What do medical students expect from primary care teaching?

Problem

Concerns remain about the declining workforce in general practice. Educators must do their utmost to guarantee medical students a positive introduction to general practice. Medical schools’ curricula and LOs are aligned with GMC guidance and mapped to Outcomes for graduates; how does this line up with students’ expectations? Our aims were to determine what students believe their learning objectives in primary care teaching should be, to decide if we are teaching them what they want to know, and to develop primary care aspects of the University of Bristol’s medical school curriculum. Students can give a unique perspective on “curriculum-inaction” and the hidden curriculum. Results from our research can be fed into development of the new, evolving curriculum at the University of Bristol, and also nationally. There is potential for an impact not only on medical education, but the future of recruitment in general practice.

Approach

220 third-year students were emailed a survey using SurveyMonkey, with Likert scales and white spaces; 37 completed it. 220 GP teachers from CAPC were emailed a similar survey; 59 completed it.

Findings

Quantitative and qualitative data was obtained and analysed. Students and teachers were asked to select LOs they felt should be in the curriculum. Reassuringly, students and GP teachers were in agreement that LOs within the current curriculum are relevant for them. There were discrepancies, the biggest of which was "spend time with practice and district nurses": 83.1% of GP teachers felt this should be in the curriculum; 43.2% of students agreed. Interestingly, the LO "describe the other systems that provide open access health care in the UK" was only selected by 42.4% of GP teachers and 46.0% of medical students.

Medical students were asked ‘what do you expect from primary care teaching?’ A word cloud was produced following thematic analysis of white space answers, with consultations, insight into being a GP, and common conditions as the 3 main themes.

Medical students were asked, ‘do you think you have enough exposure to general practice throughout your degree?’ 55.6% said yes, 19.4% said no, and 25.0% were not sure.

Consequences

The surveys produced a large amount of rich data, a great source for further analysis in future.

This is an important area of research which needs exploring further, not only for UoB, but all medical students. The statistic of 55.6% of students agreeing they have enough exposure to general practice is reassuring - or arguably, is it worryingly low? Until the workforce issues are resolved, the question remains – are we getting it right? Results will be discussed with UoB as the new curriculum is developed, which involves students becoming more exposed to general practice throughout their degree. There is scope to revisit this with future cohorts of medical students to see if teaching matches their expectations.