Undergraduate medical education: recommendations

Appendix E: Measuring GP teaching

Scottish GP Heads of Teaching

Nov 2018

Background

Drivers

• Recruitment to GP
• By Choice - Not by Chance¹
• Scottish Government aim to increase GP based teaching to 25% of the undergraduate curriculum

Issues

• 6 different curricula some with additional GP enhanced programmes
• No existing standard method for measuring and recording of GP involvement
• Not all GP involvement is easily quantifiable (goodwill, part of infrastructure rather than 'itemisable' tasks)
• Multiple requests for data

Risks

• Counting what can be counted rather than what accurately reflects the value and extent of GP involvement
• Multiple data sets from different perspectives lead to lack of credibility and utility of data overall

Proposal

• To agree a standard data set for use by all 5 Medical Schools as baseline and to measure progress
• Use of a dataset mapped to By Choice-Not by Chance¹

GP Heads of Teaching - Proposed measurements

These are based on areas proposed in the literature with each measure (in bold) proposed linking to relevant recommendations underneath from 'By Choice - Not by Chance¹

Actual GP placement time - both absolute (number of sessions/days) and as a proportion of all clinical placement time

• Recommendation 8: An increase in UG GP placements must address improved quality, content, timing and variety. This should include exposure to a variety of practices.
• Recommendation 9: Positive and enthusiastic role models should be identified and made visible across all medical schools.
• Recommendation 15: Existing GPs should champion the vision of the profession as an exciting intellectually challenging and rewarding career.

Curriculum time specifically badged as GP led/managed/designed - both absolute and as a proportion of the whole curriculum

• Recommendation 6: Students should recognise the breadth and complexity of general practice care and be stimulated by the complex intellectual challenge.
• Recommendation 15: Existing GPs should champion the vision of the profession as an exciting intellectually challenging and rewarding career.

Joint primary /secondary care teaching

• Recommendation 5: All medical schools must revise their undergraduate curricula to ensure they develop to reflect the patient journey through different healthcare settings and offer a more integrated less specialty organised approach.
• Recommendation 6: The formal curriculum must better inform students on NHS management and delivery at the primary-secondary care interface.

GP based SSC/elective availability and uptake

• Recommendation 8: An increase in UG GP placements must address improved quality, content, timing and variety. This should include exposure to a variety of practices.
• Recommendation 9: Positive and enthusiastic role models should be identified and made visible across all medical schools.

Admissions interviewers who are GPs - both proportion of slots and proportion of overall interviewers

• Recommendation 4: All medical schools must ensure that GPs contribute significantly in all selection processes.

GP based vacation scholarship availability and uptake

• Recommendation 8: An increase in UG GP placements must address improved quality, content, timing and variety. This should include exposure to a variety of practices.
• Recommendation 9: Positive and enthusiastic role models should be identified and made visible across all medical schools.

Evidence of involvement of GPSTs in teaching and assessment

• Recommendation 9: Positive and enthusiastic role models should be identified and made visible across all medical schools. This includes enhancing and supporting the role of GPSTs as educators and assessors and interaction in primary care between medical students and near peers.

GP contribution to careers events - both as absolute and proportion of overall medical school delivered careers sessions

• Recommendation 6: The business elements of, and career option within, GP (e.g. partnership v salaried v locum roles) need to be clear to students.
• Recommendation 14: The range of opportunities within GP should be actively promoted within medical schools and students should be offered a far better understanding of what being a GP can offer.
• Recommendation 15: Promotion of GP careers should be carefully considered to ensure students have the ability and flexibility to make informed career decisions without feeling pressurised by market forces.

Evidence in curriculum of efforts to tackle undermining of general practice (e.g. teaching about hidden curriculum, improved feedback mechanisms to enable students to report any serious undermining on placement.)

• Recommendation 11: Work should take place to tackle undermining of GP as a career across all medical school settings including primary care.)

Reference

[1] Health Education England/ Medical Schools Council. By Choice - Not By Chance. 2016.