From serendipity to technology: use of a web-based information and booking system to improve clinical attachments at a district general hospital.

Background: Clinical attachments form a vital part of the learning experience for medical students but may vary in educational value. This paper describes a project intended to improve the quality of attachments at a District General Hospital in Devon, UK after negative feedback was received from students. Aims: To improve educational quality by providing information and choice for students. Method: The intervention was to set up a wéb - based system that allowed students to view before arrival all educational opportunities available, not only in the hospital but in the surrounding district. Students were contacted by email 2 weeks before their attachment and were then able to construct their own timetable from the menu of opportunities available. Results: The system was popular with students, recruited new providers of learning opportunities and also integrated learning across primary and secondary care. Conclusions: The intervention encouraged a sense of ownership of the learning experience as well as maximising the use of available learning resources. Practice points Clinical attachments form a vital part of medical student training but vary in educational quality. Conflict may arise from a clash of "discourses" between modern medical curricula emphasising active, self-directed learing styles and a traditional, "apprenticeship" based clinical environment. Web-based technology can be used to provide information and choice to students prior to attachments, thus increasing student autonomy and acting as a "bridge" between discourses. This qualitative study in a single UK health community found that such a system was workable, popular with students and also had the effect of widening the teaching base. The system is versatile and could be adapted to many situations. [ABSTRACT FROM AUTHOR]