Teaching and learning in the clinical setting: a qualitative study of the perceptions of students and teachers

OBJECTIVE: To describe the perceptions of medical students and clinical teachers of teaching and learning in the clinical setting. DESIGN: Qualitative study of focus groups with undergraduate medical students and semistructured interviews with hospital consultant clinical teachers. SETTING: The School of Medicine, University of Leeds and the Leeds Teaching Hospitals Trust, UK. PARTICIPANTS: Fourth year medical students and consultant clinical teachers. MAIN OUTCOME MEASURES: Analysis of narratives to identify students' perceptions of clinical teaching and consultants' views of their delivery of undergraduate clinical teaching. RESULTS: Students believed in the importance of consultant teaching and saw consultants as role models. However, they perceived variability in the quality and reliability of teaching between physicians and surgeons. Some traditional teaching venues, especially theatre, are believed to be of little clinical importance. Generally, consultants enjoyed teaching but felt under severe pressure from other commitments. They taught in a range of settings and used various teaching strategies, not all of which were perceived to be 'teaching' by students. CONCLUSIONS: While students and teachers are educational partners, they are not always in agreement about the quality, quantity, style or appropriate setting of clinical teaching. To enable teachers to provide more high quality teaching, there needs to be support, opportunities and incentives to understand curricular developments and acquire teaching skills.