"Engagement Is Not One-Dimensional": The Multiple Roles of Patient Educators With Physical Disabilities in Family Medicine.

INTRODUCTION

Patient interaction has long been central to medical training. In recent years, involving patients as educators and bringing their lived experiences of illness or disability to the classroom has been valued in clinical education. These "experts by experience" enrich learning by offering authentic perspectives that foster empathy, challenge assumptions, and promote person-centred care. To our knowledge, there is no existing research on the experiences of persons with disabilities (PWD) serving as patient educators.

METHODS

Semi-structured in-depth interviews conducted with seven patient educators with physical disabilities (all PWD patient educators who consented to the study) about their experiences teaching in an undergraduate medical student workshop on communication with PWD. Reflexive thematic analysis was used for analysis.

RESULTS

Illustrating that "engagement is not one-dimensional," participants described engaging students through three overlapping and dynamic roles: patient, educator, and advocate. Four distinct types of patient educator were identified: Type A (Patient role is more predominant than the Educator role), Type B (Patient and Educator roles are equally important with less emphasis on the Advocate role), Type C (Patient, Educator, and Advocate roles are all equally important), and Type D (Patient and Advocate roles are equally important with less emphasis on the Educator role). Patient educators who demonstrated stronger integration of the educator role (Types B and C) were more confident, pedagogically effective, and aligned with curricular aims than those in Type A, whereas those whose engagement was primarily advocacy-oriented (Type D) occasionally diverged from educational goals.

CONCLUSIONS

This study highlights the multidimensional nature of patient educator roles and identifies the strengths and limitations associated with different engagement orientations. Recognising and supporting these intersecting identities can inform recruitment and facilitation practices. Structured training and guided reflection may help patient educators balance personal narratives and advocacy aims with educational objectives, thereby optimising learner outcomes and strengthening the meaningful inclusion of PWD voices in medical education.

PATIENT OR PUBLIC CONTRIBUTION: This study focuses on the perspectives of PWD as educators in an undergraduate medical student workshop on communication with PWD. This workshop was co-created with patient educators with disabilities.