Evaluating teaching quality in family medicine practice: A medical student perspective in Switzerland

Stefania Di Gangi, Oliver Senn, Andreas Plate

Keywords: family medicine / general practice, undergraduate medical education, teaching placement, educational quality

Background:

Teaching placements in family medicine practice (FMP) aim to motivate medical students to choose FMP as a career. Student evaluations are helpful to understand educational needs and to improve the quality of teaching provided. However, interpretation of these evaluations can be challenging, as the student-to-FMP ratios may be small.

Research questions:

1) How students experienced the FMP as a teaching environment to acquire the FMP skills. 2) How to identify a benchmark for the quality of teaching provided.

Method:

Retrospective, cross-sectional survey research recruiting all undergraduate fourth-year medical students at the University of Zurich, Switzerland, attending a mandatory placement in FMP during 2019-2022. The evaluation, 33 questions, focused on: communication and course content, course satisfaction, FMP environment, skills acquisition. FMPs in benchmark quality group were identified using a k-means cluster analysis algorithm, based on individual item average score on 14 indicator questions for “good teaching” and on the number of students per FMP.

Results:

A total of 713 students (response rate 81%) and 249 FMPs (median[interquartile-range]: 2[1,4] students per FMP) were included. Overall, 89% of the students were satisfied with the placement and 82% reported an increased confidence in clinical skills. Taking into account the quality indicator scores and the number of students per FMP, we identified a cluster of 26(10%) FMPs below the benchmark group score range. Placement in FMPs of this cluster was negatively associated with raised student motivation to choose FMP as a career.

Conclusions:

Our study described students' experiences in FMP and identified FMPs below educational quality benchmark, taking into account the risk of misinterpretation of students' experiences due to low student-to-FMP ratios. Proper identification of these FMPs could improve the quality of teaching with positive effects on students’ experience and their future career paths.

Points for discussion:

Are students good judgers of quality of teaching?

Can we optimize the placement of medical students in general practice?

What is the best way to approach the practitioners needing improvement (below the benchmark) for an internal evaluation process?