Table 3 Four aspects of junior doctors’ educational role with description and illustrative quotes. *ACS = acute coronary syndrome. †Trop = troponin, biochemical marker of myocardial ischaemia.

Teacher

Didactic information delivery, discussion, or direct questioning.

High effort and interruptive to clinical practice, low to moderate yield for student learning. Used when clinical pressures allowed.

“there’s probably less [sic] than ten topics they want to know about, you can just take them to one side and teach them a little bit” – P7 (FG2)

“I’ve often just talked verbally at whoever was following me or shadowing me […] I’m not sure what they gain from it” - P12 (FG3)

Demonstrator

Supporting student through active or passive observation of clinical practice.

Low effort for junior doctors, but low impact on students’ learning. Adopted more frequently for unwell patients.

“or if [the patient] was sick, I’d ask [the student] to join me” - P13 (FG3)

“they’re just, like ‘oh can I shadow you?’ and, you know, you don’t really want to watch me doing discharge summaries and stuff” – P7 (FG2)

“some of them literally do just want to follow you around, which – fine! – [but] I would say is less effective in teaching” - P12 (FG3)

Coach

Direct observation of skills, actual or simulated clinical practice with feedback.

Time intensive for junior doctors, but high yield learning for students. Rarely used on the acute take.

“Prioritisation. Though that’s quite a difficult thing to teach […] it’s quite hard [for them] to do that unless they’re sort of with you […] you don’t have time for that.” - P4 (FG1)

“[referring to teaching that is time consuming] I think bedside teaching because you have to go there and be with them and they’ll do half an hour of work and examinations, that’s just not going to work on take” - P5 (FG1)

Supervisor

Supporting independent clinical practice and active participation.

Low effort for junior doctors, highly effective learning experience for students when managed well. Used for more experienced students and with suitable patients of lower clinical acuity.

“they’re normally quite good about being independent and going and seeing somebody and feeding back” – P1 (FG1)

“[referring to hands-on clinical experience] by the time they’re fifth year I think learning through doing those type of things is actually useful for them” – P11 (FG3)

“you know the ‘query ACS’* – they’ve already been clerked, they’ve had their bloods taken and you’re awaiting another trop†, that’s a perfect opportunity for the students to go [and see them]” – P13 (FG3)