As a Phoenix Fellow advancing patient engagement in health professions admissions I commonly hear from colleagues that they are already engaging patients in admissions as the “community” is engaged within their institution’s admissions processes. So it has brought me to the question – “Is community engagement and patient engagement within admissions processes the same type of engagement?” Or “Are they distinct types of engagement but with the potential for overlap?”
Is community engagement and patient engagement within admissions processes the same type of engagement?
During my admissions tenure at the University of Toronto medical school I had the opportunity to contribute to the development of two admissions initiatives involving community engagement – Indigenous Student Application Program (ISAP) and Black Student Application Program (BSAP). In my opinion, both of these initiatives reflect community engagement. Despite what my colleagues might say I do not see these initiatives as patient engagement in admissions.
A definition for patient engagement within admissions is therefore important to advancing this work. Indeed, this lack of a clear definition may represent a barrier to patient engagement within admissions. In this blog post I will begin a process of inquiry regarding a definition for patient engagement within admissions.
So let’s begin.
In admissions work, community engagement essentially defines communities by language, ethnicity, geography, cultural station etc. For Canadian medical school admissions, this definition applies to multiple communities – Indigenous Peoples, Black Canadians, rural and remote geographic communities and French-speaking minority communities outside of Quebec. These communities reflect the identification of under-represented communities within medical student classes. The community engagement short-term goal is to grow these communities’ representation in Canada’s medical schools. The long-term goal is to grow these communities’ representation in Canada’s physician workforce and ultimately the delivery of health care and health status for these communities.
The first defining-criteria for patient engagement is “real patient” status – therefore being a “potential patient” is not sufficient for the definition of patient engagement.
In admissions, patient engagement is not clearly defined. One could say that everyone engaged in admissions processes are “potential patients” – so end of discussion and end of definition. I propose we go further in defining patient engagement (probably not a surprise to you). The first defining-criteria for patient engagement is “real patient” status – therefore being a “potential patient” is not sufficient for the definition of patient engagement. I propose that the basic, essential definitional components of patient engagement include 1) being a “real patient” plus 2) defining the “real patient” relationship(s) to the health care delivery system. For example, my Phoenix fellowship application project originally incorporated this basic definition with its focus upon engagement of “real patients” of all ages as they visited their health care professionals. Embedded within this example is the goal of engaging “real patients” of all ages including pediatric “real patients”. The reason I emphasize this example and my proposed basic definition is to highlight the inclusion of pediatric “real patients”. This is important because in the institutional admissions committee meetings, including those at SickKids Hospital that I have and continue to attend there are only adult “potential patients” represented; no pediatric “potential patients” or pediatric “real patients” represented. So if you accept “potential patients” as your defining criteria – pediatric “real patients” will likely never be engaged in admissions processes. This key definitional point for patient engagement of being a “real patient” appears simple but it is powerful for it defines this type of engagement as distinct from community engagement. Community engagement may include members who are “potential and/or real patients” but that is not essential to the definition.
These two types of admissions engagement share overlapping purposes in that they engage “real patients” and/or communities not commonly engaged within admissions processes – processes that are traditionally the exclusive domain of educational institutions. One could therefore propose that they share a common purpose of injecting inclusivity into processes that are known for their exclusivity.
To return to my original question –Is community engagement and patient engagement within admissions processes the same type of engagement ? No, they are distinct but with overlap of purpose. Advancing these definitions will enable future investigations to better delineate the presence (or absence) of added value attributed to these two, distinct forms of engagement in health professions admissions processes.
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