Outpatient learning perspectives at a UK hospital

Comparing medical student experience of face-to-face and remote access consultations during the coronavirus pandemic

INTRODUCTION

As a result of the coronavirus pandemic, outpatient consultations in National Health Service Lanarkshire were conducted using various forms of teleconsultation. A qualitative study was undertaken to ascertain how senior medical students valued the experience of outpatient teleconsultations in comparison to face-to-face consultations during the pandemic.

METHODS

Anonymised, voluntary surveys were emailed to all medical students who attended clinical placements in specialties utilising teleconsultations. Participants were asked to compare their experience of and perceived value of virtual consultants to face-to-face consultations. Thematic and statistical analysis was performed on the collected data.

RESULTS

Participants unanimously agreed face-to-face consultations enabled learning, with 71.4% (n = 7) having similar experiences in video consultations if a senior was physically present beside them. Video consultation, when the senior clinician was also present virtually, was deemed useful to a lesser extent (66.7%, n = 6). Only half (57.1%, n = 14) valued the learning from telephone consultations. Qualitative analysis revealed that although face to face was the preferred consultation style, there was useful learning gained in all modalities. Students appreciated discussion with senior clinicians to facilitate learning and valued involvement in the consultation through history taking, especially in teleconsultations.

DISCUSSION

Teleconsultation was an effective learning tool for medical students during the coronavirus pandemic, which preserved student exposure to patients during lockdown. This study is optimistic that widespread incorporation of teleconsultation, in all modality, has the ability to support students' clinical exposure and learning, which is becoming increasingly limited as medical student numbers continue to rise and with the ongoing effects of the pandemic.

Effective Veterinary Clinical Teaching in a Variety of Teaching Settings

This review explores different modalities for clinical teaching of veterinary learners globally. Effective clinical teaching aims to prepare graduates for a successful career in clinical practice. Unfortunately, there is scant literature concerning clinical teaching in veterinary medicine. Our intent for this review is to stimulate and/or facilitate discussion and/or research in this important area. We discuss the different forms that veterinary clinical teaching can take, depending on their setting, which can be university-based clinical activities, work-based in commercial clinical practices, or in a traditional academic setting with little to no real-time exposure to clients and patients. We suggest that each of these modalities has a place in clinical teaching of veterinary learners at any point in the curriculum but that a mix of these approaches will likely provide an improved experience for the learner. Further, we discuss strategies to improve clinical teaching in these different settings. Potential strategies related to the teaching skills of clinical instructors could include training in delivery of clinical teaching in a variety of learning settings, and instructors’ official recognition, including opportunities for career progression. Potential strategies to improve clinical teaching in different teaching settings would vary with the learning settings. For example, in traditional academic settings, case-based learning with incorporation of simulation models is one proposed strategy. The involvement of learners in ‘teach-others’ is a strategy for both traditional academic and clinical settings. Finally, clearly addressing Day One competencies is required in any clinical teaching setting.