Primary care placements in the post-COVID era: A qualitative evaluation of a final year undergraduate clerkship

Abstract

Introduction

In March 2020, UK primary care changed dramatically due to the COVID-19 pandemic. It now has a much greater reliance on triaging, e-consultations, remote consultations, online meetings and less home visits. Re-evaluating the nature and value of learning medicine in primary care has therefore become a priority.

Method

70 final-year medical students placed in 38 GP practices (primary care centres) across the East of England undertook a 5-week clerkship during November 2020. A sample of 10 students and 11 supervising general practitioners from 16 different GP practices were interviewed following the placement. Qualitative analysis was conducted to determine their perceptions regarding the nature and value of learning medicine in primary care now compared with prior to the pandemic.

Results

A variety of models of implementing supervised student consultations were identified. Although contact with patients was felt to be less than pre-pandemic placements, triaging systems appeared to have increased the educational value of each individual student-patient contact. Remote consultations were essential to achieving adequate case-mix and they conferred specific educational benefits. However, depending on how they were supervised, they could have the potential to decrease students’ level of responsibility for patient care.

Conclusions

Undergraduate primary care placements in the post-COVID era can still possess the educationally valuable attributes documented in the pre-pandemic literature. However, this is dependent on specific factors regarding their delivery.

Keywords:

• Primary care
• undergraduate
• clinical skills
• work-based learning
• communication skills
• remote consultations

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Glossary

Post-COVID Era: The time period following the commencement of the COVID-19 pandemic which was declared by the World Health Organisation on 11th March 2020. For another example of the term post-COVID to describe this period, see https://www.rcgp.org.uk/-/media/Files/News/2020/general-practice-post-covid-rcgp.

Remote Consultations: Consultations occurring via telephone, internet, or video link. See UK General Medical Council guidance on remote consultations at https://www.gmc-uk.org/ethical-guidance/ethical-hub/remote-consultations.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Notes

1 We have defined “post-COVID” as the time period after March 2020.

Additional information

Notes on contributors

Richard Darnton

Richard Darnton is a general practitioner (family physician) and academic with lead responsibility for medical student teaching in primary care at the University of Cambridge.

Maaz Khan

Maaz Khan is a medical student in their penultimate year of the University of Cambridge standard entry course.

Xiu Sheng Tan

Xiu Sheng Tan is a medical student in their penultimate year of the University of Cambridge standard entry course.

Mark Jenkins

Mark Jenkins is an administrator at the University of Cambridge Academic Unit of Primary Care.