Virtual Primary Care learning: Sticking plaster or permanent suture for remote learning following COVID-19?

Problem

COVID-19 proved significantly disruptive to undergraduate training for students in primary care. With GPs having to isolate, GP surgeries restricting access and reduced physical ‘face-to-face’ consultations, opportunities to learn were reduced. This coupled with students also requiring periods of absence to self-isolate created untold pressures on how undergraduate primary care training opportunities could be delivered safely.

Approach

Prior to Covid-19, Virtual Primary Care (VPC) consultations had limited use as an educational resource, but were employed as a rapid solution to continue delivering education in primary care. Students watched playlists of previously recorded real-life consultations that showcased the diversity of general practice and communication skills from minor illness, long-term conditions and multi-morbid complexity. Students watched the videos as part of self-directed learning, followed by a 90 minute debriefing session to discuss the content and issues arising. Students in their final and penultimate years on a Primary Care rotation were asked to provide feedback on a survey using a Likert scale (1= strongly disagree, 5= strongly agree) and free-text responses to provide both qualitative and quantitative feedback.

Findings

Quantitative feedback from students was ascertained (mean averages in brackets) that VPC alone was useful to their learning (3.8), debriefing after watching VPC was useful (4.2), debriefing sessions were well timed (4.4), students felt involved in discussions during debriefing (5), they felt they were relevant to their stage of training (4.6), helped them learn during the clinical placement (4.6) and were satisfied with teaching using VPC (4.6). Qualitative feedback included “going through some of the larger [primary care] topics [was] really helpful- I had some interesting discussions", "Using patient videos helps to put discussion topics into context.”

Consequences

The requirement to rapidly implement remote learning in primary care was a challenge. Whilst students felt watching real recorded consultations was useful even remotely, feedback suggested that interaction was valued more strongly and the opportunity to discuss the content with an educator rather than just watching the recordings in isolation. Students found VPC relevant and beneficial to their learning when unable to attend GP placements in person. Preliminary feedback would suggest that using VPC coupled with debriefing is a possible viable alternative educational activity when conventional placement experiences cannot be delivered and could be employed post COVID-19. Further work would need to examine if VPC has an impact on summative assessment and if it could be employed to other stages of undergraduate training.