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Comparison of delivery modes for online medical education

Context and setting We present the format and the first year’s evaluation results of our Early Patient Contact Programme (EPCP) in the Year 2 curriculum. We implemented the EPCP during the 13-week Introduction to Clinical and Pathological Sciences block. We used a portfolio-driven, multisetting-based, experiential learning approach to teach patient interviewing skills to students. Why the idea was necessary Although early student)patient contact is generally seen as an educationally sound approach, the hospital setting seems not to be optimal. Previously, there was no structured patient contact programme in our curriculum. Teaching took place on an ad hoc basis during the clinical years and there was neither content nor method consensus among teachers. What was done In the preparation phase, an educational collaboration contract was signed with 20 primary health care centres (PHCCs). A computerised standardised patient laboratory was established. Using guidelines drawn from the Calgary-Cambridge Observation Guide to the Consultation and MAASGlobal (an instrument designed to rate the communication and clinical skills of doctors in consultations), a conceptual framework and a set of patient interview guidelines were developed. A total of 284 Year 2 students were divided into 3 main rotating groups and then into 32 subgroups, each consisting of 3 students. Teaching teams were formed, each composed of 1 clinical teacher and 1 general practitioner (GP) teacher and each in charge of 3–6 subgroups. Nine teacher training and programme development workshops were organised for GPs and faculty members. A student learning and assessment portfolio was developed. In the implementation phase, the programme included 8 hours of preparatory lectures, 3 half-day work sessions at PHCCs and hospital clinics, 9 SP encounters (in 3 doctor and 6 observational roles) and 3 group feedback sessions. In each session, teachers worked with 3–6 students and used the experiential learning cycle. Students were given feedback on the SP contacts by their peers and the SPs following the SP contact and from their GP teachers through the records. Evaluation of results and impact The EPCP was evaluated by: • student achievement: assessed with a portfolio (40%) and an SP-based performance examination (60%); • a student feedback questionnaire; • a student programme evaluation meeting, and • teachers’ SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis.