Context

Competency-based assessment of learners may benefit from a more holistic, inclusive, approach for determining readiness for unsupervised practice. However, despite movements toward greater patient partnership in healthcare generally, inclusion of patients in postgraduate medical learners’ assessment is largely absent.

Methods

We conducted a scoping review to map the nature, extent and range of literature examining the inclusion (or exclusion) of patients within the assessment of postgraduate medical learners. Guided by Arskey and O’Malley’s framework and informed by Levac et al. and Thomas et al., we searched 2 databases (MEDLINE® and Embase®) from inception until February 2021 using subheadings related to assessment, patients and postgraduate learners. Data analysis examined characteristics regarding the nature and factor influencing patient involvement in assessment.

Results

We identified 41 papers spanning four decades. Some literature suggests patients are willing to be engaged in assessment, however, choose not to engage when for example, language barriers may exist. When stratified by specialty or clinical setting, the influence of factors such as gender, race, ethnicity, or medical condition, seem to remain consistent. Patients may participate in assessment as a standalone group or part of a multisource feedback process. Patients generally provided high ratings but commented on the observed professional behaviors and communication skills in comparison to physicians who focused on medical expertise.

Conclusion

Factors that influence patient involvement in assessment are multifactorial including patients’ willingness themselves, language and reading-comprehension challenges and available resources for training programs to facilitate the integration of patient assessments. These barriers however are not insurmountable. While understudied, research examining patient involvement in assessment is increasing; however, our review suggests that the extent which the unique insights will be taken up in postgraduate medical education may be dependent on assessment systems readiness, and in particular, physician readiness to partner with patients in this way.