1. I am in Melbourne University.
2. To quote from here
Patient-centred care has various definitions, but three elements are important:
communication with patients;
a focus beyond specific conditions, on health promotion and healthy lifestyles.
This type of care requires a thorough explanation of disease to patients and exploration of their feelings, beliefs and expectations (patient “affect and cognition”). Management is influenced by these cognitions, patients’ social and physical environments and access to affordable local support services, as well as clinical guidelines. There is also a need for increased teamwork, especially with early-discharge schemes, ageing populations, and myriad management protocols.
The key to patient-centred care is not only to construct “more expert” patients, but to develop common ground with them for integrated management. The goal is to form a partnership with patients, allowing them to express their individual problems, fears and frustrations with having chronic disease. Some patients will require ongoing support, while others will develop their own coping and acute management strategies, but all should have the autonomy within the clinician–patient interaction to contribute as much as they feel comfortable with to decision-making. This comfort will vary between individuals, and with cultural background and age.
Patient autonomy can be a two-edged sword. Occasionally, a fully informed and empowered patient may decide to take risks or not to adhere to management guidelines. This concept of “fully informed choice” may sometimes frustrate the clinician. Nonetheless, patient-centred partnerships are still warranted and will result in a net population health benefit.
To cut the long story short, patient-centred care is basically "make the patient the boss of their own health which covers not just the bodily illness but all aspects of their lives which make up one's health". It's an approach to patient care that most doctors agree is the best.
In the past medicine used to be about what the doctors order the patient to do, and if the patient doesn't follow the doctors' instruction it's entirely the patient's fault (without even asking why they are not following the instruction). Besides, healthcare used to be only like a glorified "repair service", where the patients themselves are just "defective goods" that are waiting in the conveyor belt to be fixed by the doctors one by one via magical drugs. However, over time it's found that such an approach is not effective in many illness, because in order for certain treatments to work it's not just the doctors who need to do the good work, we need to involve the patients by making them understand their own illness. We understand them not just as "someone with disease X", but "someone with disease X who comes from a difficult family background with an abusive husband, who has been in debt for the last six months, and who has a mother who is old and needs to be taken care of". Then we try to tackle those issues instead of just saying "take drug A then your disease X will go away, NEXT PATIENT".
When you add these "patient-centred approaches", your treatment then becomes more holistic (because health is not just the absence of illness, but an overall optimum state of one's physical, psychological and social well-being). Your treatment will become more effective, and your patient will like you more.
3. In my university the learning system is the "system-based learning" and "problem-based learning", which is the approach used by most newer medical schools over the world nowadays. System-based means that we learn the course by body systems such as digestive system, nervous system, heart and circulation, lungs and respiration, and so on. And within these systems we then learn about what they are (the anatomy), how they work (physiology), what goes wrong when something goes wrong (pathology), and so on. The old approach (still used in certain universities e.g. cambridge etc) is subject-based, where you learn anatomy of everything in one subject, physiology in one subject, pathology in one subject, and so on.
As for problem-based learning, basically we are given a "patient case" on paper, and then we work through the case almost as though we are actually treating a real patient in real life. We do problem-based learning (PBL) from the very first year until we graduate, even when we already see real patients later on in our course. PBL approach is supposed to give us more understanding of how doctors work and prepare us better to become a doctor.
Is the system good? Yeah it's pretty good. But is it better than the old system? I have no idea. I suspect whatever system you put those high-achievers through (I am hardly one
), they will turn out about the same.