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Remote consulting has become part of the medical student clinical experience in primary care, but little research exists regarding the impact on learning. To describe the experiences of General Practitioner (GP) educators and medical students in using student-led remote consultations as an educational tool. A qualitative, explorative study conducted at four UK medical schools. GP educators and medical students were purposively sampled and interviewed. Nine themes arose: practical application, autonomy, heuristics, safety, triage of undifferentiated patients, clinical reasoning, patient inclusion in student education, student–patient interaction, and student–doctor interaction. Remote consulting has become part of the clinical placement experience. This has been found to expose students to a wider variety of clinical presentations. Verbal communication, history-taking, triage, and clinical reasoning skills were practised through remote consulting, but examination skills development was lacking. Students found building rapport more challenging, although this was mitigated by having more time with patients. Greater clinical risk was perceived in remote consulting, which had potential to negatively impact students’ psychological safety. Frequent debriefs could ameliorate this risk and positively impact student–doctor relationships. Student autonomy and independence increased due to greater participation and responsibility. Pre-selection of patients could be helpful but had potential to expose students to lower complexity patients. Practice pointsRemote consulting confers unique educational benefits.Remote consulting can help develop history-taking and communication skills, as well as clinical reasoning skills.The psychological safety of the student and the supervisory risk of the tutor can be impacted by remote consulting, but frequent debriefs between the student and tutor can help mitigate this risk.Learning how to conduct remote, and face-to-face consultations is important in medical education. Practice points Remote consulting confers unique educational benefits. Remote consulting can help develop history-taking and communication skills, as well as clinical reasoning skills. The psychological safety of the student and the supervisory risk of the tutor can be impacted by remote consulting, but frequent debriefs between the student and tutor can help mitigate this risk. Learning how to conduct remote, and face-to-face consultations is important in medical education.

> ‘Across the bay I heard the surgeon ask about the decorative button sewn delicately onto a night gown allowing access to the wound where a breast once was. He tried to garner interest from the anaesthetist in the family story of the button’s creation. I breathed in the humanity as I waited for him to come round to me with news of my op.’ > > (Louise Younie, cancer experience reflection, 2019) The clinical encounter sits at the heart of all medical practice. This may be a place of short exchanges, evaluation, and explanation. It may also be a sacred place of hope or despair, a liminal space that sits somewhere between life and death, a sharing of vitality, fragility, and mortality.1 The complexity and wonder of the individual patient encounter should not be underestimated. A collision of two — sometimes more — diverse universes of lived experience, seeking, in a short space and time, to work together on some of the most life-defining, world-fracturing experiences that patients go through. In this article we consider the ‘selves’ present in the clinical encounter2 and how creative enquiry can help to open up the space in-between, a space that is owned by neither but which might be shaped by both.3 Winnicott4 has termed this space ‘the third space’, within which the contours of self and the other might be perceived, where mutual assertion and recognition might lead to the emergence of meaning and fresh perspectives.3 Attending to this in-between space …

> ‘Practice is a form of art and practitioners are a particular variety of artist.’ 1 As a young GP in 2006 and new to the blood, sweat, and tears of practice, I found myself at a narrative medicine conference exploring a difficult consultation. Through creative writing and dialogue about ‘the girl in black’, who entered and left my room fruitlessly, it became evident that I was catching her sense of helplessness and responding by offering solutions that made me feel better. This revelation emerged in a moment but transformed my practice forever. Creative enquiry has been described in the research world as: ‘... the making of artistic expressions … as a primary way of understanding and examining experience.’ 2 This may involve poetry, photography, painting, or any art form coupled with reflective writing. Creative enquiry allows for imaginative engagement with one’s own experience as well as trying out someone else’s shoes. But why invite creative reflective thinking on practice when creative exploration can feel uncomfortable, unfamiliar, and exposing? A medical student on a creative enquiry module wrote: ‘The arts and the “human side” of medicine are scoffed at by many medical students.’ 3 In this article we draw on our experience within under- and postgraduate education3,4 to show that the arts can play a significant role in enlarging human understanding through, for example, inviting participants to reframe experiences, engage with multiple perspectives, embrace other languages of expression, and …

I never made a painting as a work of art, it’s all research. Pablo PicassoVisual images have a long and interwoven history with medicine, from anatomical drawings such as those of Leonardo Da Vinci (1452-1519) to the use of textbook illustrations or photographs of disease, and radiological images of the internal structures of the body. There is a multitude of paintings that offer commentary on the doctor (Park and Park 2004) and medical practice more generally, as well as doctors who have picked up the brush themselves and engaged in painting (Weisz and Albury 2010). However, engagement with visual art as part of the learning process, to develop skills, explore practice or reflect on experience is a much more recent phenomenon. Visual art invites human meaning making through symbol, metaphor and imagery (Elliott 2011), often transcending time and culture (Schaff et al. 2011). Art celebrates existence and yet does not shy away from that which disturbs or is paradoxical (Elliott 2011). It is a means of responding to and exploring the world – both for the child with shapes and colours of all dimensions and for the professional artist seeking to critique or transform (Seeley and Reason 2008). In this chapter I consider the contested penetration of the visual artsinto the arena of medical education as part of the wider medical humanities (sometimes referred to as ‘health humanities’) movement. I review what the visual arts may have to offer educationally, particularly in the area of practice development, as well as the challenges of integration of visual art into the undergraduate curriculum.

In this educational case study I describe how one student used words and painting to produce a creative interpretation and representation of an encounter with a patient. This creative opportunity to develop narrative competence has been available to first year undergraduate medical students at Bristol University for three years. Student creative pieces are often a mixture of raw, powerful, poignant and medically naive workings as students allow their imagination to help them step into the patient’s shoes. The student, Amy, visited Mrs Jones, a 50-year-old woman suffering with depression, in her home. Amy then produced a moving and vivid account of Mrs Jones, their meeting and how it affected her. She captured the illness narrative she had heard both through painting and a written reflection, presenting a story of severe depression and self-harming resulting from childhood abuse. Mrs …

Since 2004, medical students at the University of Bristol have been required as part of their core curriculum to submit creative works for assessment. This requirement, which we term, ironically, compulsory creativity, may be unique within medical education where arts-based modules are typically elective. Such courses often harness the insights of established artists and writers in the illumination of medical themes. Less commonly students are called upon to link their own creative work with clinical and other life experience. Occasions for students to develop such an interpretative voice are generally sparse but the benefits can be argued theoretically and practically. In this paper we explore the rationale for the inclusion of such opportunities, the ways in which we have woven creativity into the curriculum and the sorts of artistic outputs we have witnessed. Contextualised links to a wide range of original student works from the www.outofourheads.net website are provided, as is a range of student reflection on the creative process ranging from the bemused to the ecstatic. The paper provides a model and a guide for educationalists interested in developing artistic creativity within the medical curriculum. Keywords: creativity; arts; personal development (Published: 26 November 2010) Citation: Medical Education Online 2010, 15: 5394 - DOI: 10.3402/meo.v15i0.5394