<p>Developing Medical Students’ Broad Clinical Diagnostic Reasoning Through GP-Facilitated Teaching in Hospital Placements</p>

Abstract

Purpose: Graduating medical students need broad clinical diagnostic reasoning skills that integrate learning across clinical specialties to deal with undifferentiated patient problems. The opportunity to acquire these skills may be limited during clinical placements on increasingly specialized hospital wards. We developed an intervention of regular general practitioner (GP) facilitated teaching in hospital placements to enable students to develop broad clinical diagnostic reasoning. The intervention was piloted, refined and delivered to a whole cohort of medical students at the start of their third year. This paper examines whether students perceived opportunities to improve their broad diagnostic clinical reasoning through our intervention. Methods: GP-facilitated teaching sessions were delivered weekly in hospital placements to small groups of 6-8 students for 90 mins over 6 weeks. Students practiced clinical reasoning with real patient cases that they encountered on their placements. Evaluation of learning outcomes was conducted through a student questionnaire using Likert scales with free-text boxes for additional explanation. Focus groups were conducted to gain a more in-depth understanding of student perspectives. Results: As high as 87% of students agreed that their broad clinical diagnostic reasoning ability had improved. Thematic analysis of the qualitative data revealed four factors supporting this improvement: practicing the hypothetico-deductive method, using real patient cases, composing student groups from different speciality placements and the breadth of the facilitators' knowledge. Students additionally reported enhanced person-centredness in terms of understanding the patient's perspective and journey. Students perceived that the added value of general practitioner facilitators lay in their broad knowledge base and knowledge of patient needs in the community. Conclusion: Our results suggest that medical students can develop broad clinical diagnostic reasoning skills in hospital settings through regular GP-facilitated teaching. Our approach has the advantage of working within the established curricular format of hospital placements and being deliverable at scale to whole student cohorts.

Medical Students and the Level of Their Knowledge on Normal Flora: Results from an Electronic Questionnaire Conducted in a Private Medical School

“…Clinical teachers, as a role model, also have an important role in the effectiveness of pre-clinical and clinical education in supporting their learners, and in the same time encouraging reflection, and for the faculty policy maker it will provide constructive and regular feedback for further continuous improvement [11][12][13][14]. Identifying effective teaching practices which best suits to our faculty is also a future challenge [14][15][16].…”

“…Early and frequent clinical experiences should be planned and integrated in curricula, even though according to Quintero et al, [12] there is also disadvantage beside the advantage of doing such an integration. The provision of such opportunities is associated with the development of appropriate attitudes and the acquisition of commendation and diagnostic skills among undergraduate medical students [16]. Further study need to be conducted to measure the effect on our students.…”

<p>GP-Facilitated Teaching in Hospitals: The Way Forward? [Letter]</p>

“…We read with great interest the article by Bansal et al 1 on incorporating GPfacilitated teaching on clinical placements. We thought it to be a thoughtprovoking and innovative approach.…”

How Do Clinical Supervisors and Managers in Swedish Primary Care Perceive Their Opportunities to Meet the Learning Needs of Medical Students?

“…2 , 10–13 Due to its constant rapid flow of patients needing to be managed, often independently, and with a high variety of complaints, primary care is potentially an excellent environment for practicing clinical skills under supervision and for experienced-based learning, and for developing clinical reasoning in the later stages of medical education. 14 Students perceive the interaction with primary care physicians as having a crucial impact on their learning outcomes, particularly for developing communication skills and rapport with patients. 15 …”