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A University of Lancashire program places first-year medical students in care homes to learn about residents through conversation rather than clinical assessment. Student reflections describe adapting communication and relating to residents, but the project did not formally measure empathy or establish lasting effects.
The University of Lancashire has made a care-home conversation placement compulsory for first-year medical students, giving them time to learn about residents’ lives before approaching them primarily as patients. Early student reflections describe learning to listen and adapt, but the project did not formally measure empathy or show whether any changes last.
Called The Person Before the Patient, the project was piloted during the 2023–24 academic year and became compulsory in 2024–25. It operates across 11 care homes. Students spend four weeks meeting residents, some of whom live with dementia, frailty or long-term conditions. Their task is not to take medical histories or make diagnoses, but to learn about residents’ interests and experiences through conversation.
In the project report, a first-year student described feeling nervous about starting conversations and unsure how to keep them going. Another said the placement required listening more closely, letting the resident guide the discussion and accepting pauses while someone searched for words. The student also reported paying more attention to facial expressions and gestures.
Of 281 students who completed the placement, 157 voluntarily submitted written reflections for the ethically approved project. Those responses record what participating students said they learned; they are not a formal assessment of empathy. The report’s author says the project did not measure empathy directly, and students who chose to write reflections may have viewed the placement more positively than those who did not respond.
Practice Listening Beyond the Clinic
The placement focuses on a part of medical care that can be difficult to teach through simulated consultations alone: understanding the person behind a health condition. Students must respond to what a resident wants to discuss rather than rely only on prepared questions. That can give them practice in listening at another person’s pace and noticing nonverbal communication.
The report connects this approach to wider concerns about medical education. Some research suggests empathy may decline during training, particularly as students enter clinical settings, while other studies have found mixed results. A possible influence is the “hidden curriculum”—attitudes students absorb from clinical environments in addition to formal lessons. A 2023 review of 16 studies identified heavy workloads and poor role models among factors that may contribute to emotional detachment.
The findings matter to medical schools considering how to teach communication and respect for older people. However, positive student accounts are an early indication of perceived learning, not evidence that the program changes later clinical practice or produces lasting empathy.
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Why the Placement Starts Early
The University of Lancashire program introduces students to care-home residents in their first year, before their conversations are shaped mainly by clinical assessment. The report says students may arrive with prepared questions expecting predictable answers, but must instead follow what residents choose to share. That difference is central to the project’s aim of encouraging curiosity about people’s lives.
Other research offers some support for direct contact, but does not settle the question of impact. 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; some participants questioned the educational value. A UK evaluation of Time for Dementia, which involved repeated visits to people with dementia and their families, found gains in knowledge and attitudes but no significant difference in measured empathy compared with other students.
The report also cites a New Zealand analysis based on reflections from five students involved in nursing-home care. Some said hands-on personal care helped them see residents as individuals, while difficult encounters could leave students overwhelmed. The small study concerned caregiving rather than conversation, but the report uses it to underline the value of supporting students as they reflect on uncomfortable experiences.
“I was very nervous at the start of the placement because I have always struggled with starting conversations.”
— First-year medical student, as quoted in the project report
Empathy Gains Remain Unproven
The project has not established whether the conversations cause measurable changes in empathy, how long any learning lasts, or whether it affects students’ behavior with patients later in training. Its evidence comes from voluntary written reflections, and the report acknowledges that respondents may have been more positive about the experience than nonrespondents.
Research cited in the report also cautions against treating positive impressions as proof of lasting results. A review of long-term empathy training found little evidence that gains persist. The account provided does not set out a longitudinal evaluation of this placement, so the program’s lasting educational effect remains unknown.
Residents’ experiences and views also matter. The report says residents should be able to choose whether to participate and decide what they want to share. Some participating homes involved residents in discussions about hosting students and, alongside staff, how placement funding would be used. The supplied report excerpt says managers describe residents enjoying visits and looking forward to students returning, but it does not provide a quantified resident survey or further outcome data.
Evaluate Learning Over Time
The report argues that a fuller assessment should follow students over time, including after they begin clinical training, rather than rely on immediate reflections. Such research could test whether communication lessons persist and whether they are reflected in clinical behavior. The available material does not give a timetable for that evaluation or announce a planned next study.
For now, the program continues as a first-year placement across 11 care homes. The report’s findings support treating student reflections as useful feedback about the experience, while keeping claims about lasting empathy or patient-care effects open until they are measured.
Key Questions
What do students do during the care-home placement?
Students meet residents during a four-week placement and learn about their interests and experiences through conversation. They are not there to take medical histories or diagnose residents.
How many students submitted reflections?
Of 281 students who completed the placement, 157 voluntarily submitted written reflections. The reflections describe what respondents felt they learned; they do not represent a formal empathy assessment.
Did the project show that students became more empathetic?
No formal measure of empathy was used for this project. Some students described feeling more able to empathize, but the report says that does not establish lasting changes or effects on clinical behavior.
Do residents choose whether to take part?
The report says residents should be able to choose whether to participate and what they share. Some homes involved residents in discussions about hosting students and the use of placement funding.
Source: rss
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