  
• ii) 공동 의사 결정에 참여;
  
• iii) 자기 관리 및 회복력 지원;
  
• iv) 의사소통 및 공감과 배려의 관계 강화;
  
• v) 환자 안전과 질 향상 촉진;
  
• vi) 공유 가치, 포용성 및 사회 정의 증진.

3.2 Patient collaboration in education is essential to prepare current and future practitioners to work in partnership with patients in order to:

• i) deliver person-centred, relationship-based care;
• ii) engage in shared decision-making;
• iii) support self-care and resilience;
• iv) enhance communication, and empathic and caring relationships;
• v) promote patient safety and quality improvement;
• vi) foster shared values, inclusion and social justice.

3.3 따라서 우리는 모든 교육 기관과 평생교육 제공자가 [환자와 파트너십을 구축하고 협력]할 수 있도록 [보건 및 사회복지 전문가를 준비시킬 필요성]에 대응할 것을 촉구합니다.
3.3 Therefore we call on all educational institutions and providers of continuing education to respond to the need to prepare health and social care professionals to build and work in partnerships with patients.

4. 현재 상태 
4. The current state 

4.1 환자를 적극적으로 참여시키는 교육은 혁신적이고 진화하고 있으며, 특히 환자의 전문성과 삶의 경험에 대한 인정과 존중과 관련하여 학습자의 흥미를 유발하고 있습니다.
4.1 Education that actively engages patients is innovative and evolving, especially with regard to recognition and respect for patient expertise and their lived experience, and is engaging for learners.

4.2 팀 기반 교육 및 치료를 촉진하기 위해 개별 전문 프로그램을 넘어 교육에 환자 참여를 확대할 기회를 놓치는 경우가 많습니다.
4.2 Opportunities are often missed to expand patient involvement in education beyond individual professional programs to promote team-based education and care.

4.3 현재 활동은 소수의 열성적인 사람들에 의해 주도되는 경우가 많고, 교육 구조에 통합되기보다는 단편적이거나 일시적인 경우가 많으며, 기관 내에서 지위와 우선순위가 낮은 경우가 많습니다.
4.3 Current activities are often driven by a small group of enthusiasts, are often fragmented or episodic rather than integrated into educational structures, and are often of low status and priority in the institution.

4.4 권력, 직업적 정체성, 학습 장소와 관련된 제도적 및 교육적 장벽이 존재하여 환자의 목소리를 듣지 못하게 합니다.
4.4 Institutional and educational barriers exist related to power, professional identity and location of learning which prevent patients from being heard.

4.5 환자를 교육자로 참여시켰을 때 얻을 수 있는 이점에 대한 결과 데이터는 제한적입니다.
4.5 Outcome data on the benefits of involving patients as educators are limited.

4.6 보건 및 사회복지 전문가 교육에 대한 환자 참여의 영향에 대한 [혁신, 평가 및 연구]를 위한 자금은 종종 불충분하고 안전하지 않습니다.
4.6 Funding for innovation, evaluation and research into the impact of patient involvement in health and social care professional education is often insufficient and insecure.

4.7 환자가 참여할 수 있도록 준비시키고, 권한을 부여하고, 자신감을 심어줄 수 있는 자원과 환자를 지원할 수 있는 구조와 지원이 없는 경우가 많습니다.
4.7 Resources to prepare, empower and give patients confidence to participate, and structures and support in place to support patients are often not present.

5. 향후 5년간의 행동 우선순위 
5. Priorities for action in the next five years 

5.1 인증 기준, 외부 및 내부 정책, 전문 기관의 선언문, 모범 사례 성명서 등의 지침을 통해 보건 및 사회복지 전문가 교육에 환자의 참여를 촉진합니다.
5.1 Promote the involvement of patients in health and social care professional education through directives such as accreditation standards, external and internal policies, pronouncements from professional bodies and best practice statements.

5.2 이러한 활동의 근거가 되고 가치가 있는 환자 전문성에 대한 기관, 지역, 국가 및 전 세계의 인식을 촉진합니다. 성과를 인정하고 성공을 축하합니다(교육 혁신 개발 및 보급을 위한 기금에 대한 정보를 파악하고 공개하며, 출판 기회를 늘립니다).
5.2 Foster institutional, local, national and global recognition of patient expertise that grounds this activity and makes it valued. Recognize achievement and celebrate success (identify and publicize information about funding to develop and disseminate educational innovations, increase publication opportunities).

5.3 현재 및 미래의 의료 전문가 교육에 참여하는 것이 본질적으로 매력적이고 가치 있는 활동이라고 믿는 환자, 지역사회 기관, 환자 옹호 단체 및 지역사회 구성원의 동기와 열정을 활용하여 참여하는 사람들의 다양성을 높입니다.
5.3 Increase the diversity of people who are involved by harnessing the motivation and enthusiasm of patients, community agencies, patient advocacy organizations and community members who believe that being involved in the education of current and future health professionals is an intrinsically attractive and valuable activity.

5.4 가능한 한 빨리 학습자에게 환자의 목소리 이니셔티브를 소개하고, 선발 과정, 커리큘럼 및 평가를 포함한 교육 연속체 전반에 걸쳐 이를 유지합니다.
5.4 Introduce the patient’s voice initiatives to learners as early as possible, and sustain them throughout the educational continuum, including selections processes, curriculum and assessment.

5.5 환자 파트너십과 팀워크에 대한 보다 총체적인 접근을 촉진하기 위해 새롭게 부상하는 다중 및 전문가 간 학습 활동에 환자의 참여를 목표로 삼습니다.
5.5 Target patient involvement in new and emerging multi- and inter-professional learning activities in order to facilitate a more holistic approach to patient partnerships and teamwork.

5.6 환자의 교육 참여를 촉진하기 위해 교육 기관과 지역사회 조직 간의 협력을 촉진하는 모델을 탐색하고 개발합니다.
5.6 Explore and create models to promote collaboration between educational institutions and community organizations to promote patient involvement in education.

5.7 환자와 협력하여 고품질의 포괄적이고 접근 가능한 연구 및 평가를 수행하고 전파하여 환자 및 학습자 결과와 이를 달성하는 과정을 포함하여 교육에 대한 환자 참여의 장단기적 영향에 대한 추가 증거를 제공합니다.
5.7 Conduct and disseminate high quality, inclusive and accessible research and evaluation in partnership with patients, to provide further evidence of short and long-term impact of patient involvement in education, including patient and learner outcomes, and the processes by which it is achieved.

5.8 컨퍼런스 및 교육 행사의 계획, 제공, 평가에 환자가 참여할 수 있도록 컨퍼런스 위원회에 로비하고, 환자가 컨퍼런스에 참석하고 발표할 수 있도록 지역사회 단체, 대학, 대학 및 기금 기관에 보조금을 제공할 수 있도록 로비합니다.
5.8 Lobby conference committees to involve patients in the planning, delivery and evaluation of conferences and educational events; lobby community organizations, colleges, universities and funding bodies to provide grants for patients to attend and present at conferences.

5.9 협력하고, 정보를 전파하고, 유망한 사례를 공유하고, 추가 회의를 계획할 수 있도록 지역 네트워크와 챔피언을 구축합니다.
5.9 Create regional networks of people and champions to collaborate, disseminate information, share promising practices and plan further meetings.

---

결론
Conclusion

우리는 이 성명서가 학회 대표들과 협력하여 개발되었기 때문에 현장에서 일하는 모든 사람들의 견해를 대표하지 않을 수 있으며, 행동 우선순위와 모범 사례를 결정할 때 맥락의 중요성을 고려하지 않았음을 알고 있습니다. 이러한 한계에도 불구하고 이 성명서는 이미 문헌에 나와 있는 아이디어를 하나의 문서로 통합했습니다.
We recognize that the statement was developed in collaboration with conference delegates and therefore may not represent the views of all those working in the field, and does not take into account the importance of context in determining the priorities for action and best practices. Despite these limitations the statement does bring together ideas, some already in the literature, into one document.

이 회의 성명서는 향후 5년 동안 보건 및 사회복지 전문가 교육에 환자 참여를 정착시키기 위해 필요하다고 생각되는 9가지 행동 우선순위를 강조합니다. 정책, 인정 및 지원, 혁신, 연구 및 평가, 보급 및 지식 교환 분야로 구성되어 있습니다. 이 중 영국의 사례에서 알 수 있듯이 실질적인 변화를 가져올 가능성이 가장 높은 활동은 정책과 관련된 활동입니다. 특히 인증 표준은 커리큘럼과 교육 환경의 변화를 이끄는 강력한 동인입니다. 인증 표준은 선도적인 교육 기관의 모범 사례와 교육 기관 외부의 정책 지침에 의해 주도됩니다. 이러한 수준의 변화를 위해서는 의료 시스템 및 전문 기관의 의사결정권자뿐만 아니라 보건 및 사회복지 전문가 교육을 직접 담당하는 사람들의 리더십이 필요합니다.
The conference statement highlights nine priorities for action over the next five years that we believe are necessary in order to embed patient involvement in the education of health and social care professionals. They are in the areas of policy, recognition and support, innovation, research and evaluation, and dissemination and knowledge exchange. Of these, the actions that are most likely to bring about substantive change, as evidenced by developments in the UK, are those related to policy. In particular, accreditation standards are powerful drivers for change in curriculum and educational settings. They are driven both by best practice within leading educational institutions and by policy directives external to them. Change at this level requires leadership from decision-makers in the health care system and professional bodies, as well as those directly responsible for the education of health and social care professionals.

리더, 교육자, 임상의가 교육 전반에 걸쳐 환자와의 협력 및 파트너십에 대한 기대치를 조기에 그리고 자주 모델링하고 설정하지 않으면 우리가 추구하는 향상된 결과, 즉 치료의 질 향상, 환자 안전 및 건강 결과 개선의 실현이 지연될 수 있습니다.Failure by leaders, educators and clinicians to model and set expectations of collaboration and partnerships with patients early and often across the continuum of education will delay the realization of the enhanced outcomes we seek: improved quality of care, patient safety and improved health outcomes.

---

Abstract

Purpose

The purpose of this paper is to present a statement about the involvement of patients in the education of health and social care professionals developed at an international conference in November 2015. It aims to describe the current state and identify action items for the next five years.

Design/methodology/approach

The paper describes how patient involvement in education has developed as a logical consequence of patient and public participation in health care and health research. It summarizes the current state of patient involvement across the continuum of education and training, including the benefits and barriers. It describes how the conference statement was developed and the outcome.

Findings

The conference statement identifies nine priorities for action in the areas of policy, recognition and support, innovation, research and evaluation, and dissemination and knowledge exchange.

Originality/value

The conference statement represents the first time that an international and multidisciplinary group has worked together to assemble in a single document specific priorities for action to embed the patient’s voice in health professional education.

Keywords

• User involvement
• Professional education
• Patient involvement
• Health professions education
• Professional development
• Public involvement

Citation

Towle, A., Farrell, C., Gaines, M.E., Godolphin, W., John, G., Kline, C., Lown, B., Morris, P., Symons, J. and Thistlethwaite, J. (2016), "The patient ' s voice in health and social care professional education: The Vancouver Statement", International Journal of Health Governance, Vol. 21 No. 1, pp. 18-25. 

Publisher

Emerald Group Publishing Limited

Copyright © 2016, Emerald Group Publishing Limited