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

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