What do students value in their General Practice placements? A multi-centre evaluation.

Problem

Medical schools are using general practice (GP) placements to deliver a significant proportion of the undergraduate medical curriculum – on average 13% in the UK. Whilst we are developing an understanding of the learning taking place in GP, we are yet to explore fully students’ perceptions about the value of their GP placements. The Wass report reminds us of the responsibility of medical schools to improve GP placements, to address the current GP recruitment crisis. We need to identify and understand students’ experience in GP placements: firstly, to improve ways to support students’ engagement with general practice learning and assessment, secondly, to inform integration of doctor’s training with the future needs of society, based on a need for more general practitioners and community care. We sought to identify what students do, and do not value in GP placements, and what students feel is transferable to their future practice.

Approach

Student year-groups undergoing GP placements at three UK medical schools were invited to provide feedback via an online survey at the end of their placements. Three additional feedback questions were included:1. What did you value about your GP placement? 2. What did you not value about your GP placement? 3. What did you learn that might be relevant for your future practice? Pilot studies across the individual institutions were used to generate initial coding themes. We identified similarities with the Manchester Clinical Placement Index (MCPI). We mapped themes to the MCPI, developing additional codes for items inductively identified within the data. A process of inductive and deductive thematic analysis is being used across the feedback cohort data, to map to identified codes, and iteratively develop themes. Teleconference data clinics are being held across the sites.

Findings

Preliminary data from three of the UK medical schools (560 respondents) show that students particularly value active learning, seeing a wide variety of real patients and receiving feedback. They value welcoming, supportive and well-prepared tutors and staff. Poor timetabling, organisation, and preparation of tutors, and lack of patient contact and protected teaching time were the most common components valued least. Learning for future practice was primarily reported as development of the consultation process, relationships with patients, and career considerations.Full findings from the three UK medical schools will be presented.

Consequences

Cross-institutional analysis highlights how GP fulfils many existing MCPI characteristics of good workplace placements. Students reported excellent relevance to future practice. In addition, student reference to GP-based tutorials/seminars and assessments, demonstrate how GP placements can be perceived as holistic learning environments, potentially normalising GP as a ‘home’ learning context for students. These findings provide useful insights into the development of student learning, quality assurance, and teaching materials, as well as guidance for tutors and faculty.