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

Abstract

<h4>Objectives</h4>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.<h4>Design</h4>Three databases were searched to conduct an umbrella review based on the recommended quality criteria.<h4>Results</h4>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.<h4>Conclusion</h4>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.