Patient instructors in rheumatology

Patient instructors are patients trained to teach students in focussed history taking and/or examination in the context of the patient's specific illness. Their espousal has been quite extensively reported in rheumatology. The majority of studies show that patient instructors are effective in enhancing the knowledge and skills relevant to practice concerned with patients with the given conditions (in this case, typically rheumatoid arthritis and osteoarthritis). Most studies show patient instructors to be as effective as clinicians in this respect. They are especially effective at enhancing students' understanding of the impact of living with a chronic condition. With appropriate (quite extensive) training, they can also assess the examination skills of students, both undergraduate and postgraduate. Students value them, and the patient instructors themselves derive benefit from the activity. There are issues to be aware of regarding the adoption of patient instructors. The training required is significant. If employed as described in the literature, quite significant selection criteria come into play. In some cases, patient instructors feel under-rewarded financially; they should not be seen as medical education on the cheap. Nonetheless, patient instructors represent an excellent, relatively under-utilised, resource for the aiding of student learning in many areas of medicine.