Remote teaching, remote consulting: what and how have students learnt?

Problem

The COVID pandemic has resulted in unprecedented adaptations to the way in which undergraduate medical education has been delivered to 427 King’s College London year 2 medical students, on an immersive GP longitudinal placement. Students usually attend a GP practice in groups of 8, over 21 days of the year for GP tutor (GPT)-led workshops, teaching clinics and patient home visits. In addition, students attend 7 ‘campus days’, whereby they develop consultation skills in small GPT facilitated groups with simulated patients (SPs). Much of the programme has been delivered remotely. Campus day scenarios were adapted to reflect current practice in primary care, with a focus on developing skills in remote telephone and video consulting. Additionally, a student policy was developed to facilitate students consulting with patients from their own homes with the support of their GPTs, thus overcoming many of the current barriers to clinical contact. This was introduced at the start of the second lockdown (January 2021) when face-to-face teaching was suspended. The aim of this study is to evaluate the processes implemented facilitating the development of remote consulting skills in both simulation and practice.

Approach

This is a mixed methods evaluation, collecting both quantitative data (through use of Likert rating scales) and qualitative data (open-ended questions for comments), based on surveys sent following the clinical campus days to both students and tutors. Further data is still currently being collected. Thematic analysis of the qualitative data will be carried out.

Findings

Early findings suggest that students were able to practise remote consulting (98% agreed or strongly agreed, with 50% response rate) and highly valued the opportunity to develop these skills on their campus days. Students valued being able to experience the advantages and disadvantages of remote consulting, with an appreciation that it reflects current practice and will form some part of future clinical practice. Some students felt more comfortable speaking to SPs in the remote setting, compared to face-face sessions. Themes around the perceived disadvantages of remote teaching paralleled with those of remote consulting- students appreciated the technological difficulties encountered; described difficulties in gauging non-verbal communication and developing rapport with SPs; and felt they were missing out on opportunities to perform physical examination. Further research data will be available by the end of the academic year.

Consequences

There is much uncertainty surrounding the pandemic in the forthcoming year, but we anticipate the continued need for remote teaching. There is also a consensus in the GP community that remote consulting is here to stay, to some extent and therefore there is a need for the future workforce to develop the requisite skills. Therefore, it is essential to evaluate the processes involved in facilitating remote consulting skills development, to inform future curriculum development.