Using fourth-year medical students' reflections to propose strategies for primary care physicians, who host students in their practices, to optimise learning opportunities

Setting and subjects: Fourth-year medical students at the University of Pretoria are required to work with a primary healthcare practitioner for two weeks. After the preceptorship, reflective photo-story reports on the students' experiences and personal and academic growth are submitted. Objectives: To identify whether the objectives of the preceptorship were met and to describe the experiences of students, the reflective reports were qualitatively analysed. A second purpose of the analysis was to propose strategies that could be implemented by the primary healthcare practitioners to optimise the learning experience of students in their practices. Design: A qualitative approach to analyse the narratives of the photo-story reports was used. Main and subthemes were identified from the topics that were thought about. Quotes from the narratives were selected to support the themes. Each of the quotes was then scrutinised to ascertain if evidence of learning had taken place. Results: The main themes were identified as: the impact that the visit had had on the student, the emotions that they had experienced, working with the physician, interacting with patients and the clinical care of patients. Learning was achieved under conditions that made the students feel comfortable, confident, happy and inspired; required their active participation; challenged them; inspired them to see the advantage of learning; and when feedback was given to them. Conclusion: Strategies for use by practitioners to optimise the learning experience of students in their practices were proposed. These included active student participation, reflection, the creation of a positive environment, student participation in challenging experiences, active learning and quality time spent with patients.