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UK undergraduate medical curricula are under pressure to become more community-focused and generalist in approach to equip all future doctors with generalist skills and increase recruitment to generalist specialities like general practice. However, the amount of general practice teaching in UK undergraduate curricula is static or falling. Undervaluing, in the form of general practice denigration and undermining, is increasingly recognised from a student perspective. However, little is known about the perspectives of academics working within medical schools. To explore the cultural attitudes towards general practice within medical schools as experienced by general practice curriculum leaders. A qualitative study using semi-structured interviews of eight general practice curriculum leaders in UK medical schools. Purposive sampling for diversity was used. Interviews were analysed using reflexive thematic analysis. Seven themes were identified covering 'a kaleidoscope of attitudes towards general practice', 'overt everyday denigration of general practice', 'a hidden curriculum of undervaluing general practice', 'valuing general practice: representation, recognition and respect', 'relating to others, relating to oneself', 'power, empowerment and vulnerability', and 'the pandemic as an opportunity'. Cultural attitudes towards general practice were diverse: a spectrum varying from valuing general practice to overt denigration, with a 'hidden curriculum' of subtle undervaluing of general practice. Hierarchical, tense relationships between general practice and hospital were a recurring theme. Leadership was identified as important in setting the tone for cultural attitudes, as well as indicating general practice is valued when general practitioners are included within leadership. Recommendations include a shift in narrative from denigration to mutual speciality respect between all doctors. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the decisions and decision-making strategies employed by academic GPs tasked with adapting the delivery of undergraduate general practice education curricula to virtual platforms during the Covid-19 pandemic. We sought to investigate how their experiences of this adaptation might influence the development of future curricula. Recognising our 'insider' positions and constructivist paradigm preferences, we approached the study from a constructivist grounded theory (CGT) perspective and participants participated in semi-structured interviews. Nine participants from three university GP departments in Ireland described the transition to online delivery of the curriculum as a 'response approach'. Participants described seeking collaboration both within and between institutions. The value and limitations of student feedback as a driver for change differed between participants and recognised the impact of limited social engagement between peers on social determinants of learning. Participants with prior experience in e-learning were inclined to recommend some level of continuation. Two institutions plan to continue to incorporate aspects of blended learning. All participants recognised a level of value (efficiency, social engagement and continuity) in online learning, they were less clear on the specific educational value and impact of this (e.g. on knowledge, skills and attributes). We need to consider which elements of undergraduate education can be delivered effectively online. Maintaining the socio-cultural learning environment is of critical importance but must be balanced by efficient, informed and strategic educational design. [ABSTRACT FROM AUTHOR]

Medical schools may find it difficult to coordinate GP practices to support undergraduate medical education in primary care. In England, every Integrated Care System area now has a funded training hub to plan and upskill the primary care and community health workforce. We evaluated whether a training hub could help deliver undergraduate medical education, co-facilitated by patient educators. No published research has evaluated this model before. We used before and after surveys (617 students), interviews (28) and focus groups (20 people) with undergraduate medical students, patient educators and training hub and medical school team members. It was feasible for a training hub to develop and co-deliver a workshop with patient educators. 61% of Year 4 undergraduate students (first clinical year) took part, a high attendance rate during the COVID-19 pandemic. 80% of students said they learnt a lot about managing conditions in primary care and the community as a result. They particularly valued engaging with patient educators and seeing interprofessional working between GPs and pharmacists, which were cornerstones of the training hub approach. The hub was able to recruit and retain patient educators more effectively than the medical school alone. Patient educators said they felt valued and developed new skills. Working with training hubs may be part of the solution to issues medical schools face when organising undergraduate education about primary care. This small evaluation suggests that this model could be tested further. [ABSTRACT FROM AUTHOR]

In this article, we review key factors in promoting a culturally diverse and inclusive learning environment for all undergraduate medical students, and the role of primary care educators in preparing students to work with diverse teams, patients and communities. These factors include approaches to curriculum and assessment, student community, faculty development and recruitment, and wider institutional factors. By highlighting these, including areas where further research, evaluation and consensus are needed, we hope to support further discourse on how primary care educators can promote culturally diverse and inclusive undergraduate medical education. [ABSTRACT FROM AUTHOR]

General practice worldwide is facing a severe recruitment crisis, with significantly fewer medical students choosing to pursue careers in primary care than are required to meet society's growing demands. The role of GP placements and GP tutors has been highlighted as having a significantly positive influence on medical students' perceptions of general practice. However, how students perceive these experiences to have influenced their subsequent career preferences remains poorly understood. We sought to explore how a longitudinal GP placement influences medical students' preferences regarding a career in general practice, in order to gain a deeper understanding of the significance of such placements. Semi-structured interviews were undertaken with five fourth-year medical students using Interpretive Phenomenological Analysis methodology. Four overarching concepts were identified, with nine superordinate themes, to describe how a longitudinal placement had influenced medical students' preference regarding a career in general practice. There appears to have been a matching process between an expanding knowledge of the realities of being a GP and an increasing understanding of self. The GP tutor and 'authentic' experiences to consult patients themselves developed a growing sense of self-efficacy within students, all of which resulted in a significant internal desire to become future GPs. [ABSTRACT FROM AUTHOR]

Medical schools are required to train the workforce needed to care for the population they serve. In the UK, we are expected to produce more graduates choosing to be general practitioners and to equip all graduates with the ability to care for an ageing population with increasingly complex care needs. These doctors need to be effective members of multi-professional teams, possessing generalist skills including an understanding of uncertainty and risk. Curricula where a significant proportion of clinical learning is based in general practice are best placed to address this pedagogic need. The authors evaluate the sociocultural factors which impede the expansion of undergraduate medical education in general practice. These include historic cultural divides between secondary and primary care, medical school leadership, funding, contractual arrangements and capacity in general practice to deliver increasing education of medical students alongside other established and emerging health professions. The piece concludes with two recommendations: undergraduate student teaching should be incorporated into contract negotiations and there must be urgent UK-wide investment in appropriate placement tariff for students. Furthemore, there is an imperative to pilot and evaluate novel collaborative approaches to the education of undergraduate medical and other health professions students. [ABSTRACT FROM AUTHOR]

There is a need to increase undergraduate primary care exposure and subsequently enhance primary care recruitment. This study aimed to establish the current use and education potential of the primary care out of hours (OOH) learning environment. This was a mix methods study. A questionnaire was sent to UK primary care heads of teaching nationally to explore the current use of GP OOHs in the undergraduate curriculum and focus groups evaluated final year medical students' experience of an OOH placement. There was a 100% response rate from primary care heads of teaching. Despite 86% being in favour of integrating OOH placements within the undergraduate curriculum, only 28% of medical schools currently offer primary care OOH placements. 36 out of 240 students volunteered for a clinical OOH session. Focus group data from 6 of these students revealed that the placements provided unique learning opportunities and allowed students to appreciate the organisational structure of the National Health Service (NHS). However, barriers included logistical difficulties with the OOH providers and inadequate supervision. It appears that we are overlooking a unique educational opportunity for medical undergraduates. With increasing demands for GP exposure within the undergraduate curriculum, GP OOH is a useful resource for UK medical schools. [ABSTRACT FROM AUTHOR]

In November 2016, the Medical Schools Council and Health Education England published a joint report chaired by Professor Val Wass: 'By choice – not by chance' to raise the profile of general practice as a positive career choice for medical students. We sought to evaluate the impact of the report by firstly, asking the views of Heads of GP teaching at UK medical schools whether and how the report has supported them in raising the profile of general practice and secondly, describing the initiatives developed by medical schools in a national survey. There was a perception reported by heads of GP teaching that the report has been highly influential in facilitating the promotion of general practice as a career to medical students. We describe multiple specific initiatives developed in response to the report's recommendations. The national survey confirmed that whilst there is significant variation across medical schools in their response to the specific recommendations in the report, definite progress is being made. A number of areas that need particular consideration have been highlighted and we would recommend that future surveys are completed at appropriate time intervals to review further progress. [ABSTRACT FROM AUTHOR]

Introduction: Social theories of learning consider learning and thinking as social activities. These activities may occur within a community of practice. Communities of practice may position learners as legitimate peripheral participants. This study tests whether legitimate peripheral participation provides an overarching theory to assist in evaluating learning and teaching of medical students undertaking short primary care attachments. Methods: A questionnaire was delivered to all Year 4 students at the University of Auckland in 2015. A deductive content analysis was undertaken on the data utilising a categorisation matrix. Legitimate peripheral participation theory was used to develop the categorisation matrix. Results: Three broad themes explained legitimate peripheral participation by medical students undertaking a short primary care attachment. These three themes were 'hospitality,' 'collegiality' and 'responsibility.' Conclusion: Legitimate peripheral participation, in the context of undergraduate primary health care attachments, appears to depend upon positive social activities between students and health professionals and patients. Using legitimate peripheral participation as a theory to underpin evaluations of general practice attachments it is possible to determine improvements in the learning and teaching experience of medical students. [ABSTRACT FROM AUTHOR]

Previous research has identified the 'unique experience' of home visits for medical students, yet in-training health professionals' exposure to them is limited and there is not a structured method of performing them. It is already recognised that simulation prior to clinical experience improves knowledge and confidence with the additional benefit that the experience can be standardised. We ran a 'Virtual Home Visit' for falls assessment for third year medical students as part of their teaching on multidisciplinary team (MDT) working. Students considered a clinical scenario involving a lady who had fallen at home and fractured the wrist of her dominant hand. They then watched a short video of her home, where each room was filmed in turned. They were then asked to identify both falls risks and possible adaptations. The session was co-facilitated by a GP Educator and an Occupational Therapist. The students enjoyed the session and performed well in a related OSCE assessment. The technology required was minimal to run the session. The facilitators also recognised the potential to use such a session in an interprofessional education environment. [ABSTRACT FROM AUTHOR]

With a crisis in general practice recruitment, we need 50% of UK medical students to choose general practice as a career. Nottingham University does not achieve this. 2 paired careers tutorials, giving guided careers advice were embedded into a 4-week undergraduate attachment in primary care. They promoted portfolio GPs and how general practice could fit into career choices. Paired evaluation was completed (Open-ended questions on current career choices and a 5- point Likert scale "Is General Practice is a possible career choice for me?") The data was analysed using the Wilcoxon signed rank test. 100% response was achieved (218/218) with 80 (36.7%) giving a higher score in tutorial 2, suggesting they were more likely to choose general practice as a future career, 107 (49.1%) had no change in score and 31 (14.2%) provided a lower score. There was a significantly higher median score at the end of the attachment. Median (IQR) presurvey score 3 (3-4) and median (IQR) post-survey score 4 (3-5). P = <0.0001. These results show that increasing medical student exposure to general practice with innovative, paired, careers tutorials may increase the number of students who would consider a career in general practice. [ABSTRACT FROM AUTHOR]

The ageing population and push to community care has significantly increased the workload of General Practitioners (GPs) in the UK and internationally. In an attempt to tackle this, NHS England has promised 5000 more GPs by 2020/21; however, recruitment is in crisis with GP training posts remaining unfilled. Little research has been carried out to assess the fundamental questions of what medical students' perceptions of General Practice are and what shapes their perceptions at medical school. We aimed to explore medical students' conceptualisations of being a GP and specifically the role of the medical school in shaping their perceptions. Two focus groups of year one and year four medical students were undertaken using an interpretive phenomenological approach. Our study has revealed that medical students perceive General Practice to lack prestige and challenge. These perceptions come, at least in part, from a process of socialisation within medical school, whereby medical students internalise and adopt their role models' perceptions and values, and the values portrayed by the hidden curriculum in their medical school culture. Perceived external pressures to pursue a career in General Practice can have a negative influence and medical schools should be made aware of this. [ABSTRACT FROM AUTHOR]

The article describes the 10-day attachment of students of Bachelor of Medicine and Bachelor of Surgery (MBBS) for community diagnosis by family survey in the Rajegudde village of Bantwal Taluk in the Dakshina Kannada district of Karnataka, Mangalore, India to describe the health of citizens. The study determined the demographic profile, environmental determinants of health, maternal and child health issues, morbidities and health seeking, and perceived needs of the community for better health.

The article focuses on development of the Integrated Clinical Apprenticeship (ICA) for assistance of medical students in their transformation to student doctors. Topics discussed include association of the Imperial College London in an introduction of ICA along with on-job training; assessment of the ICA's curriculum y comparison of ICA students with other medical students; and increment in an exposure for medical care services by ICA towards undergraduate primary care students.

The article discusses the development of case-based learning (CBL) for assessment of medical ethics and law (MEL) into the Student Selected Component (SSC) programme within the Bachelor of Medicine and Bachelor of Surgery (MBChB) course in Great Britain. It mentions the goal of the CBL to address the poor integration of MEL with other parts of the curriculum as a key weakness within medical schools' curricula. It also notes the key lessons to improve the implementation of the approach.

Teaching communication skills is an important task in the medical curriculum. It is widely agreed that the ability to communicate with the patient is just as important as biomedical knowledge and technical skills. We present data from an early patient contact (EPC) course with integrated theoretical and practical skills inspired by modifications of Kolb's learning cycle. Our objective was to examine first-term medical students' personal experiences and challenges with EPC. A qualitative design was adopted, with data from written logbooks and focus group interviews with medical students who had recently completed an EPC course. Data were analysed with a grounded theory approach. We found that meeting with a real patient - a person - was a central point of learning. Students' perceptions and reflections on their future profession and personal skills were broadened. Students became respectful of a patient's life and illness experiences, and their understanding of communication as central to a doctor's daily work increased. Our results deepen the current knowledge of students' benefit from EPC by taking it into first-term students' perspectives and focusing on the personal experiences and challenges that the students met during the course. Further integration of the patient in the learning processes is recommended. [ABSTRACT FROM AUTHOR]

The article discusses a programme of teaching for students' attachment to general practice and also nurse education and a U.S.-based short piece on a problem-based learning. The article also focuses on ways in which General Practitioners (GPs) can assist medical students in consultation skills training in primary care and offering the GP teachers visual models as guidance. Several key elements discussed are teaching students about illness, consultation mechanics, and communication skills.

The author discusses evaluation of the methods of teaching and learning of each medical student (MS) attached to general practice (GP) surgery. The author conducted an enquiry for the MS, to understand their learning needs and prepared a curriculum for GP attachment for the best of the multidisciplinary surgery team (MDT). Identifying the student's individual learning needs and setting the scene for those involved in teaching maximized the chances of their individual learning needs being met.

The article focuses on the new approach in teaching occupational health issues in the undergraduate curriculum which aims to understand work environment health issues. The program covers three areas such as health problems in medical students and doctors, attitude adjustment from disease-focus to disease in life context, and patient health work issues. Furthermore, the sessions were designed by an occupational physician (OP) within the context of the community-based education department (CBME).

The article offers information on a study on teaching leadership through experiential learning to medical students and the army. Topics discussed include introduction of new medical undergraduate curriculum in Liverpool, England; military exercise for undergraduate medical students; and clinical leadership has been reported as one of the major underlying causes of poor patient care in Great Britain's National Health Service (NHS).

A major goal of the core undergraduate curriculum is to prepare students for their future medical specialty. In this study we examined the learning approaches of senior students in traditional medical school, using the Biggs, Kember and Leung's revised two-factor version of the study-process questionnaire, in a quasi-experimental design with two control groups. All student groups showed a rather low to moderate score for deep and surface approach at the pre-test. After our short educational intervention of 17 weeks, which essentially was a multi-target approach aimed at resembling real life in which our graduates will work and learn in the coming years, the intervention group showed a significant shift to a deeper approach to learning in contrast to the two non-intervention groups. We do not know to what extent the positive shift in learning attitude among the GPs will be retained in the coming years. Further research is needed to test for concurrent validity of our findings in comparable cohorts. [ABSTRACT FROM AUTHOR]

A three-day programme of training in leadership was delivered to Hull York Medical School (HYMS) fourth year undergraduate medical students as a student-selected component of the course. It was evaluated by pre- and post-course questionnaire. Students supported the notion of leadership training for all medical students before and after the course. The students showed significant (P<0.05) increases in support after the course for the notions that leadership can be learnt and that everyone is a leader. They also became significantly (P<0.05) more aware of the differences between leadership and management and expressed increased confidence in their own leadership skills following the course. These conclusions must be tempered by the small number on the course and self-selection of students. [ABSTRACT FROM AUTHOR]

The article discusses the impact of the budget decrease on the Medicare Indirect Medical Education (IME) in the U.S. The government proposed that the budget be cut by more than 60% along with the payments to hospitals for Medicare patients and Medicaid payments for graduate education. The move is detrimental to the medical industry because it would have a profound impact on the funding landscape of medical and graduate medical education of the country.

During the planning of the new model of out-of-hours care there has been no mention of any impact it might have on the provision of teaching for medical students. This study sought to determine the current experience gained by medical students in general practice out-of-hours, the feasibility of providing out-of-hours teaching and opinions about its value. We performed three surveys: medical students at the University of Bristol, their GP teachers and the Heads of Departments of General Practice at all UK medical schools. Of the 69 medical students who replied (71% response rate), 16 (23%) had experienced out-of-hours teaching during their general practice attachments. One hundred and thirteen GP teachers replied (78% response rate) and almost 50% felt they could offer out-of-hours teaching. Twenty seven of the 29 UK medical schools replied to the survey about provision of out-of-hours teaching. Such teaching is on an ad hoc basis in 12 schools, is compulsory in two and there is no provision in 13 schools. In conclusion, we estimate that about 18% of UK medical students currently have experience in general practice out-ofhours. Eighty one percent of GP teachers and 41% of Heads of Department in UK medical schools feel that out-of-hours teaching is beneficial for medical students. This study provides a baseline for determining possible teaching opportunities for medical students in general practice out-ofhours. [ABSTRACT FROM AUTHOR]

The article discusses the integration of undergraduates and postgraduates in the community-based medical education in Great Britain. It highlights the three developments that facilitate outside hospital environment teaching in the region including the primary care trusts (PCTs), the independent sector treatment centres (ISTCs) and the "Darzi practices." It also discusses the postgraduate and undergraduate integration, interprofessional participation and resources of community care education.

Because of the increasing contribution of university departments of general practice to the undergraduate curriculum in UK medical schools, involving large numbers of general practices and community based teachers, quality assurance of these 'distributed' curricula is essential. We have conducted a cross-sectional survey of all UK university departments of general practice to determine how they are approaching the task of quality assurance of their community based curricula. The response rate to our survey was over 85%. Most departments now contribute across all years of the undergraduate curriculum providing an average of 13% of total curriculum time. Over 85% of departments were confident that the teaching delivered in their community based programmes was consistent with the aims, objectives and content of their core curricula and also in the quality of their community based teachers. Whilst the majority of departments employed student feedback and feedback from external examiners as part of their quality assurance mechanisms, a minority (24%) used feedback from patients. Almost all departments undertook practice visits and direct observation of teaching and peer review. Most departments would dispense with poorly performing teachers identified through these mechanisms. Quality assurance is being taken seriously by the university departments of general practice. The results of this survey also indicate areas in which both established and newly created medical schools can make further progress towards ensuring high-quality community based undergraduate teaching. [ABSTRACT FROM AUTHOR]

The paper examined the relative importance of factors which influenced final year medical students to consider or discount general practice as a career option. A questionnaire was administered to three cohorts of approximately 30 final year medical students at Barts and The London (Queen Mary's School of Medicine) on the first and last day of their four-week Final Year General Practice Module. In addition, three focus groups explored in further depth the influences on students' views of general practice as a career. There was a significant increase in the number of students who said they would consider a career in general practice following the Final Year General Practice Module (47.5% before compared to 68.1% after). Influencing factors were both intrinsic and extrinsic to the MBBS curriculum with perceptions of a 'GP lifestyle' emerging as the most important factor for those considering general practice, with a preference for hospital careers the most important reason for those not. Qualitative results demonstrated prevalent pre-existing negative perceptions of general practice as a career, with the Final Year General Practice placement in particular 'tipping the balance' back toward considering general practice. Other important factors were the lack of opportunities as an undergraduate to experience the long-term rewards of general practice, how students perceived the hierarchy in medicine and what factors they felt were the most important to have control over in their careers. Most undergraduates in our study were not ready to commit to any definite career plans, instead postponing this for a time when they had real experience and a greater understanding of what being a general practitioner would be like. This has implications for the usefulness of the Foundation Year 2 posts in providing tasters in general practice, but also highlights that the Modernising Medical Careers structure may restrict those in our study who wished to retain flexibility, and would consider general practice after having worked in other specialties. [ABSTRACT FROM AUTHOR]

Recruitment and retention in general practice is a national issue. We used two qualitative methods to examine the attitudes of final year medical students to general practice as a potential career. Although students considered experience of general practice during their clinical course as the most important influence, a good experience of the discipline is not enough in itself for students to commit to general practice as a career. Individual general practitioners (GPs) can have a significant impact on students' perception of general practice careers. A range of aspects was considered by students in respect of careers in general practice; aspects that encouraged some students towards general practice dissuaded others. Not all students were interested in holistic aspects of medicine. [ABSTRACT FROM AUTHOR]

The article highlights the nature of podcasting which is defined as a digital recording of a radio broadcast made available over the Internet, along with its significant for undergraduate healthcare education. The author also determines the potential use of podcasting for undergraduate healthcare education. Moreover, areas for further research and development are addressed.

Specialty teaching in general practice can be delivered in structured sessions or in routine general practice consultations. However, structured sessions have substantial resource implications. This survey examines these two models. The method was a cross-sectional survey of general practice (GP) tutors and students recording diagnoses, signs and symptoms during teaching sessions. Data were obtained from 2516/2534 (99%) structured teaching sessions and 114/264 (43%) of routine GP sessions. The results showed that for structured sessions: 1.92 (95% CI 1.86-1.98) diagnoses per patient, 0.98 (95% CI 0.98-0.99) symptoms per patient, and 0.93 (95% CI 0.92-0.94) signs per patient were observed. Whereas for routine general practice consultations: 0.79 (95% CI 0.77-0.82) diagnoses per patient, 1.02 (95% CI 1.01-1.02) symptoms per patient, and 0.09 (95% CI 0.08-0.12) signs per patient were observed. Structured teaching sessions in general practice offer greater exposure to relevant signs and diagnoses than routine general practice consultations for students learning internal medicine. There may, however, be some loss of exposure to commonly presenting symptoms, with implications for students' development of clinical method and problem-solving skills. However, for novice clinical students, structured teaching sessions in general practice appear to be a highly effective teaching method. [ABSTRACT FROM AUTHOR]

Community based teaching for student doctors has expanded and continues to do so. The impact of such teaching on students, GP tutors and patients is becoming understood but few studies have examined the impact on the wider practice team. In 2001 the University of Cambridge introduced the Graduate Course in Medicine which has a significant general practice-based element: students spend two days per week in five local practices in West Suffolk. In 2003 the practices were required to undertake more intensive and prolonged student teaching than hitherto. We studied the impact of prolonged student teaching by GPs on a wide range of parties including patients, GPs, practice managers, practice administrative staff and allied health professionals (AHPs). This paper reports the qualitative findings of the study of 46 practice members in the five CGC practices. Prolonged student teaching had a differential impact on different groups. Those GPs with higher levels of involvement in student teaching reported experiencing greater benefits and greater costs. On balance, GPs felt that benefits derived from student teaching outweighed costs. However, not all practice members reported being involved in or consulted about the decision to undertake student teaching. Some practice members, receptionists in particular, reported experiencing costs in the form of added complexity and stress in their job as a result of a decision to which they did not feel party. The economic concept of externalities was used to illustrate the differential benefits and costs experienced by different groups within practices arising from prolonged student teaching. Expanded undergraduate teaching is both feasible and acceptable from the perspective of most practice members but care is needed in organising change to meet the needs of all practice members. [ABSTRACT FROM AUTHOR]

This paper reports on the experiences of tutors involved in teaching on an SSC in literature and medicine. Previous research has demonstrated benefits for students on such courses, but there has been no study of how the course affects tutors. This is the first paper to investigate tutors' experiences on such a course. Tutors from the 2004 course took part in two group interviews. The data obtained from the interviews were analysed thematically and discussed by the study team. New tutors from the subsequent year examined the data for participant validation, and added their own comments. The themes discovered were that the course provided: stimulation, educational benefits, opportunities for mentoring, ownership, a different part of the curriculum and practicalities. The course affords educational, personal and professional benefits for tutors, and continues to offer an original style of teaching. It 'stretches' tutors who have to think of how to help students learn in novel ways. This literature SSC helps teachers and doctors reflect on their personal and professional roles. [ABSTRACT FROM AUTHOR]

This project explored the experiences and perceptions of medical students taught in primary care using a problem-based learning (PBL) approach, within the context of a conventional (non-PBL) curriculum. Four independently moderated focus group interviews were undertaken with a total of 15 final year undergraduate medical students from the University of Leeds, England, immediately after experiencing a four week PBL-based clinical attachment in a primary care setting. Medical students exposed to a PBL module within a non-PBL curriculum appreciated the opportunity for deeper learning, gaining understanding of course material and retaining knowledge. They considered the PBL approach acceptable within isolated modules, and relevant for clinical practice. They exposed tensions between their perceived needs for superficial learning for medical finals and the perceived strengths of the PBL approach. Isolated use of PBL-based teaching in a non-PBL curriculum appears acceptable to medical students and was considered to have many advantages over non-PBL teaching. Students' concerns regarding the timing of PBL intervention near to medical finals raise interesting questions about where PBL modules could fit within a mixed methodology teaching curriculum and also about the nature of assessing final year students. [ABSTRACT FROM AUTHOR]

The article presents a study that investigates the views of medical students on their experiences of learning in primary care in a curriculum that is 20% community-based in Great Britain. The study found out that students have negative preconceptions on general practice reinforced by the medical school, peers, tutors and the curriculum. Results indicated that good educational experience enabled students to understand the important role of primary care and thus reversing their preconceptions.

The article presents a study that investigates students' reason for studying medicine which was conducted at the University of Cape Town, South Africa. The study focused on the data collected from qualitative methods, the focus groups and interviews. It found out that students' reasons for studying medicine range from an interest in biology, family factors, status, financial gain, job security and mostly altruistic reasons.

Participation in primary care clerkships is known to be a strong facilitator for choosing primary care specialties. These programmes for undergraduate students in Japan are shorter and less intensive than those currently available in the USA or UK, as primary care is still an evolving discipline in Japan. The primary objectives of this paper are: to introduce the major issues that exist with respect to primary care education for undergraduates in Japan; to investigate the level of career preference for primary care among Japanese medical students; to examine the factors that influence this career preference. In 2002, a survey was conducted using a closed-question, locally administered, written questionnaire. Subjects were sixth-year students attending 62 of the 80 medical schools in Japan. The questionnaire dealt with their interest in, and career preference for, primary care at the time of the survey. Data regarding medical school characteristics and certain student attributes were also gathered. Of the 6185 students solicited, 4521 (73%) responded. Seventy-eight percent were interested in primary care, and 34% expressed a preference for becoming a primary care physician. After excluding data from 12 schools which did not supply curriculum information, data from 3199 subjects (from 50 schools) were analysed. Although clerkship programmes were significantly associated with an interest in primary care, they were not associated with a career preference for primary care (odds ratios from multivariate logistic regression were 1.4 (1.0-1.9) and 1.0 (0.8-1.3), respectively). Furthermore, female students, degree-holders, students whose parents were primary care doctors, students attending a private medical school, or students attending a special rural medical school were more likely to aspire to be primary care doctors; odds ratios were 1.5 (1.3-1.7), 1.5 (1.2-1.8), 1.7 (1.3-2.3), 1.8 (1.5-2.2) and 3.8 (2.2-6.5), respectively. In summary, current community-based clerkship programmes are associated with an interest in, but not with a career preference for, primary care among Japanese medical undergraduates. This finding may support further development of clerkship programmes in Japan, to increase the number of medical graduates who consider primary care as a career choice. [ABSTRACT FROM AUTHOR]

The article cites a study which aims to serve as a practical guide for those involved in the design and delivery of communication skilled programs. The study summarizes the main results from the current literature with special emphasis on teaching assessing communication skills at an undergraduate level.

The article focuses on the use of mobile phones in undergraduate medical education. A large number of undergraduate medical students use mobile phones. Three main areas in which mobile phones are used in education are: organization and support of education, learning content and collaborative learning. An exchange of text messages between teachers and first-year undergraduate students has been found to be effective in retaining students.

The article focuses on education related to family medicine and community healthcare at Arabian Gulf University's College of Medicine and Medical Sciences in Bahrain. The Department of Family and Community Medicine was set up at the college in the year 1995. Its objective is to include the importance of environment and social context to the health of populations, communities, families and individuals in the curriculum.

WHAT IS ALREADY KNOWN IN THIS AREA• Letters from hospital specialists to a patient's GP promote informational continuity of care. There are no benchmarks for the quality of letters from specialists to GPs. Medical students are seldom taught how to correspond with professional colleagues.WHAT THIS WORK ADDS• The majority of students recognise the value of sharing comprehensive information across the interface between primary care and secondary care. Almost one in five students retains the view that discharge summaries do not affect care provided by a GP. Some students believe it is defensible to be rude about patients in discharge letters.SUGGESTIONS FOR FUTURE RESEARCH• Those students who hold questionable views must be identified and offered a tailored educational experience if they are to adopt helpful attitudes. [ABSTRACT FROM AUTHOR]

With the increase in undergraduate teaching taking place within general practice, it is important that general practice (GP) teachers are offered training and developmental activities to support their educational work. It is also important that this support is well targeted, if it is to be effective in raising teaching quality. This study set out to elicit the views of GP teachers both in terms of the value of current developmental activities being provided by the Centre for General Practice and Primary Care (CGPPC), and action points for the future. A questionnaire was sent to each lead GP teacher at all 108 active teaching practices involved in community-based medical education. The responses indicated that student feedback reports, module specific training, peer observation and, importantly, the opportunity to network with peer tutors in other practices, were regarded as useful activities. The research demonstrates that GP teachers are well able to articulate their own support needs and the results set a clear agenda for working with practices based on a collaborative understanding. [ABSTRACT FROM AUTHOR]

In Malaysia, there has been a recent shift in emphasis from secondary care to primary care, both in terms of healthcare as well as medical education. However, general practice is not considered as a desirable career path and less than 1 % of general practitioners (GPs) are trained. This could be due to many factors, one of which is the perception of primary care among medical students during their undergraduate training. This study aimed to look at the perceptions of medical students towards primary care and their influencing factors. Thirty-three final-year medical students participated in six focus group discussions at two universities in Malaysia in 2003. Participants were recruited by snowballing, taking into account the participants' gender, ethnicity and social background. The results of this study showed that there were mixed perceptions about primary care as a discipline. Understanding of the discipline, role-modelling of doctors, disparity between training and practice were highlighted as significant influencing factors. Lack of understanding of the discipline still exists among the medical students. Understanding their perceptions and the underlying influencing factors will allow educators to find ways to improve the students' attitudes towards the discipline. [ABSTRACT FROM AUTHOR]

Increasing numbers of medical students are learning medicine in primary care. This is a response to address the needs of Tomorrow's Doctors, increasing student numbers and the decreasing length of hospital stays. Previous studies have explored student perceptions of early clinical attachments and one-to-one teaching in primary care. Finalyear medical students from one UK university have the opportunity to undertake four-week medical firms in a primary care setting. This qualitative study examines students' expectations, experiences and perceptions of the value of such placements. Before the placements, students expected a high degree of individual attention, with more opportunities for informal and formal teaching than in the hospital setting. They were concerned about 'hanging around', 'observing instead of doing' and spending too much time with other professionals. Their experiences suggested that these hopes and fears were realised. The students considered primary care teaching was more organised, offered better teaching, gave a chance to see chronic illness and offered more appropriate feedback and assessment. Concerns were raised about the lack of acutely ill patients and an over-emphasis on interprofessional learning. We have shown that students value well-planned, structured teaching with a variety of clinical exposure, and that primary care can deliver this to the satisfaction of one group of final-year medical students, and raise suggestions for future research. [ABSTRACT FROM AUTHOR]

Explores whether the shift to group teaching in the undergraduate curriculum in British medical schools is as well evaluated as the traditional one-to-one teaching. Question of whether there is an added value to students of learning medicine in primary care; Question of whether it offers something different from secondary care.

A variety of community-based medical undergraduate modules have been developed over the last six years that complement more traditional hospital teaching. To monitor and enhance the quality of this teaching, a system was designed that regularly and accurately fed back student evaluation to the general practice tutors. An evaluation of the effectiveness of this system was undertaken to explore how our teaching prac-tices perceive the student feed- back documented by the departmental evaluation forms, and whether this information helped to maintain and improve the quality of teaching. A generic evaluation form was designed to record student feedback, following all their community-based modules. The data from these forms are entered into a relational database. This is then analysed to produce a two-stage report. The initial report is sent out to general practices after the students finish a module. The second stage of the report is sent to tutors at the end of the academic year, providing them with an opportunity to review their teaching performance and compare themselves with other practices. To explore these issues, two focus groups containing tutors from our major teaching practices were convened. The emerging themes were further investigated by using a postal questionnaire, which was sent to a wider group of teaching practices. The results of this work confirmed that positive feedback actively maintained, but also promoted, good teaching practice, whilst negative feedback was the main instigator of change. Tutors compared their per- formances, which acted as an incentive to do better. Tutors were satisfied with and used effectively this system of receiving student feedback. Both positive and negative feedback is valuable in maintaining and improving teaching practice. [ABSTRACT FROM AUTHOR]

Primary care in the United Kingdom has become a regular contributor to basic medical training for all undergraduates, and is likely to be a core component of the new foundation stage of doctors' postgraduate medical training, regardless of their ultimate career choice. This discussion article aims to describe the nature of the contributions that primary care is currently making to basic medical training, compare this with the overall potential and values of general practice, examine the underlying concepts that are being drawn upon, and critique the factors that make this sustainable for the future (or not). The article combines relevant back- ground literature and expert opinion from the author, who has been a GP educator for 20 years and is a clinical academic involved in the planning, delivery and research evaluation of medical education. It is a personal view, based on a belief that primary care has a uniquely valuable role for patients and learners, but that its ability to contribute to medical education remains at risk. [ABSTRACT FROM AUTHOR]

The article discusses a study involving the integration of paediatric students within primary care settings in order to help them better observe the early presentation of paediatric problems within the community and compare them with those in the secondary care setting. The results of the study suggest that the time spent by the paediatric students within the primary care settings helped overall learning across the community and hospital divide.

The article discusses the use of Symptom-based learning model in primary care. To make students understand the true nature of illness and the fact that illness is a dynamic process, the model can be used to show the relationship between symptoms and time. The various figures presented in the article are useful to understand the model and symptom-time relationship. It is also discussed that the model can be an aid in producing doctors with better understanding of the disease.