**6. Conclusions**

where patients, lay representatives, students, doctors, and researchers work in collaboration, this helps to produce pedagogies that reflect the needs of wider societal groups, and not ones

The GMC as a medical regulator is pushing for more patient-centered medicine and patient engagement—see GMC [45], GMC [71], GMC [72]. Although there is only scant PPI literature in relation to its role in UK regulation [73]. It is essential that medical educators comprehend the perspectives and wishes of medical regulator's priorities for patient involvement in medi-

Effective educational strategies for engaging medical students with patients and members of the public in medicine and medical assessment has been an aspiration in medicine for a long time. However, this agenda was diminished in the twentieth century due to the rise in popularity of statistics and biomedical technology in medicine, replacing opportunities for patient

*"for the junior student in medicine and surgery, it is a safe rule to have no teaching without a patient* 

There is still a need for tutors and other staff to increase patient and public involvement in their student's education. We would also point to the Soar and Ryan ([75]: p. 80) who

*"The General Medical Council recently issued advice about patient and public involvement in all areas of medical education, including curricular design, but it is not immediately clear how this should be* 

Steps need to be taken so that we can more clearly explain how PPI can be used in curriculum design and clinical teaching more widely, for which there is clearly an educational need and a regulatory agenda. In 2018, the problem remains, how do we progress from aspiration to delivery of a truly patient-centred form of medical education? More specifically how can we provide a variety of PPI solutions, both bespoke and generic that other PPI stakeholders can replicate or ruminate upon? Medical educators recognise that medical education is a spectrum (undergraduate, post-graduate and continuing professional development); consequently, the development of a pedagogy of PPI in medical education must also reflect this.

The different approaches to pedagogies given in this chapter hang together as a cohesive whole rather than as separate individual approaches. This is because the unifying theme amongst approaches is that they aim towards increasing the patient-centeredness of medicine, patient benefits, and the role and voice of the public in medical education. I agree with the World Health

contact. Prior to this medical reformer, William Osler in 1905 wrote:

*for a text, and the best teaching is that taught by the patient himself"* ([74]: p. 332).

simply formed by doctors or academics in isolation.

278 New Pedagogical Challenges in the 21st Century - Contributions of Research in Education

*4.3.2. Regulatory need*

cal education.

commented:

*incorporated."*

**5. Discussion**

*4.3.3. Educational need*

Looking at the development of the population and public health based pedagogies by the PHEMS group, one of the conclusions of this chapter is that through dialogue with likeminded professionals and support of a professional body, newer clinical subjects can start to come to a consensus on the best approaches to pedagogy within their area.

We can also conclude that there may be instances where because of the variety of stakeholders involved in medical education: patients, public, clinical staff, medical schools, medical regulators etc. not all the stakeholders will uniformly accept new approaches to education within medicine, due to the perceived lack of statistical evidence-base, and this can lead to tensions. As such, teaching approaches in more politically sensitive parts of clinical subjects like Widening Participation may face opposition in certain quarters.

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In addition, one can also see that the external policy decisions about medical student numbers and regulatory pressures to increase the patient-centeredness of medicine act as drivers in terms of how tutors approach teaching their classes. As such, in medicine, there are external factors outside the medical school itself that act as drivers for how and which pedagogies are implemented in clinical teaching.

Lastly, the chapter has also highlighted that while research about pedagogy in clinical areas is not as prevalent an area of academic activity as it might be, even though papers on the subject do exist. What is required going forward is the production of textbooks or monographs which provide in-depth long form and multiple platforms to debate issues of pedagogy in a way that academic paper length does not permit.
