Students' and tutors' experiences of remote 'student-patient' consultations.

BACKGROUND: Remote consulting has become part of the medical student clinical experience in primary care, but little research exists regarding the impact on learning. AIM: To describe the experiences of General Practitioner (GP) educators and medical students in using student-led remote consultations as an educational tool. METHOD: A qualitative, explorative study conducted at four UK medical schools. GP educators and medical students were purposively sampled and interviewed. RESULTS: Nine themes arose: practical application, autonomy, heuristics, safety, triage of undifferentiated patients, clinical reasoning, patient inclusion in student education, student-patient interaction, and student-doctor interaction. DISCUSSION: Remote consulting has become part of the clinical placement experience. This has been found to expose students to a wider variety of clinical presentations. Verbal communication, history-taking, triage, and clinical reasoning skills were practised through remote consulting, but examination skills development was lacking. Students found building rapport more challenging, although this was mitigated by having more time with patients. Greater clinical risk was perceived in remote consulting, which had potential to negatively impact students' psychological safety. Frequent debriefs could ameliorate this risk and positively impact student-doctor relationships. Student autonomy and independence increased due to greater participation and responsibility. Pre-selection of patients could be helpful but had potential to expose students to lower complexity patients.[Box: see text].

Nurturing the Human Dimension in Digital and Medical Spaces Through Pedagogy of Care - a Case of Creative Enquiry.

The COVID-19 pandemic ushered in digital learning experiences to front and centre of medical education in disruptive ways. As the pandemic subsides students and educators sigh in relief, longing to move away from the loneliness and disconnection and back to the norms of face-to-face learning and consulting. In the field of medical education however, the need for digital education has exponentially increased over the decade with strong evidence for future growth. We face the pressure of increasing student numbers on clinical placement and some students now desire or even need hybrid options for the flexibility of time, place, and pace. There is persistent criticism that digital education lacks human connection. This paper argues, however, that it is possible and vital to humanise the virtual learning experience, though particular attention needs to be given to digital pedagogy and relational aspects of learning and teaching. Drawing on Noddings' pedagogies of care and her theoretical model, we unpack one case-study of a medical education elective course that transitioned online during the pandemic. The aim of this paper is to engage medical educators with the pedagogy of care and relational pedagogy literature, which are currently almost absent from the medical education literature, as applied to the digital education realm. Core themes include modelling care and connection, enabling dialogue, inviting student engagement and practice in caring for each other and supporting the deeper work of being present themselves and confirming each other. Limitations and implications for future research will also be explored.

Beginner's mind.

The concept of 'beginner's mind' invites the expert medical professional to be present to their patients, remaining curious and responsive in the face of the individuality of illness. Each patient is a universe of unknowns, presenting with suffering which cannot always be classified with a diagnosis. Improvisation and openness may not just benefit our patients enduring their patient journeys but may also revive and reconnect us with our own humanity. WHY THIS MATTERS TO ME: My experience as cancer patient brought home to me the value of encountering a doctor who was present and able to listen and respond to me as an individual. It did not necessarily take longer, but was about an attitude of heart.Like any professional, as GPs we are at risk of presumption and habitual thinking. Beginner's mind, that is recapturing the openness and curiosity modelled to us by children, can powerfully transform the medical encounter, allowing space for emergence of patient perspective and doctor response. KEY MESSAGE: Embrace curiosity and learning into our expert clinical practice.

'Compulsory creativity': rationales, recipes, and results in the placement of mandatory creative endeavour in a medical undergraduate curriculum.

Since 2004, medical students at the University of Bristol have been required as part of their core curriculum to submit creative works for assessment. This requirement, which we term, ironically, compulsory creativity, may be unique within medical education where arts-based modules are typically elective. Such courses often harness the insights of established artists and writers in the illumination of medical themes. Less commonly students are called upon to link their own creative work with clinical and other life experience. Occasions for students to develop such an interpretative voice are generally sparse but the benefits can be argued theoretically and practically. In this paper we explore the rationale for the inclusion of such opportunities, the ways in which we have woven creativity into the curriculum and the sorts of artistic outputs we have witnessed. Contextualised links to a wide range of original student works from the www.outofourheads.net website are provided, as is a range of student reflection on the creative process ranging from the bemused to the ecstatic. The paper provides a model and a guide for educationalists interested in developing artistic creativity within the medical curriculum.