The nature and prevalence of threats to medical student placement capacity in primary care: a survey of East of England GP practices

Abstract

BackgroundGP practices deliver vital medical student teaching in the face of increasingly challenging circumstancesAimTo understand the nature and scale of threats to medical student teaching capacity in primary careDesign & settingAn electronic survey of a pre-defined population of 120 East of England GP practices who host medical student placements.MethodThe survey was completed on behalf of the practice by the GP lead for medical student teaching. They were asked to pick (from a list of sixteen) the four main challenges they faced delivering medical student teaching placements, then explain their selection and suggest solutions. Thematic analysis of free text responses was undertaken from an activity theory perspective.ResultsResponses were received from 114 of the 120 practices in the study population (95% response rate). After clinical/practice workload (picked by 92 practices), lack of space in the practice was by far the most commonly selected challenge to delivering placements (picked by 63 practices). Thematic analysis produced a model whereby a practice’s decision to continue hosting students was influenced by level of motivation and burden of teaching, but only if a certain level of resource enablement is present. Analysis of free text responses suggested that space pressures were perceived as being exacerbated by the need to accommodate more clinicians – especially advanced practitioners employed by primary care networks under the additional roles reimbursement scheme (ARRS).ConclusionThis study provides much needed quantitative evidence to support the view that lack of space in GP premises is a major threat to the future of undergraduate general practice.

Towards an empathic hidden curriculum in medical school: A roadmap

“…It also helped students enhance communication and other clinical skills 18 . Unfortunately, pressures on healthcare systems can make it challenging to arrange student placements which are required in the clinical phase 48 . Despite this, it is important that medical schools continue to provide students with the opportunity to experience the clinical environment in the early years.…”

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“…Research into barriers to practices taking medical students has highlighted the issues of funding, space and shortage of GPs available to teach 14 , with the former thought to be less of an issue since the introduction of the new undergraduate primary care teaching tariff. Other studies have highlighted the necessity of medical schools forming ongoing relationships with their GP teachers in order to foster a teaching community, and encouraged any possible means to ensure that this is prioritised 15 .…”