Are we prepared for the future? A mixed-method study on quality management in decentralized family medicine teaching

Figures & data

Table 1. Case examples developed from narratives in the interviews

Case example 1: Problems in student-teacher interaction A student calls you after the family medicine clerkship and reports that her GP teacher made derogative, unfair, and unmotivated comments about her in front of the nursing team. There had been sexualized comments. You are unaware of past negative feedback on the teacher. To your best knowledge, the teacher is engaged, constructive, and popular among colleagues and students.

Case example 2: Didactic problems On the 3rd day of the family medicine clerkship, a student writes an angry email complaining that he has no opportunity to work independently whatsoever at his current teaching practice. The owner of the practice and teaching doctor has been around for a long time. His teaching performance is rather mediocre. Several student feedbacks indicate that independent work is hardly possible in this practice. The student wishes to change practices.

Case example 3: Problematic student behavior A dedicated teacher, who has not been with your department for very long, calls you during the clerkship. She reports that her current student is acting irrationally. He has already used up his allowed absence time. Furthermore, he keeps leaving the room during the patient consultations. He seems absent-minded in his contact with the nursing staff and during patient consultations. He avoids eye contact and has already been late several times. She is seriously concerned about the student’s health. She is unsure if the student can even be certified as having successfully participated.

Table 2. Summary of Survey results

Variable	Valid	Item	Count	%valid	Sig^3
Respondent characteristics
Respondent position at department	27	Management+	11	41%	n/a
		Administrative staff	16	59%
Years of employment at department	27	0–3 yrs	7	26%	n.s.
		4–6 yrs	11	41%
		7–10 yrs	6	22%
		>11 yrs	3	11%
Department characteristics
Employees	27	1–5	3	11%	n.s.
		6–10	10	37%
		11–15	3	11%
		16–20	3	11%
		More than 20	8	30%
Age of department (For how many years has your family medicine department been with an independent chair?)	25	Less or equal 10 years	11	44%	n.s.
		More than 10 years	11	44%
		No chair established (yet)	3	12%
Number of associated teaching practices	27	1–50 GP practices	0	0%	n.s.
		51–100 practices	9	33%
		101–200 practices	10	37%
		201–300 practices	7	26%
		301 practices and above	1	4%
Students supervised in block internships per semester	26	1–50 Students	1	4%	n.s.
		51–100 Students	0	0%
		101–200 Students	20	77%
		201–300 Students	4	15%
		301 Students and above	1	4%
Quality management (QM) in decentral teaching
Actively involved in QM	27	Yes^1	26	96%	n.s.
QM Standard (Free text)	26	Standard provided by faculty	3	11%
		ISO standard	2	8%
		Don’t know	2	8%
		System accreditation	1	4%
		No specified standard	18	69%
What are you most satisfied with within your institution^4 in terms of the organization of teaching? (Free text, multiple answers possible)	27	Workflow at the institute	8	30%	n/a
		Support by faculty	7	26%
		Specific learning environment	7	26%
		Cooperation with teaching physicians	7	26%
		Other	14	52%
		No response	4	15%
What area of your organization of teaching needs improvement? (Free text, multiple answers possible)	27	Decentralized QM	8	30%	n/a
		Staffing resources	5	18%
		Digitization	4	15%
		Other	16	60%
		No response	3	11%
Qualification of teaching practices and GP teachers
Didactic standard for teaching practices	27	Yes^1	22	81%	n.s.
Didactic standard publicly accessible	22	Yes^1	9	41%	<0.01
Frequent didactic training for teachers	27	Yes^1	20	74%	n.s.
Frequency of didactic training for GP teachers	20	1x/year	3	15%	n.s.
		2x/year	11	55%
		3 or more x/year	6	30%
Obligatory	20	Yes^1	11	55%	n.s.
Performance assessment for students	26	Yes^1	18	90%	n.s.
Negative events in decentral training
Do you systematically collect feedback from students about negative events during the family medicine clerkship?	27	Yes^1	23	85%	n.s.
Does it happen that students contact you because of negative events in family medicine clerkship?	27	Yes^1	26	96.3%	n.s.
Student preference when taking contact (Free text)	26	Email	20	77%	n/a
		Personal	18	69%
		Telephone	13	50%
		Via evaluation	4	15%
How many times do students contact you during the semester due to negative events? (Minimum)^2	24	0	3	13%	n.s.
		1	11	46%
		2	7	29%
		3	2	8%
		4	1	4%
How many times do students contact you during the semester due to negative events? (Maximum)^2	24	1	4	17%	n.s.
		2	6	25%
		3	9	37%
		4	4	17%
		5	1	4%

¹unless stated otherwise, the remaining valid responses were ‘no’. ² This variable was a free text variable in which most respondents gave a range (e.g. 2–4 times). The minimum and maximum variables represent the first and the last digit in these ranges, respectively. ³ Tested for significant differences between Administrative and Management personal; Fisher’s exact test was used. ⁴ The institution was defined as ‘the family medicine department or institute with an affiliated chair at your university’.

n.s., Not significant; n/a, not applied.

Figure 1. Meta-process and survey reporting frequency of case 1 (Problems in student-teacher interaction)

Figure 2. Meta-process and survey reporting frequency of case 2 (Didactic problems)

Figure 3. Meta-process and survey reporting frequency of case 3 (Problematic student behaviour)