Mapping the Impact of Early Primary Care Placements on Medical Students’ Professional Development

Problem

Policy makers have advised a shift in the balance of healthcare and education delivery from secondary to primary care (GMC and MSC, 2017; Thompson, 2016). This aligns with the development of integrated medical curricula with the promotion of early clinical placements. During the Covid-19 pandemic early clinical placements were paused or changed to virtual alternatives. As we emerge from public health restrictions medical schools are reviewing how and in what format to reintroduce early clinical placements thus raising the question what is the rationale for these early clinical placements? Whilst the impact of early primary care placements on increasing the GP workforce is well established, less is known about how they impact medical students’ professional development. The aim of this study is the investigate what is known in the research about how early primary care placements facilitate medical students’ professional development.

Approach

A scoping review was performed according to the 6-step framework as described by Arksey and O’Malley (2005) and enhanced by Levac et al. (2010). Searches were carried out on Ovid MEDLINE, EMBASE and Web of Science databases and records screened at abstract and full text levels. Data was extracted from articles for inclusion and numerical and thematic analysis performed employing constructivist epistemology.

Findings

23 articles met the criteria for inclusion at an international level; 12 of these were in the last 4 years. 2483 participants were involved over 18 of the primary studies and the most frequent method used was questionnaires (n=6) or semi-structured interviews (n=6) as a single study method. 32 initial codes related to the impact of early primary care placements on medical students’ professional development were identified and organised into 5 overarching themes; modification of attitudes, knowledge, skills, professional identity and career aspirations. The most frequently represented themes were modification of knowledge and skills with professional identity was the least common and more recent theme in the literature.

Consequences

The impact of early primary care placements in medical education is an under researched but growing area of interest reflecting the direction of health and education policy. The modification of attitudes, knowledge, skills, professional identity, and career aspirations facilitate medical students’ professional development through their impact on professional competencies and professional identity formation. These effects were beneficial to students irrespective of their future specialty choice and several concepts were identified as unique to primary care. These findings inform the rationale for the inclusion and prioritisation of early primary care placements.