Medical Students' Perspectives on Inclusivity Within Clinical Environments: A Pilot Study.

Purpose: Limited resources including staff, technology, and space in United Kingdom National Health Service (NHS) environments present challenges for working teaching and learning. Cumulative pressures impact mental health and prompt medical students to question career choices, leave the profession, or emigrate. There is little understanding of the experience of inclusivity in clinical environments for medical students. This pilot study explores students' perspectives of these environments, the barriers to formulating change, and possible solutions. Materials and Methods: Six diverse clinical medical students from the University of Manchester, based at a single NHS Trust, voluntarily participated in one of four recorded focus groups facilitated by a near-peer with protected characteristics. Low participation emphasised the importance of undertaking this pilot study to consider methods for future study design. Transcriptions were independently analysed by two reviewers to generate themes using NVivo. Results: Key themes included positive experiences with resident doctors; negative interactions with patients; negative attitudes and poor role modelling from some staff; perceived lack of institutional support; and poor learning opportunities. Students suggested staff training and better support structures to improve learning environments. Conclusion: This study highlights universal issues from the perspectives of minoritised students and emphasises their low participation in research. Authors suggest exploring clinical faculty support and training to improve learning environments, and innovations in study design for wider, more democratic and culturally sensitive participation.