Reflecting on Experiences of Senior Medical Students’ External Clinical Teaching Visits in General Practice Placements: A Pilot Study

Shaoting Feng,1,* Daya Yang,1,* Kunsong Zhang,1,* Denise Joy Findlay,2 Ming Kuang,1 Haipeng Xiao,2 Dan Xu1,2 1Department of Medical Education, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2General Practice Research, Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Australia*These authors contributed equally to this workCorrespondence: Dan Xu; Ming Kuang, Email daniel.xu@curtin.edu.au; kuangm@mail.sysu.edu.cnPurpose: Australian general practice training uses external clinical teaching (ECT) visits for formative work-based assessments. ECT visits appoint senior general-practitioners (GPs) observe trainee GPs’ consultations, provide feedback, and make performance-enhancing recommendations. As ECT visits are one of the best assessment tools in Australian GP training, there is limited evidence of its use in undergraduate teaching. This study aims to introduce ECT visits and evaluate assessment tools during senior medical students’ GP placement.Methods: This study included external and internal GP supervisors and twenty-five Chinese and Australian students during GP placements. The supervisors provided structured in-person feedback, while the ECT assessment tool used a standardised, validated feedback platform to assess every component of a consultation. Students’ feedback was recorded and collected by both internal and external supervisors, and then semantically analysed by external supervisors.Results: Twenty-five ECT visit feedbacks were collected and analysed semantically. All participating students rated ECT visits excellently and confirmed the relevance of assessment tools for discussions with supervisors to achieve the designed learning outcomes. Chinese students rated the assessment tools as innovative from a cultural perspective and recommended the ECT visit teaching model and assessment tools to their home university, whereas Australian students suggested more ECT visits during GP placements. Time management was a limitation for both the students and supervisors.Conclusion: ECT visit is an innovative placement teaching model and work-based assessment tool for senior medical students’ GP placements, and is rated as the most preferred formative assessment tool. The limitations of this study include small group of students/supervisors and lack of patient feedback; however, all of these limitations can be overcome by involving multiple GP clinics in ongoing large-scale study. ECT visits can be introduced quantitatively into students’ GP placement curricula to improve clinical reasoning, learning, and quality assurance with assessments during clinical placements.Keywords: external clinical teaching, general practice placement, senior medical students placement learning, clinical reasoning learning, work-based assessment