Medical student experiences of a generalist curriculum: A qualitative study.

Problem

Recruitment to general practice (GP) is a national challenge. Medical student experience during placements is an important factor in shaping career choices. One important challenge is to demonstrate the intellectual stimulation and complexity of clinical practice in this setting, which can be difficult in fast paced consultations. In response to the Wass Report, a London medical school (UCL) expanded year 5 general practice placements from four to six weeks.

'Connected curriculum’ sessions were introduced to highlight complex elements of generalism including ‘ways of knowing’, how and when to use evidence in primary care, ‘Health Justice’; ‘prescribing in primary care’, culinary medicine’ integrating science and practice of diet, ‘multi-morbidity’ and critical analysis of interactions using video analysis and micro-ethnographic guide. This study aims to examine student experiences and perceptions of impact on future professional practice, as well as workplace-based and remote learning during the COVID-19 pandemic.

Approach

Data Collection: We will recruit medical students by purposive sampling and will use student communication channels, such as the student bulletin, in order to do this. We plan to interview around 20 medical students from the 5th year to understand their thoughts about learning experiences in their primary care course, which is intended to teach them about the thinking underpinning decision making in these settings. In order to explore students' thought processes in depth, interviews will be conducted 1:1 by a facilitator using a semistructured interview guide using MS teams, due to covid-19 restrictions. We will transcribe these interviews.

Analysis: we will then perform a thematic analysis of the data, to identify codes and frequent themes, which emerge from the qualitative research.

Findings

This work is currently awaiting ethical approval. We anticipate we will gather rich data from student interviews and explore which sorts of teaching sessions and consultations have made an impact on them. We will also explore how they learned from the situation and the style of learning that occurred; was it more self or tutor-led? We will also explore how they responded to the scenarios they describe, for example anxiety in cases where they felt overwhelmed. We will explore the data to see if students do experience the intended benefits of this course and whether further restructuring is required.

Consequences

We will explore the data to see if students do experience the intended benefits of this course and whether further restructuring or support is required in order to maximise learning opportunities for students. This course is relatively unique and we hope learning from this project can be shared more widely to inform the training of medical students.