Abstract
Introduction
Health professions education (HPE) must continuously evolve to keep pace with the increasing complexity and diversity of healthcare. As patient needs, workforce demographics and societal expectations shift, medical education cannot remain static – it must actively adapt to ensure future GPs are prepared for the realities of modern practice. More than just a vehicle for technical training, HPE must cultivate reflective, adaptable and patient-centred GPs. Yet, despite advances in teaching methodologies, many learners continue to experience a profound sense of unease and uncertainty in clinical environments – barriers that impede their ability to fully immerse themselves in the learning process (Cheng et al., 2022).
A key factor in learner success is a sense of belonging (Roberts, 2020). When medical students and GP registrars feel valued and supported, they are more likely to take ownership of their education and thrive in clinical environments. Traditional group-based inductions often focus on logistics while neglecting individual learning needs, leaving many learners struggling to integrate and engage effectively in practice environments. By actively implementing strategies that dismantle barriers of language, culture and socio-economic status, we can create an educational landscape where every learner feels heard and supported – an essential precursor to meaningful learning experiences (Mullen Davis, 2022).
To strengthen learner support during clinical placements, we introduced an ‘inclusive induction’ intervention to supplement the standardised group inductions currently offered. This one-to-one meeting, led by the clinical supervisor, aims to shift responsibility toward educators. It encourages them to proactively understand and respond to individual learner needs, fostering a more personalised and inclusive learning environment (Epstein et al., 2020). Following a successful pilot with 300 medical students between January and June 2024 – with 89% reporting they received the intervention – we conducted an audit to explore learner perceptions, thereby assessing its potential for wider implementation across GP training and other clinical education settings.
Method
The inclusive induction intervention was formally implemented between September 2024 and April 2025 across East London GP practices. It involved 268 Year 3 medical students at Queen Mary University of London and their supervising GP tutors during clinical placements. GP tutors were asked to deliver a 15–30 minute inclusive induction within the first 2 weeks of each placement.
To support GP tutors, they received a user guide (‘handbook’) and an explanatory video tutorial on how to deliver the inclusive induction. The content encouraged GP tutors to ask questions that enabled students to reflect on their learning journey through open-ended questions exploring challenges, communication preferences and recognised sources of overwhelm.
The handbook included:
Rationale for inclusivity in placements
Clear aims and objectives
Guidance on delivery, approach and communication style
Key discussion topics
Additional resources for further learning
Data were collected by reviewing student responses on the existing mid-placement feedback forms, completed halfway through the 8-week placement.
Results
Of the 268 students, 254 completed the questionnaire. Among them, 238 (93.7%) reported receiving a one-to-one inclusive induction and 235 of these (98.7%) found it helpful. The 16 who did not receive the one-to-one intervention cited GP tutor unawareness, non-attendance or having only participated in an inclusive group induction as the reasons.
Learner perceptions and experiences suggested five key areas of benefit.
1.
‘I was able to let the GP tutors know what can best aid my learning.’
‘[My GP tutor] agreed to implement my suggestions.’
2.
‘It helped me hone in on the goals and targets I wanted to achieve.’
‘I got to discuss my goals with the GP tutor and how to make the most out of GP placement.’
3.
‘It created an open environment where I felt comfortable to bring up concerns.’
‘I was heard and any concerns/teaching points were voiced.’
4.
‘It allowed me to build a rapport with the GP (tutor) early on and has made the experience very fun and engaging.’
‘I was able to tell my GP tutor about how I prefer to learn and some of the anxieties I can feel when I am in a group setting.’
‘I could speak comfortably to the GP about any private issues before starting placement.’
‘It showed our GP (tutor) cared about what we wanted to get out of this placement and how to go about it.’
5.
‘It was private and supportive.’
‘Helped me feel comfortable and facilitated me to ask questions.’
‘I felt safe and welcomed.’
Discussion
The findings highlight both the feasibility and potential impact of one-to-one inclusive inductions in enhancing learner engagement and satisfaction by fostering a culture of belonging. Creating space for open communication enables learners to voice concerns, engage in problem-solving and reflect on their learning styles and goals. This approach may address longstanding challenges within medical education, where educators have historically expressed concerns about meeting the needs of students with ‘hidden’ impairments (Matthews, 2009).
With the 2023 NHS Long Term Workforce Plan aiming to double the number of medical school and GP training places by 2031, the demand for structured and supportive placements is only set to grow. The anticipated expansion in student and trainee numbers is likely to increase reliance on longitudinal integrated clerkships (LICs), which, while valuable, are known to pose challenges in fostering a sense of belonging (Bonney et al., 2014). The personalised nature of the inclusive induction model offers a means of providing tailored support, while also empowering learners to take ownership of their development. As newly qualified doctors often report feeling unprepared for the transition to practice, such interventions may help bridge residual knowledge and confidence gaps prior to graduation (Miles et al., 2017).
Strengths and limitations
A key strength of the inclusive induction model lies in its structured yet flexible approach, which achieved a high implementation rate. This suggests the model is scalable and potentially transferable across a wider range of general practice learners, including GP registrars and other healthcare professionals in both hospital and community placements. These educational environments, known for their innovative teaching practices, further support the professional development of learners. Positive feedback from students suggests that the model fosters a sense of collaboration, reframing placements as educational partnerships and positioning learners as co-creators in both their education and its quality assurance (Kassab et al., 2023).
However, the intervention had some limitations. It did not assess whether concerns raised during the inductions were subsequently addressed during the placement period. Furthermore, while the intervention aims to enhance learner experience, it was not designed to evaluate outcomes related to workforce readiness, professional identity formation, or long-term workforce retention. Future audits should explore these areas as well as assess the model’s applicability across a broader range of healthcare education settings.
Recommendations
This intervention highlights several key lessons that support the routine embedding of inclusive induction practices within clinical education and curricula. First, engaging learners from the outset of their placements is essential for fostering a positive and productive learning environment. Second, the implementation of inclusive practices – such as one-to-one inductions – can play a significant role in identifying and reducing barriers to learning. Third, supporting diverse learner experiences requires adaptable approaches that include placing responsibility on educators to proactively discuss individual needs.
