Telephone Triage for Medical Students: An Exploration Through Cultural Historical Activity Theory.

backgroundTelephone triage services are widely used in many countries, reflecting a broader shift towards remote patient consultations. Acknowledging this trend, we introduced a programme that placed medical students within a telephone triage service. We present this novel teaching intervention alongside an evaluation of student experiences. APPROACH: Attendance at the 111 call centre was mandated for Year 5 medical students and was offered as an optional experience for Year 2 students. Students who had attended a call centre visit were invited to contribute to in-person focus groups. Three focus groups were conducted, involving 14 students. A semi-structured interview guide was employed and developed iteratively between focus groups. Data were analysed using thematic analysis. Findings were interpreted through the lens of cultural historical activity theory (CHAT). EVALUATION: Students developed an understanding of how uncertainty and risk are managed in information-sparse environments. Applying CHAT helped identify tensions within the activity system. These tensions were linked to the tools mediating their learning-specifically, decision-making algorithms and telephone consultations. Additional tension emerged around the underlying rules of the educational experience and the division of labour within the call-centre community, which often conflicted with final-year students' expectations and hindered their learning. IMPLICATIONS: Students valued the opportunity to gain first-hand insight into telephone triage and its role within the health system. This setting may offer a useful perspective on managing uncertainty and risk in information-sparse environments. However, further research is needed to better understand how such placements can be optimised before wider educational adoption is recommended.