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A University of Lancashire program places first-year medical students in care homes to talk with residents about their lives, rather than conduct medical assessments. Student reflections describe learning to listen and adapt communication, but the project did not formally measure empathy or establish lasting effects.
The University of Lancashire made a care-home conversation placement compulsory for first-year medical students in 2024/25, giving them time to learn about residents as people rather than assess their health. Reflections from participating students describe changes in how they listen and communicate, but the project did not formally measure empathy or show whether any learning lasts into clinical practice.
Called The Person Before the Patient, the project was piloted in 2023/24 and now runs across 11 care homes. Students spend four weeks meeting residents, some of whom live with dementia, frailty or long-term conditions. The goal is to hear about residents’ interests and experiences, not to take medical histories or make diagnoses.
The report’s author says students may arrive with prepared questions and expect predictable answers. In practice, residents choose what to share, so students have to follow the conversation. One student said they learned to listen more, adapt their communication and allow silence while a resident searched for words. They also became more attentive to facial expressions and gestures.
Of 281 students who took part, 157 voluntarily submitted written reflections for the project. Those accounts describe what respondents felt they learned; they do not establish an effect across all students. The author notes that students who chose to write reflections may have viewed the placement more positively than those who did not.
Practising Communication Beyond the Clinic
The placement gives students an opportunity to practise communication without the pressure of completing a clinical assessment. That matters because patients may have hearing loss, memory difficulties or other communication needs, and a conversation can require attention to pace, pauses and nonverbal cues. NICE dementia guidance recommends adapting communication to people’s needs and taking account of their histories and preferences.
The approach also addresses a challenge in medical education: students need to manage emotional responses to illness without losing curiosity about the people experiencing it. The report describes the “hidden curriculum” as attitudes absorbed from clinical settings alongside formal teaching. A 2023 review of 16 studies identified heavy workloads and poor role models as influences that may encourage emotional detachment. The care-home project offers one way to foreground personal stories early in training, though its effect on future practice remains unestablished.
Residents’ interests and choice are part of the program’s purpose, not just a teaching tool. The report says residents should be able to decide whether to take part and what to share. In some homes, residents discussed hosting students and, with staff, how placement funding would be used. Managers reported that many residents enjoyed visits and looked forward to students returning.
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How the Placement Was Developed
The project introduces students to residents before their conversations become focused on clinical assessment. The report contrasts this with simulated consultations, which can help students practise communication but do not involve hearing someone describe their own life. One student said conversations with residents helped them understand empathy in a way that simulated-patient exercises had not.
Other research offers a mixed picture. An Australian study of 61 fifth-year medical students found that five-day care-home placements improved dementia knowledge and attitudes toward working with older people, while some participants questioned the educational value. A UK evaluation of Time for Dementia reported improvements in students’ knowledge and attitudes but no significant difference in measured empathy compared with other students.
A separate New Zealand analysis examined reflections from five students involved in nursing-home care. Some described recognizing residents as individuals, while difficult hands-on experiences could leave students overwhelmed. That study concerned personal care rather than conversation-based visits, but the report says it highlights the need for students to reflect on difficult feelings rather than let discomfort shape their attitudes.
“I learned to become comfortable with periods of silence while residents searched for the words they wanted to use.”
— A first-year medical student reflecting on the placement
Long-Term Effects Still Unmeasured
The project’s reflections cannot show whether students become more empathetic over time or behave differently with patients in clinical settings. The author says empathy was not formally measured, and the reflections came from a voluntary subset of participants. It is not clear whether students who did not submit reflections had similar experiences.
Evidence from other programs also cautions against treating positive impressions as proof of lasting change. The UK Time for Dementia evaluation found no significant difference in measured empathy, and a review of long-term empathy training found little evidence that gains persist. The report says a fuller evaluation would need to follow students over time, including after they enter clinical training. The supplied report excerpt ends mid-sentence while discussing residents’ experiences, so further details about resident feedback and outcomes are not available here.
Evaluating Learning Over Time
The program is operating across 11 homes, and the report identifies longer-term evaluation as the next step needed to test whether students’ reported learning persists. That would mean assessing students beyond their immediate reflections and after they begin clinical placements. No further evaluation timetable or results are provided in the source material.
For residents, meaningful participation remains a continuing consideration: they should have a choice about hosting students and what they share. The report describes some homes involving residents in planning, but does not give a complete account of how participation or resident feedback is monitored across all 11 sites.
Key Questions
What do medical students do during the care-home placement?
Students spend four weeks meeting residents to learn about their interests and experiences. They are not there to take medical histories, make diagnoses or assess residents’ health.
Where and when did the program begin?
The University of Lancashire piloted The Person Before the Patient in 2023/24 and made it compulsory for first-year medical students in 2024/25. It operates across 11 care homes.
Did the project prove that students became more empathetic?
No. Some students described learning about empathy in their written reflections, but the project did not formally measure empathy or establish lasting changes in students’ attitudes or clinical behavior.
What did students say they learned?
Reflections described listening more, adapting communication, following residents’ lead and becoming comfortable with pauses. The accounts came from 157 voluntary respondents among 281 students who took part.
Can residents choose whether to participate?
The report says residents should be able to decide whether to take part and what to share. In some homes, residents discussed hosting students, but the source does not describe participation arrangements in detail across every home.
Source: rss
