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Review
. 2025 May 19;11(1):52.
doi: 10.1186/s40900-025-00704-4.

The pedagogical liminality of patient and public involvement in initial healthcare professional education: an umbrella review

Olivia Gross  1 , Yannick Ruelle  2   3
Affiliations
Review

The pedagogical liminality of patient and public involvement in initial healthcare professional education: an umbrella review

Olivia Gross et al. Res Involv Engagem. .

Erratum in

Abstract

Objectives: Patient and public involvement in undergraduate healthcare professional education (PPI-PE) raises questions about its value and the ways it can be implemented, which has been explored by several literature reviews from various angles. This study aimed to take stock of our current knowledge of the foundations and effects of PPI-PE, the structure of programs of this type, their implementation conditions and identify any gaps in the studies conducted so far. The aim was also to identify the questions that run through the studies, pinpoint their foundations and implicit assumptions, and make sense of any discordant elements.

Design: Three databases were searched to conduct an umbrella review based on the recommended quality criteria.

Results: The 27 reviews included were based on 529 independent articles. The analysis carried out has enabled us to consolidate existing knowledge of stakeholders' motivations, patient recruitment process, the implemented educational initiatives and their impact. Numerous studies agree on the benefits of PPI-PE. In contrast, there are few studies on patient profiles, and the lack of grounding in intervention theories does not help to structure curricula.

Conclusion: The results explain the lack of chrono-pedagogical reflection. At this stage, it would be useful to develop realistic evaluations of whose aim is to link effects to contextual elements and the mechanisms that produce them, to optimize actions. Despite the well-documented benefits of PPI-PE, its limited integration suggests a form of pedagogical liminality. This may stem from institutional inertia in medical and nursing education, where entrenched traditions, power dynamics, and the dominance of qualitative research create barriers to change.

Plain language summary

Objectives: Many scientific articles are devoted to the implementation of patient and public involvement in the initial training of healthcare professionals (PPI-PE). The aim of this study was to gather the current state of knowledge on the subject. The aim was also to identify the questions that run through the studies, pinpoint their foundations and implicit assumptions, and make sense of any discordant elements.

Design: The synthesis was based on existing structured literature reviews.

Results: 27 literature reviews covering 529 separate articles were analyzed. The analysis carried out has enabled us to consolidate existing knowledge of stakeholders’ motivations, patient recruitment process, the implemented educational initiatives and their impact. Numerous studies agree on the benefits of PPI-PE to understand patients’ perspectives, develop students’ empathy and help them to be more respectful of patients’ priorities. In contrast, there are few studies on patients’ profiles or on the methods needed to obtain the best outcomes.

Conclusion: PPI-PE remains under-funded and under-implemented, which cannot be rationally explained, given the well-documented benefits of this approach. Clear political incentives promoting a systematic PPI approach in professional training are needed to overcome the resistances that this matter of fact seem to reveal.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: Not relevant (as there is no new data). Consent for publication: Both authors agree. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the umbrella review
See this image and copyright information in PMC

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