Dyad placement in general practice: interview study with Norwegian medical students and their clinical supervisors

Clinical placement for medical students in general practice is a key component of the primary healthcare curriculum and has proven to be a strong recruitment arena for general practice. Because of supervisor shortages and an increasing number of medical students, placing two students together with one supervisor is a potential option. While such dyad placement has been explored in undergraduate skills and simulation training, there is less research from teaching medical students in general practice. If a lack of capacity forces universities into new placement structures, it is important to evaluate the benefits and challenges in general practice settings. This study therefore aimed to investigate dyad placements in general practice.

We performed a qualitative study in which eight 6^th-year medical students and three clinical supervisors (general practitioners, GPs) were interviewed individually or in groups. All participants were involved in dyad placements at the University of Bergen, Norway, during spring 2023. Audio recordings from interviews were transcribed verbatim and analysed thematically using systematic text condensation. The theory of psychological safety was used to frame the discussion.

Dyad placements were organised in multiple ways according to preferences, needs and prerequisites, showing that there are many ways to make such placements work. Supervisors experienced feasibility despite their initial concerns about workload and time to follow up each student. They also illustrated situations where dyad placement could be challenging. Students saw many patients and assessed dyad placement as not to be a hindrance to this. The student dyad provided a safe space, resulting in rich learning experiences and enhanced social integration in the work environment at the surgery. Students learned from each other's clinical strengths.

Dyad placement added peer teaching and peer learning to students' clinical experiences. By supporting each other's presence and learning processes, the students experienced psychological safety, which is known to be a prerequisite for beneficial learning behaviour. We therefore argue that dyad placement can provide students with educational advantages. With a consulting room and sufficient patients available for the students, the supervisors assessed dyad placement as feasible in general practice.