Summary of systematic review
| University | Author (year) | Description of CBE | Type of evaluation | Evaluation findings | Evaluation method | |
|---|---|---|---|---|---|---|
| 1. | Aberdeen (University of) | Sinclair et al (2006)32 | Years 1–3: GP-led patient-centred tutorials and clinical sessions Year 4: 5-week community-themed clinical rotation Year 5: optional 7-week general practice attachment | Impact assessment | Increase in students interested in pursuing a career in general practice as curriculum progressed Exposure to community settings had positive effect on students’ attitudes towards a career in general practice | Questionnaire—Student Survey |
| 2. | Barts and The London School of Medicine and Dentistry | Nicholson et al (2001)31 | Year 4: Community-based Module prior to obstetrics and gynaecology hospital placement | Implementation assessment Impact assessment | Adequate clinical exposure within the community Variation in opportunities to gain relevant experience in clinical exposure Students found small-group learning and GP attitudes to be beneficial to their learning Multidisciplinary interaction enhanced their clinical experience Successfully Incorporated specialty with community environment | Questionnaire—Student Feedback |
| 3. | Birmingham (University of) | Parle et al (1999)7 | Years 1–4: General practice practice visits | Implementation assessment Impact assessment | Students found GP tutors to be encouraging GP tutors reported: ▸ Enhanced development of both students and GPs ▸ Organisational drawbacks | Questionnaire—Student Feedback |
| 4. | Cambridge (University of) | Alderson and Oswald (1999)33 | 15-month attachment to general practice practice | Implementation assessment | Adequate exposure of all clinical specialities was achieved Individual experiences may vary due to variation in opportunities | Student log Diary |
| 5. | Cambridge (University of) | Oswald et al (2001)17 | 15-month attachment to general practice practice | Implementation assessment Impact assessment Cost assessment | Course was feasible in terms of organisation and student logistics Extended relationships with patients enriched students’ clinical experience No difference in academic performance on formative assessments between students undertaking community-based versus hospital-based teaching Reported costs were less than the average ‘SIFT into the Future’ student-year | Debriefing Sessions—Student Feedback |
| 6. | Cardiff University | Grant and Robling (2006)24 | Year 5: General practice attachment | Needs assessment Impact assessment | All parties found the attachment to be positive general practices felt more confident clinically through teaching students Primary care team felt team ethic was strengthened | Discussion Meetings—Primary Care Team Feedback Interviews—general practice Feedback |
| 7. | Dundee (University of) | Muir (2007)25 | Year 1–3: Patient Follow-up in the community | Impact assessment | Students were able to gain a better insight into patient-centred medicine as a result of the attachment Early exposure to patients evoked student enthusiasm | Focus Group—Student Interview |
| 8. | Glasgow (University of) | Davison et al (1999)6 | Year 1: Educational exercise of three teaching sessions | Needs assessment | Students found that learning objectives were met through community-themed educational exercises | Questionnaire—Student Evaluation |
| 9. | Glasgow (University of) | Mullen et al (2010)26 | Year 1: Patient interviews in the community | Impact assessment | Integration of community-based exercise positively influenced students’ attitudes in regards to: ▸ Understanding of psychosocial model of illness ▸ Development of empathy | Questionnaire—Student Evaluation |
| 10. | Imperial College | Powell and Easton (2012)27 | Year 3: 3-session surgical module conducted by general practice tutors | Implementation Assessment | Surgical teaching delivered by general practices was favourable based on the following benefits: ▸ Protected time for learning ▸ Regular access to suitable patients ▸ Learner-centred teaching However GP lacked specialist knowledge, and teaching was not directed by syllabus | Focus group—Student Interview |
| 11. | King's College London | Seabrook et al (1999)8 | Year 1: Healthcare Team Module Year 2: Special Study Module | Implementation assessment Impact assessment | Community-based courses are feasible and well-received by students Multidisciplinary teamwork is encouraged positively | Questionnaires—Student feedback Small-group discussions—Student feedback Focus groups—Tutor Feedback |
| 12. | King's College London | Gavin et al (2002)19 | Year 2—Community-based Special Study Module | Impact assessment | Student appreciation of: ▸ Psychosocial needs of patients ▸ Inter-professional teamwork | Questionnaire survey: students and teaching professionals |
| 13. | Leeds (University of) | Thistlethwaite and Jordan (1999)10 | Year 3: general practice-led days in community setting | Impact assessment | Early community exposure to patient-centred consultations allowed students to: ▸ Appreciate importance of patient-centred communication ▸ Gain more confidence in their abilities Direct observation and feedback from clinician was beneficial to student learning | Focus Groups—Student Interviews |
| 14. | Leeds (University of) | Thistlethwaite (2000)13 | Year 3: general practice-led days in community setting | Implementation assessment Impact assessment | Positive feedback from students: ▸ Community environment allowed ease of patient-centre approach ▸ Students now routinely ask about patient concerns Positive feedback from general practices: ▸ Teaching was motivating and gratifying | Questionnaire—Student Feedback |
| 15. | Leeds (University of), Sheffield (University of) and Hull York Medical School | Macallan and Pearson (2013)42 | Years 3–4: General practice attachment | Implementation assessment | general practice enthusiasm and engagement crucial to determining the quality of the placement Well-organised general practice were valued by students Students felt that general practices needed to be better informed of placement outcomes | Focus Groups—Student Interviews |
| 16. | Leicester (University of) | Lennox and Petersen (1998)30 | Year 3: Patient Study | Needs assessment Implementation assessment Impact assessment | Precourse needs assessment of CBE programme based on students’ opinions of: ▸ Structure of course ▸ Method of implementation ▸ Assessment format End-course impact assessment revealed that: Course effectively achieves GMC recommendations for ‘Tomorrow's Doctors’ ▸ End-Course Implementation assessment revealed that: Continuation of the course was supported by all participants (students, patients and agencies) | Questionnaire—Student, Patient and Agency Feedback |
| 17. | Leicester (University of) | Hastings et al (2000)11 | Year 3 or 4: General practice practice-based teaching | Implementation assessment | Comparison of practice-based & hospital-based teaching with respect to the ‘teaching content’ and the ‘teaching processes revealed students favouring practice-teaching in both respects | Questionnaire—Student Feedback |
| 18. | Leicester (University of) | Anderson et al (2003)21 | Year 3: Community placement and Patient study | Implementation assessment Impact assessment | Implementation assessment: ▸ Continuation of course was well-supported by students, patients and staff ▸ Impact assessment: ▸ Course effectively achieved students’ learning objectives in community education. ▸ Positive patient and staff experience in their involvement in medical education | Questionnaires—Student and Patient Feedback Focus Groups—Staff Interviews |
| 19. | Liverpool (University of) | Watmough (2012)28 | Years 1–4: Community-based teaching Year 5: Community placement | Implementation assessment Impact assessment | Implementation assessment: ▸ Increased curriculum time on community-based teaching was appreciated in terms of clinical skills practice, and understanding the role of primary care Impact assessment: ▸ Reformed course achieved significantly better understanding on the relationship between primary, social care and hospital care | Questionnaires and Interviews—Student Feedback |
| 20. | Liverpool (University of) | Watmough et al (2012)43 | Years 1–4: Community-based teaching Year 5: Community placement | Impact assessment | Impact assessment: ▸ Graduates from reformed curriculum had more confidence in clinical skills & communication skills, but felt less well prepared with their medical knowledge | Questionnaires—Student Feedback |
| 21. | Manchester (University of) | Jones et al (2002)20 | Years 3–4: General practice teaching in core modules Year 5: Community placement | Impact assessment | Overall positive impact on students’ perception of preparedness in competencies and skills for entering professional practice. This includes a significantly improved understanding of the role of primary care. Students also had no disadvantage to graduates of traditional programme in terms of basic science and clinical knowledge | Questionnaires—Student and Supervisor Feedback |
| 22. | Newcastle University Medical School | Stacy and Spencer (1999)9 | Year 2: Patient study projects | Impact assessment | Patients have a positive perception of their role in community-based teaching. They also feel that they benefited from participation | Interviews |
| 23. | Royal Free and University College Medical Schools | Walters et al (2003)22 | Year 4: Community education integrated in the psychiatry attachment | Impact assessment | Impact of participation in teaching on patients: ▸ Mainly positive experience (more balanced doctor–patient relationship, and some had therapeutic benefit) ▸ However a few patients found the teaching encounter distressing | Questionnaire—Patient Survey Interviews—Patients, Students and general practice tutor Feedback |
| 24. | Royal Free and University College Medical Schools | Jones et al (2005)23 | Intercalated BSc in Primary Health Care | Impact assessment | Students saw benefit in: ▸ Development of critical approach and skills relevant to medicine ▸ Adding depth to views on general practice and primary care | Interviews—Student Feedback |
| 25. | Sheffield (University of) | Howe and Ives (2001)15 | Year 4:General practice placement | Impact assessment | Increased exposure to primary and community care alters career intention, and enhances the view of the role of primary care | Questionnaires—Student Feedback |
| 26. | Sheffield (University of) | Howe (2001)14 | Year 4: General practice placement | Needs assessment | Students value community-based learning which have the qualities of: ▸ Person-centred clinical methods and learning contexts ▸ Positive attitude and committed general practice tutors and primary care teams | Questionnaire—Student feedback |
| 27. | University College London | Coleman and Murray (2002)18 | general practice placement | Impact assessment | Patients mainly felt positive about participating in community-based teaching. However there were also negative aspects that may concern patients There may also be shifts in the doctor–patient relationship | Interviews—Students and general practice tutor Feedback |
| 28. | University College London | Murray et al (2001)16 | general practice placement as part of the internal medicine clerkship | Implementation assessment | ▸ Time spent on teaching and learning activities were similar in both settings ▸ Supervised interaction with patients (which was experienced mainly with the general practice) is perceived by students as the most educationally valuable and enjoyable activity ▸ Patient-based learning was highly valued | Student Log Diary |
| 29. | University College London | O'Sullivan et al (2000)12 | Year 3: Community Medicine placement | Implementation assessment Impact assessment | Implementation assessment ▸ Basic clinical skills could be learnt in both settings, but general practice was better for learning of communication skills & psychosocial issues ▸ General practice teaching was advantageous in terms of: quality of teaching, tutors’ teaching attitude, teaching methods, course organisation. Impact assessment revealed that: ▸ General practice enabled students to increase their confidence and competence | Interviews—Student Feedback Focus Groups—Student Feedback |