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. Practice points Remote consulting confers unique educational benefits. Remote consulting can help develop history-taking and communication skills, as well as clinical reasoning skills. The psychological safety of the student and the supervisory risk of the tutor can be impacted by remote consulting, but frequent debriefs between the student and tutor can help mitigate this risk. Learning how to conduct remote, and face-to-face consultations is important in medical education.