Workplace learning in general practice: Supervision, patient mix and independence emerge from the black box once again

Figures & data

Table

Practice points

Students judge the general practice clerkship's instructional quality positively. Supervision quality, patient mix and students’ independence relate to perceived instructional quality. General practice supervisors can provide vital ingredients for the clerkship's effectiveness. Determinants of instructional quality in general practice seem comparable to those in hospitals, although stakeholders’ interpretation of these key learning ingredients needs further elaboration.

Table 1.  Description of items and variables, original rating scales and eigenvalues, and explained variance after explanatory factor analysis

		Item description	Original rating scale (points)	Eigenvalue	Explained variance (%)	Cronbach's alpha
Dependent variable		Instructional quality	10	–	–	–
Independent variables	Supervision	Accessibility of supervisor when students wished to ask questions or have things explained to them	5	6.863	42.891	0.876
		Supervisor explains what is done and why	5
		Observation of students during patient consultations	5
		Feedback after observation	5
		Time spent on supervision	5
		Working climate	10
		Organisation	10
		Supervision	10
		Average number of patient discussions per week	5
		Average number of learning goal discussions per week	5
	Patient mix	Variety in patient mix	5	1.635	10.219	0.807
		Number of patients	5
		Instructional effectiveness of patient consultations	5
	Independence	Facilities to examine patients independently	5	1.294	8.087	0.719
		Opportunities to perform activities independently	5
	Information	Information about clerkship organisation	5	–	–	–

Table 2.  Mean scores, SDs and correlations between variables

		Mean	SDs	Supervision	Patient mix	Independence	Information
Dependent variable	Instructional quality	4.15	0.54	0.73*	0.65*	0.48*	0.09
Independent variables	Supervision	4.04	0.60	–	0.54*	0.44*	0.07
	Patient mix	4.44	0.62		–	0.50*	0.23
	Independence	4.41	0.82			–	0.25*
	Information	4.00	0.60				–

Note: *Correlation is significant at the 0.01 level (two-tailed).

Figure 1. Path diagram presenting the linear relations between the four variables of interest. Note: Indicated are the standardised regression coefficients (betas) that are statistically significant at p < 0.0005.