E-tivities: A way of increasing clinical exposure to undergraduate students in primary care.

Problem

The Covid-19 pandemic challenged the delivery of primary care placements of senior medical students despite them being given key worker status by the Medical Schools Council. Exposure to clinical encounters was drastically changed with increased remote consulting, unforeseen changes in workforce and workspace and increased student Covid-19 related absences. This affected the delivery of placements and time in a clinical setting.

Approach

As with all medical schools, there was rapid need to modify delivery of medical education both in placement and to support reduced clinical time with increased alternative clinical activities. At the University of Nottingham, one such intervention to address this was the introduction of asynchronous online peer and remote tutor facilitated cases called E-tivities. E-tivities is a concept developed by Professor Gilly Salmon (2002) where the tutor provides a small piece of information, stimulus or challenge – called a “spark”. Students then respond to this spark and facilitate the response of others. A tutor is then used as an e-moderator. In Nottingham, we created 20 case studies relating to GP clinical administrative activities for students to undertake during the primary care placement with 5 cases each on a series of themes – abnormal blood test, prescribing queries, other abnormal test results (throat swab, chest x-ray) and queries from others (patient, other professionals). The cases had a brief patient story, the themed information (i.e. abnormal test result) and a stem with one to three questions for the student to respond to. The aim of the activity was to increase clinical exposure, consolidate knowledge and apply clinical reasoning skills to the case. The cases were released weekly or fortnightly in the primary care attachment for students to work in their designated small groups with e-moderation being undertaken by an educational GP tutor.

Findings

This is a new pilot educational tool for students and tutors to become familiar with but preliminary feedback on its use has been positive by students (scoring 4.1/5 on a Likert satisfaction scale) and tutors alike. There is on ongoing process of collecting feedback data as the academic year progresses.

Consequences

The concept of E-tivities is a useful adjunct to time in clinical placement and offers additional peer supported and asynchronous tutor supported clinical activity. Our early pilot findings show it has been valued by students and tutors alike. It would certainly warrant further development and more formal evaluation.