| Time intensive |
Time consuming for tutors, as it requires a lot of planning. Tutors would also need to be trained to deliver the sessions. In addition, students perceived sessions were too frequent, labour intensive and often too long (owing to large groups). |
“Difficult to find teachers willing to commit to the time that the fairness model will take” [Essay No. 14]; “The main disadvantage of the FAIRness programme is that it requires more planning than standard clinical teaching, which is often improvised, and is generally more time intensive” [Essay No. 24]; “The preparation of histories and structuring them took quite a lot of time each week” [Essay No. 4] “One of the disadvantages of FAIRness is that it takes longer as time must be allocated for the student to have an active role, and for feedback to be given” [Essay No. 18] |
| Lacks specialist/medical science teaching |
Lack of in depth teaching on medical sciences, clinical decision making such as investigations and management; all of which would be beneficial particularly with exams. |
“If this program could be employed to give students some medical knowledge and to test it in a FAIR way, that would certainly help us a lot. If, however, this program exists only to test our history taking, I am not definitely sure how this will make us become doctors with a rounded outlook” [Essay No. 34]; “I feel more focus could have been given to the case in general (such as investigations, management etc.) to allow us all to get learning points from each case” [Essay No. 40] |
| Issues with feedback |
Peer feedback is not always constructive or honest. Giving only private feedback may be better as it prevents embarrassment or intimidation if a student’s work was not up to standards of members in the group. Over emphasis on feedback and repetitive in large groups. |
“Using peers meant that some students were intimidated and possibly were not as brutal, and therefore constructive, in their criticisms” [Essay No. 15]; “Though feedback encourages active learning, it should not be the sole contribution to this second component of FAIRness, for, in large groups, to get each student to deliver feedback is impracticable (too much repetition)” [Essay No. 1] |
| Lack of direct observation |
Students’ interactions with patients were not directly observed on the ward and there was no bedside teaching. |
“No direct observation of clinical history taking so quality of actual history cannot be ensured.” [Essay No. 37]; “it may not be representative of how the student is performing in the placement as a whole……the students are largely assessed through their individual performances on the written histories, which can produce a large amount of bias” [Essay No. 51] |
| Only once weekly sessions |
Sessions may not be representative of student’s overall performance in the placement. More frequent sessions would widen focus of teaching to include other generic clinical skills. |
“I believe that it would be even more beneficial if it were possible to have more sessions, and not just focus on clerking skills, but some of the other skills that we as student doctors need to develop” [Essay No. 36] |
| Relevance |
Some sessions may not be relevant to upcoming exams; pitched beyond curriculum requirement and learning objectives (i.e. aimed at junior doctors). Simulation/artificial environment not the same as practising on the wards. |
“Doing these full clerkings meant that each system examination was not done from beginning to end properly as would be required in the OSCE“ [Essay No. 78]; “the presentations of patients on the wards are often spontaneous, whereas many of the students pre-rehearsed and structured their presentations for the teaching sessions so it was not an accurate reflection of what would be required of them when they eventually become foundation year doctors” [Essay No. 78] |
| Large group |
Group size too big in some cases which limits activity and engagement with sessions. In addition, feedback is repetitive and tedious in large groups. Large groups can be too intimidating for students to engage. |
“I feel that the sessions would work better in smaller groups, as in a group of 14 the sessions took a very long time and sometimes felt a little repetitive” [Essay No. 47]; “The feedback provided was always useful and relevant, however due to this individualised approach with a single designated assessor and presenter, the group size and the number of histories to be presented led to some concentration issues among those not assessing or presenting” [Essay No. 76] |