Patient participation in general practice based undergraduate teaching: a focus group study of patient perspectives

Abstract

BackgroundPatients make a crucial contribution to undergraduate medical education. Although a national resource is available for patients participating in research, none is as yet available for education.Aim This study aimed to explore what information patients would like about participation in general practice based undergraduate medical education, and how they would like to obtain this information.Design and setting Two focus groups were conducted in London-based practices involved in both undergraduate and postgraduate teaching.MethodPatients both with and without teaching experience were recruited using leaflets, posters, and patient participation groups. An open-ended topic guide explored three areas: perceived barriers that participants anticipated or had experienced; patient roles in medical education; and what help would support participation. Focus groups were audiorecorded, transcribed, and analysed thematically.ResultsPatients suggested ways of professionalising the teaching process. These were: making information available to patients about confidentiality, iterative consent, and normalising teaching in the practice. Patients highlighted the importance of relationships, making information available about their GPs’ involvement in teaching, and initiating student–patient interactions. Participants emphasised educational principles to maximise exchange of information, including active participation of students, patient identification of student learner needs, and exchange of feedback.ConclusionThis study will inform development of patient information resources to support their participation in teaching and access to information both before and during general practice based teaching encounters.

Participation of medical students in patient care: How do patients perceive it?

“…[ 3 ] This effective patient–student bondage can also encourage patients to share detailed and accurate information about their condition and adhere to a management plan, which can lead to improvements in health outcomes. [ 5 ]…”

Teaching and learning in general practice: ethical and legal considerations forGPteachers and medical students

“…Many patients prefer to interact and establish relationships with students, rather than seeing students as passive observers (Box 1). Patient attitudes to student teaching during telephone and/or video consultations have not been explored.…”

“…It is recommended that patients be adequately forewarned of the student's potential involvement, rather than consent being sought on entry to the consulting room . Patients report being uncertain about student qualifications and their role, and both students and teachers have been reported to misrepresent the student's status . Students should be introduced to patients as students rather than junior doctors, colleagues, or doctors in training .…”

“…Given the unpredictability of general practice consultations, consent is better understood as a process rather than a single event. Consistent with legal requirements, patients express a desire for an iterative consent to student involvement if the consultation evolves into other areas . If, for example, a consultation moves into more sensitive areas, it is appropriate to remind patients that they may withdraw their consent to student participation, and ask the student to leave.…”

“…General practice patients prefer to be reassured of the student's duty to respect confidentiality and receive confirmation from the student that what has been discussed is confidential . It is recommended that medical students sign and abide by a standard confidentiality agreement and practice privacy policy as signed by other practice staff (Box 2).…”