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What do general practitioners do differently when consulting with a medical student?
Lucie Walters1, David Prideaux, Paul Worley
1Flinders University, Rural Clinical School, Flinders University, South Australia, Australia. lucie.walters@flinders.edu.au
Medical Education
|March 3, 2009
Summary
General practitioners (GPs) teaching medical students in consultations do not extend appointment times. GPs adjust activities, spending less time on examination and management, but more time on history-taking and teaching to meet patient and student needs.
Area of Science:
- Medical Education
- General Practice
- Clinical Communication
Background:
- Medical students often see patients independently before general practitioner (GP) supervision.
- This practice aims to meet patient and student needs without prolonging consultation times.
Purpose of the Study:
- To quantify and compare GP consultation activities with and without students present.
- To understand how GPs manage consultation time effectively when teaching.
Main Methods:
- Prospective cohort study involving 523 videotaped general practice consultations.
- GP activities were analyzed in 15-second intervals using a modified Davis observation code.
- Mixed-effects models were used to calculate estimated marginal means, controlling for confounding factors.
Main Results:
- GPs precepting students spent significantly less time on patient examination (-37s), management (-41s), and clerical tasks (-1m 31s).
- GPs spent significantly more time taking history from both patient and student (+39s) and teaching students (+1m 10s).
Conclusions:
- GP consultation activities significantly change when precepting students.
- GPs reallocate time, focusing more on history and teaching, and less on examination, management, and clerical duties.
- This requires different clinical activity organization and processing skills compared to solo consulting.
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