Students’ and tutors’ experiences of remote ‘student–patient’ consultations

Armstrong, S. et al. (2023) Students’ and tutors’ experiences of remote ‘student–patient’ consultations. Medical Teacher, 45(9), pp. 1038-1046. (doi: 10.1080/0142159X.2023.2170777) (PMID:36745733)

Abstract

Background: Remote consulting has become part of the medical student clinical experience in primary care, but little research exists regarding the impact on learning. Aim: To describe the experiences of General Practitioner (GP) educators and medical students in using student-led remote consultations as an educational tool. Method: A qualitative, explorative study conducted at four UK medical schools. GP educators and medical students were purposively sampled and interviewed. Results: Nine themes arose: practical application, autonomy, heuristics, safety, triage of undifferentiated patients, clinical reasoning, patient inclusion in student education, student–patient interaction, and student–doctor interaction. Discussion: Remote consulting has become part of the clinical placement experience. This has been found to expose students to a wider variety of clinical presentations. Verbal communication, history-taking, triage, and clinical reasoning skills were practised through remote consulting, but examination skills development was lacking. Students found building rapport more challenging, although this was mitigated by having more time with patients. Greater clinical risk was perceived in remote consulting, which had potential to negatively impact students’ psychological safety. Frequent debriefs could ameliorate this risk and positively impact student–doctor relationships. Student autonomy and independence increased due to greater participation and responsibility. Pre-selection of patients could be helpful but had potential to expose students to lower complexity patients.

• Item Type: Articles
• Additional Information: This study was funded by the Association for the Study of Medical Education.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Pope, Professor Lindsey
• Authors: Armstrong, S., Alberti, H., Bhattacharya, A., Dhokia, B., Hall, L., Lawes-Wickwar, S., Lovat, E., Pandya, S., Park, S., Pope, L., Sajid, M., Wilson, P., and Younie, L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Medical Teacher
• Publisher: Taylor & Francis
• ISSN: 0142-159X
• ISSN (Online): 1466-187X
• Published Online: 06 February 2023
• Copyright Holders: Copyright © 2023 The Author(s)
• First Published: First published in Medical Teacher 45(9):1038-1046
• Publisher Policy: Reproduced under a Creative Commons license