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Student assistantships: bridging the gap between student and doctor

Authors Crossley J, Vivekananda-Schmidt P

Received 21 January 2015

Accepted for publication 16 March 2015

Published 15 June 2015 Volume 2015:6 Pages 447—457

DOI https://doi.org/10.2147/AMEP.S62822

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Anwarul Azim Majumder


James GM Crossley,1,2 Pirashanthie Vivekananda-Schmidt1

1University of Sheffield School of Medicine, Sheffield, 2Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK

Abstract: In 2009, the General Medical Council UK (GMC) published its updated guidance on medical education for the UK medical schools – Tomorrow's Doctors 2009. The Council recommended that the UK medical schools introduce, for the first time, a clinical placement in which a senior medical student, “assisting a junior doctor and under supervision, undertakes most of the duties of an F1 doctor”. In the UK, an F1 doctor is a postgraduation year 1 (PGY1) doctor. This new kind of placement was called a student assistantship. The recommendation was considered necessary because conventional UK clinical placements rarely provided medical students with opportunities to take responsibility for patients – even under supervision. This is in spite of good evidence that higher levels of learning, and the acquisition of essential clinical and nontechnical skills, depend on students participating in health care delivery and gradually assuming responsibility under supervision. This review discusses the gap between student and doctor, and the impact of the student assistantship policy. Early evaluation indicates substantial variation in the clarity of purpose, setting, length, and scope of existing assistantships. In particular, few models are explicit on the most critical issue: exactly how the student participates in care and how supervision is deployed to optimize learning and patient safety. Surveys indicate that these issues are central to students' perceptions of the assistantship. They know when they have experienced real responsibility and when they have not. This lack of clarity and variation has limited the impact of student assistantships. We also consider other important approaches to bridging the gap between student and doctor. These include supporting the development of the student as a whole person, commissioning and developing the right supervision, student-aligned curricula, and challenging the risk assumptions of health care providers.

Keywords: apprenticeship, workplace learning, competency

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