The acceptability and suitability of simulated GP consultations as a teaching method for professionalism

Problem

Teaching professionalism in primary care is under researched though it appears an attractive place to do it. In The GKT School of Medical Education Curriculum 2020, 18% of the undergraduate medical curriculum is primary care based. Simulation is an increasingly used teaching method in healthcare education. The King’s Undergraduate Medical Education in the Community Team have a highly rated simulated primary care teaching programme for third year medical students which promotes patient-centred care. We took advantage of this setting to explore a novel educational approach to teaching professionalism. In this study, we evaluated the acceptability and suitability of simulated primary care consultations as a method to teach professionalism.

Approach

Themes of professionalism derived from common ethical issues faced in general practice were embedded into three medically focused scenarios. Simulated consultations lasting 20 minutes were followed by peer group discussion and GP tutor feedback. Fifteen simulation groups were observed. Two semi-structured focus groups with 15 students were held to gather students’ views on learning professionalism in the simulated consultations. Observations were noted at the time. Focus group recordings were transcribed verbatim, anonymised, thematically coded and sense checked using a framework approach.

Findings

Key themes included the usefulness of direct experience and the importance of early exposure and feedback to professional development. Some prompts within the simulation came as a shock and surprise to students. Students felt simulated consultations contributed to a safe, positive learning experience and that they allowed them to experience ‘doing’ rather than just watching. Students identified a potential translational benefit to this learning citing how it would help them in clinical practice. Students noted that the triangulation of feedback from patients, peers and tutors improved their depth of understanding from feedback. The experience contributed to learning by highlighting gaps in students’ understanding.Students found the simulations to be high fidelity overall and commented on the scenarios being realistic. Students identified that the safety innate to simulation and within the social group made challenging scenarios more approachable. There were elements of shock, surprise and humour that were highlighted in the scenarios. Consequently, some students felt some professionalism prompts were not adequately embedded in scenarios.

Consequences

Professionalism is a key component of medical education. Developing educational approaches to deliver teaching for professionalism is an ongoing challenge for undergraduate medical curricula. Simulated primary care consultations provide a novel approach and are an effective method for teaching professionalism to medical students. The study findings have contributed to ongoing scenario development. The scenarios are detailed and reproducible, and could be used by other medical schools. Aspects of professionalism can be embedded into simulated consultations to enable holistic learning for undergraduates.