The 'flipped placement': can blended learning enhance undergraduate general practice placements and alleviate capacity issues?

Background
Placements in general practice play an important role in undergraduate medical education and have a strong influence on students and junior doctors choosing careers in general practice. However GP educators report that practice workloads and lack of space are major challenges impacting medical student placements. Without increasing capacity these issues are expected to worsen as increasing numbers of learners compete for limited space.

Summary of Work
Kent and Medway Medical School (KMMS) students undertake six one-week-long placements in general practice in their first and second years termed ‘immersion weeks’. Each immersion week has a theme which corresponds with on-campus learning for systems-based modules. In the 2022/23 academic year the immersion week structured was changed, with one day of the week replaced with a half day of campus teaching and a half day of ‘asynchronous learning’. The asynchronous learning comprises an e-learning lesson created using the Xerte Online Toolkit and hosted on the university virtual learning environment. The content is designed to complement students’ learning on placement while referencing their on-campus learning in systems-based modules. Each lesson includes a mixture of case-discussions, multimedia and interactive elements which students can complete at their own pace.

Summary of Results
All year one and two students were invited to provide feedback after the third immersion weeks. 78/131 (60%) year one and 85/106 (80%) year two students responded. On a 5-point Likert scale 52/78 (67%) of year one students and 63/85 (74%) year two students either agreed or strongly agreed with the statement ‘the asynchronous material was helpful in supporting my learning’. Students found the asynchronous lessons to be a useful way of consolidating knowledge ahead of the placement and found it beneficial that they could complete it at their own pace. However issues with technology caused frustration for some.

Discussion and Conclusion
Most students found asynchronous learning helpful in supporting their learning. This highlights the potential for a blended learning approach utilising e-learning to enhance undergraduate general practice placements and to ease pressures on capacity in primary care.

Take Home Messages
A ‘flipped placement’ approach utilising e-learning can complement undergraduate primary care placements and assist in easing the pressures of capacity for teaching practices.