Professor Kamila Hawthorne MBE

BACKGROUND: This study examined the processes of thinking and learning undertaken by general practitioners (GPs, family physicians) brought about by the presence of undergraduate medical students. METHOD: A qualitative study was undertaken using critical incident templates (a novel approach in this context) and focus groups. Data were analysed thematically, with iterative discussion between members of the study team after independent analysis. RESULTS: Thirty-eight critical incident templates were returned (40%), of which 27 (28%) were completed. Three themes were identified: challenges to the GP's thinking or learning behaviour (these included having to justify actions and answer questions); changes to the dynamic between doctor and patient (listening to discussion of their condition between doctor and student was reported to change the patient's experience); and additions to the GP's workload. Teaching made GPs' day longer and sometimes caused friction with colleagues. CONCLUSIONS: Our data elucidate a range of thinking and learning activities that are brought about by the presence of a student in a GP's consulting room. They show that there are a number of challenges that stimulate these activities. We recommend that undergraduate teaching in general practice be given greater recognition for the stimulus it provides for continuing professional development.

BACKGROUND: Although there is published research on the methods markers use in marking various types of assessment, there is relatively little information on the processes markers use in approaching a marking exercise. This qualitative paper describes the preparation and experiences of general practice (GP) teachers who undertake marking a written assessment in an undergraduate medical course. METHODS: Semi-structured interviews were conducted with seven of the 16 GP tutors on an undergraduate course. The purposive sample comprised two new markers, two who had marked for a couple of years and three experienced markers. Each respondent was interviewed twice, once following a formative assessment of a written case study, and again after a summative assessment. All interviews were audio-taped and analysed for emerging themes. A respondent validation exercise was conducted with all 16 GP tutors. RESULTS: Markers had internal concerns about their ability to mark fairly and made considerable efforts to calibrate their marking. They needed guidance and coaching when marking for the first time and adopted a variety of marking styles, reaching a decision through a number of routes. Dealing with pass/fail borderline scripts and the consequences of the mark on the student were particular concerns. Even experienced markers felt the need to calibrate their marks both internally and externally CONCLUSION: Previous experience of marking appears to improve markers' confidence and is a factor in determining the role which markers adopt. Confidence can be improved by giving clear instructions, along with examples of marking. The authors propose that one method of providing this support and coaching could be by a process of peer review of a selection of papers prior to the main marking. New markers in particular would benefit from further guidance, however they are influenced by others early on in their marking career and course organisers should be mindful of this when arranging double marking.