title: A BEME systematic review of UK undergraduate medical education in the general practice setting: BEME Guide No. 32.
abstract: BACKGROUND
  General practice is increasingly used as a learning environment in undergraduate medical education in the UK.
  
  
  OBJECTIVE
  The aim of this project was to identify, summarise and synthesise research about undergraduate medical education in general practice in the UK.
  
  
  METHODS
  We systematically identified studies of undergraduate medical education within a general practice setting in the UK from 1990 onwards. All papers were summarised in a descriptive report and categorised into two in-depth syntheses: a quantitative and a qualitative in-depth review.
  
  
  RESULTS
  169 papers were identified, representing research from 26 UK medical schools. The in-depth review of quantitative papers (n = 7) showed that medical students learned clinical skills as well or better in general practice settings. Students receive more teaching, and clerk and examine more patients in the general practice setting than in hospital. Patient satisfaction and enablement are similar whether a student is present or not in a consultation, however, patients experience lower relational empathy. Two main thematic groups emerged from the qualitative in-depth review (n = 10): the interpersonal interactions within the teaching consultation and the socio-cultural spaces of learning which shape these interactions. The GP has a role as a broker of the interactions between patients and students. General practice is a socio-cultural and developmental learning space for students, who need to negotiate the competing cultures between hospital and general practice. Lastly, patients are transient members of the learning community, and their role requires careful facilitation.
  
  
  CONCLUSIONS
  General practice is as good, if not better, than hospital delivery of teaching of clinical skills. Our meta-ethnography has produced rich understandings of the complex relationships shaping possibilities for student and patient active participation in learning.
authors.affiliation: a UCL Medical School , UK.
authors.forename: Sophie
authors.initials: S
authors.lastname: Park
authors.affiliation: a UCL Medical School , UK.
authors.forename: Nada F
authors.initials: NF
authors.lastname: Khan
authors.affiliation: b University of Nottingham , UK.
authors.forename: Mandy
authors.initials: M
authors.lastname: Hampshire
authors.affiliation: b University of Nottingham , UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Knox
authors.affiliation: c University of Bristol , UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Malpass
authors.affiliation: d Institute of Education, UCL , UK.
authors.forename: James
authors.initials: J
authors.lastname: Thomas
authors.affiliation: a UCL Medical School , UK.
authors.forename: Betsy
authors.initials: B
authors.lastname: Anagnostelis
authors.affiliation: d Institute of Education, UCL , UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Newman
authors.affiliation: e University of Manchester , UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Bower
authors.affiliation: a UCL Medical School , UK.
authors.forename: Joe
authors.initials: J
authors.lastname: Rosenthal
authors.affiliation: a UCL Medical School , UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Murray
authors.affiliation: a UCL Medical School , UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.affiliation: f University of Oxford , UK.
authors.forename: Carl
authors.initials: C
authors.lastname: Heneghan
authors.affiliation: g SimPatiCo UK Ltd , UK.
authors.forename: Amanda
authors.initials: A
authors.lastname: Band
authors.affiliation: h Queen Elizabeth Hospital , UK.
authors.forename: Zoya
authors.initials: Z
authors.lastname: Georgieva