Real-time patients’ perspectives about participating in teaching consultations in primary care: A questionnaire study

Abstract

Introduction

Patients presenting with undifferentiated illnesses provide valuable learning opportunities for medical students. Evidence detailing the factors that affect patient participation in undergraduate medical education is limited. This study examines how patients regard their participation in teaching consultations in primary care.

Methods

We conducted a cross-sectional questionnaire survey in four GP practices. We tested the relationship between variables of interest and willingness to participate, using hierarchical logistic regression.

Results

We analysed 525 questionnaires. 88% of respondents were willing to have students take part in their consultation, and 72% were willing to see a student alone before seeing the doctor. Older patients and those with less sensitive clinical problems were more likely to participate. Willingness to participate was also associated with patients’ perceptions of certain costs and benefits of participation. Respondents had poor knowledge about medical education, and a sizeable minority perceived a lack of autonomy about the presence of students in their encounters. More than one-third of respondents expressed the presence of a clinician as a precondition for approval of students’ performing some active roles.

Discussion

The findings have identified potential interventions to enhance patient involvement including patient education, respecting patient autonomy, and ensuring appropriate student supervision.

Keywords:

• Work-based
• clinical
• medicine
• undergraduate
• practical procedures

Acknowledgements

The authors would like to thank all the practice managers and GP tutors of the practices involved in the survey. They are also grateful to David Kennedy, Deputy Head of School of Medical Education, Newcastle University for contribution towards the survey, and Dr Kim Pearce, Senior Statistician for providing statistical support.

Disclosure statement

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

Glossary

The tendency for research participants to provide responses that they perceive will present themselves in a favourable manner, rather than reflecting their true feelings or behaviour. It may lead to over-reporting of ‘positive’ behaviours, or under-reporting of ‘negative’ behaviours.

Grimm P. 2010. Social desirability bias. Wiley International Encyclopedia of Marketing; [accessed 2020 Sep 10]. https://doi.org/10.1002/9781444316568.wiem02057.

Notes on contributors

Adedoyin Alao, MBBS, MRCGP, PGCert MedEd, is a GP and doctoral student in medical education. She teaches and provides mentorship to medical students at Newcastle University.

Bryan Burford, BSc(Hons), MSc(Eng), PhD, is a Lecturer in Medical Education at Newcastle University. With a background in cognitive and social psychology, he has worked as a researcher in medical education for 15 years.

Hugh Alberti, BM, FRCGP, MD, MMedEd, is the head of GP teaching at Newcastle medical school. He recruits, trains and supports GPs to teach medical students, leads a team of academic GP trainees, and supervises masters and doctorate students.

Roger Barton, MBBS(Hons), PhD, FRCP, FRCP(Ed), MClinEd, FAcadMEd, PFHEA, is an Emeritus Professor of Clinical Medicine, Newcastle University. Previously Director of MBBS, Dean of International Medical Education and International Provost (Malaysia). Experienced in medical education across the globe, for the GMC and Royal College of Physicians. Chair of two national bodies for professional standards and assessment.

Susan Moloney, BA (Hons), MPhil, PhD, is a Senior Research Associate, Newcastle University. With a background in behavioural sciences, she has worked in health services research and improvement for 25 years and has led on the development of teaching and delivery of Patient and Public Involvement in research within the Faculty of Medical Sciences.

Gillian Vance, MBBChir, Ph.D., MRCPCH, is a Professor of Medical Education at Newcastle University with experience of leading and delivering undergraduate programmes, including simulation. She is also an honorary paediatric allergist at the Great North Children’s Hospital.

Additional information

Funding

This work was supported by the Faculty of Medical Sciences Unit for Educational Research Development and Practice Development, under Grant [OSR/0110/ERDP/GV01].