Communication

One tutor suggested that a ‘Scotland Undergraduate Teaching Portal’(M3) might help supervisors navigate working with different medical schools – a place where he could get information on the different expectations from each University in one place. The desire for further IT development may not be shared more widely as a couple of tutors expressed their frustration and difficulties using the

university’s virtual learning environment system which is used to share information with tutors. One described it as ‘impossible to work my way

through’ (F4) and another stated they had never actually logged in at all due to

their dislike of it as a process of acquiring information.

Communication from and with the medical schools is generally felt to be good. As well as clear course documentation, clearly identified and helpful academic

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and administrative contacts were felt to be key to supporting them in their teaching roles:

You know they are brilliant. You pick up the phone… to them and they can give you information. They can point you in the right direction. They give you a password to log into the right forms and they understand that they have [probably] emailed it to us five times already but…they don’t mind us phoning up going ‘I’m really sorry. I’m stuck. I know it's probably in an email somewhere [but] can you [help] me?’…I think it's so important to recognise that good admin support from the university is so, so important. (M3)

An area that caused specific concern from both an undergraduate and

postgraduate perspective was communication from the external organisations around learners in difficulty. While tutors reported support being readily available to help those that they had identified as struggling, they described a lack of information in advance of learners’ arrivals flagging those that may need additional support or who may present a potential patient safety concern.

I mean the big thing…is the information that we get from the

university…I still maintain that there needs to be more. …I know there [are] problems with data protection and confidentiality but we are in such an exposed…and privileged position as student tutors that

sometimes we would benefit from having a bit more background information…We are opening up our patients and our surgeries [up] to potentially quite…vulnerable people at stages of their career. (M3) We’ve had one or two difficulties with trainees where I don’t think POSTGRADUATE ORGANISATION has been particularly helpful. One of [the trainees] was arrested and charged with crimes of dishonesty and we were told that as he was innocent until proven guilty. They

wouldn’t be able to suggest that he shouldn’t…have access to the patients’ records or the patients…We just ignored POSTGRADUATE ORGANISATION and didn’t allow him access to the patients’ records but I thought that was really pretty poor. They also knew about it, having been told by the police, and decided not to bother telling us until the police arrived to arrest him one morning. (M10)

For those students that tutors identified as having concerns, more

communication back in response to their concern was desired. The need to maintain student confidentiality in this context was appreciated.

We have had medical students we've had concerns about. Not concerns about their performance. Concerns about nonattendance. We had one that was particularly bad and…we did our best to feed

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that back to the university but we don’t know what happened [after that]. Not that it's any of our business…but even if somebody just phoned you up and said…‘Okay… this is what we are going to do. You won’t necessarily hear of the outcome though.’ [That would be] fine. (F2)

As well as the GPs, the learners have to work across the boundaries. This could be most challenging for medical students as they only attend an individual practice for a maximum of five weeks. In contrast, FY doctors are embedded in practices for four months at a time and GP trainees for six months or a year. Several practices have produced induction packs to try to facilitate this

transition. These contain a range of information to ease the students’ transition into their practice. This includes the ‘rules’ relating to the attachment such as a reminder of dress code, the code of conduct and the rule of confidentiality. As well as rules, they also contain useful practice information e.g. transport information, surgery times, contact details, structure of teaching day. Several GPs describe sending these packs out to students in advance of placements to make them feel welcome and as a prompt for them to start thinking what they might want to get out of their time in general practice, in particular during their flexible sessions.

7.4.2.1 Activity Theory interpretation

These GPs are describing the challenges of boundary crossing (

Figure 7-7 Boundary crossing between teaching practices and external organisations ). The educational bodies and the GP educators have an assumed shared intended outcome in the form of supporting the learners in practice. AT can identify the tools and rules that either help or hinder the GPs and their learners navigating across those boundaries. Identifying contradictions gives opportunities for learning and induction packs and contacting learners prior to their

placements can be seen as an example of learning to facilitate boundary crossing for learners.

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Figure 7-7 Boundary crossing between teaching practices and external organisations