Patient participation at the morbidity and mortality meeting: A transformative learning experience

Purpose: Implementing a patient-centered innovation is a complex process that requires commitment and attention from the healthcare professionals and organizations involved. Even though studies show how patient participation can be achieved in clinical care, it has hardly been studied as a learning process. This study aims to understand a patient-centered innovation as a potentially transformative experience.Method: The study included morbidity and mortality meetings with patient participation (M&MM-P) at the department of gynecological oncology over a five year time period (2016-2021). Data was collected by action research methods including ethnography, in-depth- and semi-structured interviews, various observations and attendance lists, and secondary analysis of transcripts. Data was analyzed with thematic content analysis (Atlas.ti 8.4.20).Results: The results include 17 M&MM-Ps, interviews with eight patients, 17 healthcare professionals, nine observations and two attendance lists of M&MM-Ps. In total 56 healthcare professionals participated in M&MM-Ps. Patient-centered innovation may bring about transformative learning when professionals gained a lot of experience. Three overarching clusters emerged 1) feelings of trust and relatedness, 2) convictions about what constitutes good care and practice improvement, and 3) underlying perspectives and frames of reference.Conclusions: Prolonged, repeated experience with M&MM-P resulted in changes in behaviors and perceptions of healthcare professionals about person-centered care and patient participation. These experiences became potentially transformative when healthcare professionals were open and willing to push the boundaries of their professional identity, could critically reflect on their normative ideas about 'quality of care', and welcomed workplace learning as a form of care improvement complementary to more straightforward ideas about implementation.