Medical students in general practice: students' learning experiences and perspectives from supervisors and patients

Sammanfattning: During the last decades considerably more of medical students’ clinical training has shifted into general practice. The aim of this thesis was to study medical students’ learning experiences in general practice, work-based assessment, and the perspectives of GP supervisors and patients. Results Senior students’ learning in a portfolio pilot was mainly on patient-centred communication, clinical reasoning and professional development. Junior students appreciated contact with good role models. Long-term use of a work-based assessment tool for senior students significantly increased the proportion of specific goals and feedback to students, supervisors’ stringency of the assessment, and their satisfaction with the tool. The work-based assessment and the portfolio assessment had acceptable reliability, validity and educational impact. GPs were highly motivated teachers and took pride in their discipline. In their teaching of junior students, their main reward was improved quality of own work. Their predominant problem was lack of time for teaching, but relationship to patients and provision of feedback were other concerns. Teacher training was required. The vast majority of patients were satisfied with both senior and junior student encounters, even though caution was recommended when patients attend for sensitive matters. Patients perceived their teaching role mainly as facilitators of students’ development of professional skills.