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Table 3 Summary of participants’ perceptions of the benefits and risks of shared learning models

From: Vertically integrated shared learning models in general practice: a qualitative study

For Subtheme Benefits Risks
Learners Quality of teaching • Everyone challenges each other, encouraging debate and discussion • Junior learners require more 1:1 teaching
• Extra questions are asked that the individual learner did not think of • Attempting to meet needs of multiple levels of learners runs the risk of not meeting anyone’s learning needs
• The group can learn from the expertise, knowledge, skills of others in the group • Level may be too low or too advanced
• Learners discover different approaches to same problem • Less personalised teaching and fewer opportunities to address individual learning needs when compared to 1:1 teaching
• Provides early exposure to advanced skills for junior learners
• Learning increases for all levels
• Resources can be more easily shared
  Effectiveness of learning • Easier/safer to ask questions • Different clinical approaches may confuse learners
• A difficult topic explained to others can aid learners’ understanding • Shared learning models are unsuitable when learners:
• Shared learning is active learning because it requires more preparation and interaction compared to 1:1 1. Require remediation
2. Have a specific deficit that needs to be addressed
3. Are given personalised feedback
• Shared learning sessions are more likely to be structured and planned and may lead to better learning outcomes 4. Are observed by their supervisor
5. Have immediate learning needs
• Shared learning models are less effective for learning communication and procedural skills
  Group dynamics, interpersonal and personal issues • Takes pressure off the individual learners to answer all the questions • Learners less comfortable asking questions in group situation than 1:1 teaching
• More collegial, builds relationships, is enjoyable • One person may hijack the meeting
• Stimulating/supportive environment • Shy learners may not learn as much
• Learning in a group can spur everyone onto to greater efforts • Junior leaners fear imposing on senior learners
• Reduced feelings of isolation • Shared learning is unsuitable when learners have sensitive or embarrassing issues to discuss
• Being able to benchmark against peers improves self-confidence
• Confidence to acknowledge lack of knowledge or skills is less threatening if other learners demonstrate the same
• Being able to debrief and share difficult situations with other learners improves self-confidence
GP supervisor Financially rewarding • More financially rewarding due to increased clinical time and higher payment per hour of teaching  
Workplace satisfaction • Increased engagement and less repetition in teaching • More stressful than one-to-one
• Reduced workload due to time efficiency • May require more planning
• Less chance of burnout or stress  
Supervisor learns • Introduction to new techniques, information and theories by learners, often from those who recently came from big hospitals  
Maintaining teaching quality   • Different people require different teaching styles
• Teaching quality depends on GP’s practice, personality, experience and teaching style
• More difficult to address the needs of all levels of learners
Practice Financial efficiencies • More financially beneficial due to increased time to generate revenue  
Increased sustainability • Increased likelihood of sustainable practice in terms of financial viability and sustainable employability of general practitioners  
• Increased vitality in the practice
A quality improvement process • Provides a forum to standardise and improve patient management  
May increase practice workload • May require more planning
  • Lack of standardisation of teaching between practices