Are we missing something? What are medical students missing out on, and why, when they are excluded from doctor patient encounters in general practice?

Natasha Yates, Jane W Smith, Reza Ajam, Holly-Jane Mellersh-Etherton

Research output: Contribution to conferencePresentationResearchpeer-review

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Abstract

Background: Medical training uses the apprentice model,
but medical students are excluded from doctor patient
encounters during placements so miss out on learning
opportunities. There is little understanding of why patients
do not want medical students present. Consent from
patients is essential prior to encounter, but where consent
is asked, and by whom varies, and may be repeated, or
anticipated on the patient's behalf. Research in Australia
found that 70 -90% of patients said they would "never
refuse" to have a student in the room. But this is not what
our students are telling us occurs during their placements.
Method: We are collecting data from medical students
during their GP placements to explore why they are not
being allowed into consultations. Each participant is asked
to complete a short survey each time they are excluded
from an encounter during their GP placements.
Quantitative information is collected about the
demographics of the student, GP, practice, and patient;
also who asked for consent, and when; plus the frequency
of exclusions. Qualitative data is provided by free text
answers about the reasons for exclusion, the nature of the
consultation, any cultural issues, and the students feelings
regarding exclusion.
Results: Male students are more likely to be excluded by
male GPs seeing female patients, however male students
with female GPs were excluded more frequently.
The age range of excluded patients was 20 to 50 years
Most students were present when consent was asked, this
was mostly asked by the doctor, in the waiting or
consulting room, but many were not. It was more likely for
the doctor to ask the student to leave than the patient.
Mental and sexual health were commonly quoted reasons
for exclusion.
Conclusion: It is important to better understand student
exclusions from patient encounters to address the gaps in
clinical experience. It may be possible to stop some of the
exclusions, for example if the patient's decision is
anticipated incorrectly.
Take-home message: Improved insight about the issues
causing student exclusions, will improve our ability to
either prevent this happening, or compensate the lost
learning
Original languageEnglish
Publication statusPublished - Aug 2018
EventAssociation for Medical Education in Europe Conference (AMEE) 2018 - Congress Center Basel, Basel, Switzerland
Duration: 25 Aug 201829 Aug 2018
https://amee.org/conferences/amee-past-conferences/amee-2018

Conference

ConferenceAssociation for Medical Education in Europe Conference (AMEE) 2018
Abbreviated titleAMEE
CountrySwitzerland
CityBasel
Period25/08/1829/08/18
Internet address

Fingerprint

Medical Students
General Practice
Students
Aptitude
Reproductive Health
Mental Health
Referral and Consultation
Research

Cite this

Yates, N., Smith, J. W., Ajam, R., & Mellersh-Etherton, H-J. (2018). Are we missing something? What are medical students missing out on, and why, when they are excluded from doctor patient encounters in general practice?. Association for Medical Education in Europe Conference (AMEE) 2018, Basel, Switzerland.
Yates, Natasha ; Smith, Jane W ; Ajam, Reza ; Mellersh-Etherton, Holly-Jane. / Are we missing something? What are medical students missing out on, and why, when they are excluded from doctor patient encounters in general practice?. Association for Medical Education in Europe Conference (AMEE) 2018, Basel, Switzerland.
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abstract = "Background: Medical training uses the apprentice model,but medical students are excluded from doctor patientencounters during placements so miss out on learningopportunities. There is little understanding of why patientsdo not want medical students present. Consent frompatients is essential prior to encounter, but where consentis asked, and by whom varies, and may be repeated, oranticipated on the patient's behalf. Research in Australiafound that 70 -90{\%} of patients said they would {"}neverrefuse{"} to have a student in the room. But this is not whatour students are telling us occurs during their placements.Method: We are collecting data from medical studentsduring their GP placements to explore why they are notbeing allowed into consultations. Each participant is askedto complete a short survey each time they are excludedfrom an encounter during their GP placements.Quantitative information is collected about thedemographics of the student, GP, practice, and patient;also who asked for consent, and when; plus the frequencyof exclusions. Qualitative data is provided by free textanswers about the reasons for exclusion, the nature of theconsultation, any cultural issues, and the students feelingsregarding exclusion.Results: Male students are more likely to be excluded bymale GPs seeing female patients, however male studentswith female GPs were excluded more frequently.The age range of excluded patients was 20 to 50 yearsMost students were present when consent was asked, thiswas mostly asked by the doctor, in the waiting orconsulting room, but many were not. It was more likely forthe doctor to ask the student to leave than the patient.Mental and sexual health were commonly quoted reasonsfor exclusion.Conclusion: It is important to better understand studentexclusions from patient encounters to address the gaps inclinical experience. It may be possible to stop some of theexclusions, for example if the patient's decision isanticipated incorrectly.Take-home message: Improved insight about the issuescausing student exclusions, will improve our ability toeither prevent this happening, or compensate the lostlearning",
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year = "2018",
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language = "English",
note = "Association for Medical Education in Europe Conference (AMEE) 2018, AMEE ; Conference date: 25-08-2018 Through 29-08-2018",
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Yates, N, Smith, JW, Ajam, R & Mellersh-Etherton, H-J 2018, 'Are we missing something? What are medical students missing out on, and why, when they are excluded from doctor patient encounters in general practice?' Association for Medical Education in Europe Conference (AMEE) 2018, Basel, Switzerland, 25/08/18 - 29/08/18, .

Are we missing something? What are medical students missing out on, and why, when they are excluded from doctor patient encounters in general practice? / Yates, Natasha; Smith, Jane W; Ajam, Reza; Mellersh-Etherton, Holly-Jane.

2018. Association for Medical Education in Europe Conference (AMEE) 2018, Basel, Switzerland.

Research output: Contribution to conferencePresentationResearchpeer-review

TY - CONF

T1 - Are we missing something? What are medical students missing out on, and why, when they are excluded from doctor patient encounters in general practice?

AU - Yates, Natasha

AU - Smith, Jane W

AU - Ajam, Reza

AU - Mellersh-Etherton, Holly-Jane

PY - 2018/8

Y1 - 2018/8

N2 - Background: Medical training uses the apprentice model,but medical students are excluded from doctor patientencounters during placements so miss out on learningopportunities. There is little understanding of why patientsdo not want medical students present. Consent frompatients is essential prior to encounter, but where consentis asked, and by whom varies, and may be repeated, oranticipated on the patient's behalf. Research in Australiafound that 70 -90% of patients said they would "neverrefuse" to have a student in the room. But this is not whatour students are telling us occurs during their placements.Method: We are collecting data from medical studentsduring their GP placements to explore why they are notbeing allowed into consultations. Each participant is askedto complete a short survey each time they are excludedfrom an encounter during their GP placements.Quantitative information is collected about thedemographics of the student, GP, practice, and patient;also who asked for consent, and when; plus the frequencyof exclusions. Qualitative data is provided by free textanswers about the reasons for exclusion, the nature of theconsultation, any cultural issues, and the students feelingsregarding exclusion.Results: Male students are more likely to be excluded bymale GPs seeing female patients, however male studentswith female GPs were excluded more frequently.The age range of excluded patients was 20 to 50 yearsMost students were present when consent was asked, thiswas mostly asked by the doctor, in the waiting orconsulting room, but many were not. It was more likely forthe doctor to ask the student to leave than the patient.Mental and sexual health were commonly quoted reasonsfor exclusion.Conclusion: It is important to better understand studentexclusions from patient encounters to address the gaps inclinical experience. It may be possible to stop some of theexclusions, for example if the patient's decision isanticipated incorrectly.Take-home message: Improved insight about the issuescausing student exclusions, will improve our ability toeither prevent this happening, or compensate the lostlearning

AB - Background: Medical training uses the apprentice model,but medical students are excluded from doctor patientencounters during placements so miss out on learningopportunities. There is little understanding of why patientsdo not want medical students present. Consent frompatients is essential prior to encounter, but where consentis asked, and by whom varies, and may be repeated, oranticipated on the patient's behalf. Research in Australiafound that 70 -90% of patients said they would "neverrefuse" to have a student in the room. But this is not whatour students are telling us occurs during their placements.Method: We are collecting data from medical studentsduring their GP placements to explore why they are notbeing allowed into consultations. Each participant is askedto complete a short survey each time they are excludedfrom an encounter during their GP placements.Quantitative information is collected about thedemographics of the student, GP, practice, and patient;also who asked for consent, and when; plus the frequencyof exclusions. Qualitative data is provided by free textanswers about the reasons for exclusion, the nature of theconsultation, any cultural issues, and the students feelingsregarding exclusion.Results: Male students are more likely to be excluded bymale GPs seeing female patients, however male studentswith female GPs were excluded more frequently.The age range of excluded patients was 20 to 50 yearsMost students were present when consent was asked, thiswas mostly asked by the doctor, in the waiting orconsulting room, but many were not. It was more likely forthe doctor to ask the student to leave than the patient.Mental and sexual health were commonly quoted reasonsfor exclusion.Conclusion: It is important to better understand studentexclusions from patient encounters to address the gaps inclinical experience. It may be possible to stop some of theexclusions, for example if the patient's decision isanticipated incorrectly.Take-home message: Improved insight about the issuescausing student exclusions, will improve our ability toeither prevent this happening, or compensate the lostlearning

M3 - Presentation

ER -

Yates N, Smith JW, Ajam R, Mellersh-Etherton H-J. Are we missing something? What are medical students missing out on, and why, when they are excluded from doctor patient encounters in general practice?. 2018. Association for Medical Education in Europe Conference (AMEE) 2018, Basel, Switzerland.