Promoting lay participation in medical school curriculum development: lay and faculty perceptions

Although medical schools are encouraged to increase community involvement in medical student training, little information is available about how best to achieve this. While lay community members are not medical 'experts', as recipients of health care services they have vested interests in ensuring optimal health care for themselves and their families. This study explored and compared lay and faculty perceptions around lay participation in medical curriculum development at one medical school.

Thirty-two lay volunteers responded to a newspaper advertisement. Seventeen volunteers subsequently participated in 1 of 3 lay focus group discussions. Ten academic staff attended a separate faculty focus group. The 3 lay participants and 1 faculty focus group transcripts were analysed independently and then compared using an iterative process of theme identification and hypothesis testing.

Contrasting perspectives of lay and faculty participants were evident in all aspects of the focus group discussions. For lay participants, some sharing of curriculum ownership by medical experts with the lay community was regarded as necessary to create environments that legitimised lay status and acknowledged the importance of lay perspectives. Faculty participants presumed ownership of curriculum development, giving rise to a paternalistic approach to controlling resources and an assumed responsibility (as experts) to define the parameters of lay participation.

The results of this study have highlighted many of the challenges inherent in the process of lay participation in medical curriculum development. A model is proposed to facilitate and promote lay participation in medical curriculum development.