Can capacity limitations in primary care undergraduate placements be addressed using a blended learning approach?

Problem

Placements in general practice play an important role in undergraduate medical education and have a strong influence on students and junior doctors choosing careers in general practice. However GP educators report that practice workloads and lack of space are major challenges impacting medical student placements. Without increasing capacity these issues are expected to worsen as increasing numbers of learners compete for limited space.

Approach

Kent and Medway Medical School (KMMS) students undertake six one-week-long placements in general practice in both their first and second years termed ‘immersion weeks’. Each immersion week has a theme which corresponds with on-campus learning in systems-based modules. In the 2022/23 academic year the immersion week structure was changed, with one day of the week replaced with a half day of campus teaching and a half day of ‘asynchronous learning’.

The asynchronous learning comprises an e-learning lesson created using the Xerte Online Toolkit and hosted on the university virtual learning environment. The content is designed to complement students’ learning on placement while referencing their on-campus learning in systems-based modules. Each lesson includes a mixture of case-discussions, multimedia, and interactive elements which students can complete at their own pace.

All year one and two students were invited to complete a feedback survey after the third immersion weeks. Data on completion rates was recorded automatically within the virtual learning environment.

Findings

121/131 (92%) year one students completed at least one asynchronous lesson and 107 (82%) completed all three. 104/106 (98%) year two students completed at least one asynchronous lesson and 98/106 (92%) completed all three.

78/131 (60%) year one and 85/106 (80%) year two students responded to the survey. On a 5-point Likert scale 52/78 (67%) of year one students and 63/85 (74%) year two students either agreed or strongly agreed with the statement ‘the asynchronous material was helpful in supporting my learning’. In the free text comments students reported that they found the asynchronous learning to be a useful way of consolidating knowledge ahead of the placement and found it beneficial that they could complete it at their own pace. However issues with technology caused frustration for some.

Consequences

Most students found the asynchronous learning material helpful in supporting their learning. This highlights the potential for a blended learning approach to undergraduate primary care placements combining e-learning with traditional face-to-face teaching. Such an approach has the potential to ease pressures on capacity in primary care without compromising the quality of teaching and learning.