Barbour, J, Park, S, Jensen, K, McDonald, P, McKinley, RK, Randles, H, Alberti, H and Marshall, H (2019) Facilitators and barriers to teaching undergraduate medical students in general practice. Medical Education, 53 (8). pp. 778-787. ISSN 0308-0110

[thumbnail of Barber_et_al-2019-Medical_Education.pdf]
Barber_et_al-2019-Medical_Education.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (240kB) | Preview
[thumbnail of 2019.03.01 F&B final accepted Med Ed.docx] Text
2019.03.01 F&B final accepted Med Ed.docx - Accepted Version
Available under License Creative Commons Attribution Non-commercial.

Download (229kB)


Globally, primary healthcare is facing workforce shortages. Longer and higher quality placements in primary care increase the likelihood of medical students’ choosing this specialty. However, recruitment and retention of community primary care teachers is challenging. Relevant research is predominantly from the 1990s. We seek to understand contemporary facilitators and barriers for GP (general practitioner) engagement with undergraduate education. Communities of Practice (COP) theory offers a novel conceptualisation which may be pertinent in other community-based teaching settings.

Semi-structured interviews were undertaken with 24 GP teachers at four UK Medical Schools. We purposively sampled: GPs new to teaching, established GP teachers and GPs who have recently stopped. We undertook NVIVO-assisted deductive and inductive thematic analysis of transcripts. COP theory was used to interpret data.

COP theory illustrated that teachers negotiate membership of three communities of practice: clinical practice, the medical school and a community of teachers. Delivery of clinical care and teaching can be integrated or exist in tension. This can depend upon the positioning of teaching and teacher as central or peripheral to the clinical COP. Remuneration, workload, space and expansion of GP trainee numbers impact on this. Teachers did not identify strongly as members of the medical school or a teaching community. Perception of membership was be affected by medical school communication and support. We demonstrate gaps in medical school recruitment.

This research demonstrates the marginalisation of primary care-based teaching and proposes a novel explanation rooted in COP theory. Concepts including identity and membership may be pertinent to other community-based teaching settings. We recommend that medical schools review and broaden recruitment methods. Teacher retention may be improved by optimising the interface between medical schools and teachers, fostering a teaching community, increasing professional rewards for teaching involvement and altering medical school expectations of learning in primary care.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Wiley at - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: medical students, teaching, general practice
Subjects: L Education > L Education (General)
R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 06 Mar 2019 13:27
Last Modified: 23 Apr 2020 01:30

Actions (login required)

View Item
View Item