Comparison of the effectiveness of exclusively facilitated clinical teaching as an alternative to traditional practice-based primary care placements.

INTRODUCTION: COVID-19 presented major challenges to undergraduate GP placement capacity and there was an increased reliance on clinical training using facilitated simulation. The authors present a novel comparison of the effectiveness and cost-effectiveness of delivering a one-week primary care course using entirely GP-facilitated clinical teaching outside the GP setting against traditional practice-based GP clinical education. METHODS: A one-week GP placement was redeveloped from a traditional teaching model (TT-M) to an exclusively facilitated teaching model (FT-M) delivered outside the GP practice setting, using principles of blended learning, flipped classroom methods, e-learning and simulation. Both teaching models, delivered in different locations during 2022 to pre-clinical students, were evaluated using student feedback surveys for attainment of learning outcomes and course satisfaction. RESULTS: The students reported their consultation skills and clinical knowledge (amalgamated mean score 4.36 for FT-M versus 4.63 for TT-M; P = 0.05), as well as preparation for the clinical phases (mean scores 4.35 for FT-M versus 4.41 for TT-M; P = 0.68), were well developed and similar for both courses. Students reported similar enjoyment across both teaching models (FT-M mean score 4.31 versus 4.41 for TT-M; P = 0.49). The costs for delivering teaching per 4-h session for 100 students were £1,379 and £5,551 for FT-M and TT-M, respectively. CONCLUSION: Delivery of a one-week primary care attachment to third year medical students using an FT-M was similarly effective and more cost effective than delivering it by a TT-M. FT-M potentially offers an important adjunct to clinical learning and resilience to capacity challenges for GP placements.

Clinical placements in General Practice: concepts and considerations of implementing remote virtual placements in the COVID world.

Medical students are considered as 'essential workers' within the National Health Service (NHS) and the delivery of clinical experience is essential to their learning and progression into the workforce. The COVID-19 pandemic impacted the delivery of clinical placements in primary care; GPs are currently delivering the majority of consultations using telephone or video methods and difficulties in attaining placement experience are being encountered by medical students. Virtual remote consultations are an appropriate adjunct to conventional face-to-face patient encounters and could facilitate students to attain core learning outcomes. This article describes some of the approaches that enable remote (home) virtual patient encounters in Primary Care for medical students. These are categorised as methods that a) enable remote access into GP clinical systems, b) enable remote access into individual patient consultations and c) enable an observational-only experience. Key considerations are highlighted to enable safe and effective implementation of remote virtual consultations, along with the advantages and disadvantages of each method. These include patient consent, confidentiality, data sharing and protection, professionalism, student agreements and data gathering templates. It is hoped that sharing of these methods of virtual consulting will support the ongoing delivery of Primary Care education across medical schools.