Patients' views	GP tutors' views	Students' views
Positive impact	Positive impact	Positive impact
•Most patients valued time to talk to empathetic students without fear of burdening	• Tutors widely believed that patients enjoyed the teaching—with benefits for patients' self esteem in “giving back”—and saw it as a validating and empowering experience	• Most students reported that patients seemed to enjoy talking to them
• Sense of reward and raised self esteem from “giving back,” helping others, a sense of purpose, reinforcing positive self image, and validating their experiences	• Many noted benefits for the patient in having extra time to talk to empathetic students	• Some said that students may be easier to talk to as they are less “judgmental”
• Taught them how to talk about their problems, vocalising and clarifying their thoughts	• Most said that it improved the doctor-patient relationship, as a result of increased knowledge, more balance, and explicit interest on the part of the doctor	• “Giving back” raised patients' self esteem, validated their problem, and gave them a focus
• Many patients thought that students helped provide new insights by asking thought provoking questions, enabling new revelations, or by allowing patients to tell their story. This helped patients to understand how their problems evolved and progressed (or lessened), and it helped to increase their self awareness and see things in a “fresh” way	• Some said it allowed patients to develop a coherent narrative, enabling them to put their illness in context or deal with traumatic events	• Taking part in teaching makes patients feel “not alone” and normalises their illness experience
• Many patients reported a strong pre-existing relationship with their general practitioner and little additional impact from the teaching; others said it increased depth, balance, and understanding in the relationship	• Most believed that patient care benefited through more thorough knowledge and deeper understanding	• Students reported beneficial effects for patients from an opportunity to reflect “how far had they had come,” resulting sometimes in new revelations
Negative impact	• Some said that students gave new insights on patients	• A few students said that patients were clearly there for teaching not “therapy,” and it would not change how a patient felt about things
•Most patients reported no negative effects	• Some tutors integrated teaching into part of their therapeutic regime for selected patients	Negative impact
• Some were nervous before meeting students and initially in interviews, but this dissipated during the interview	• A few said that teaching encouraged them to keep up to date in that area, with indirect potential benefits for patients	• Students reported no negative experiences relating to contact with patients
• A few were anxious whether they had said the “right” things to the students	Negative impact	• After probing by the interviewer, a few students said that it could potentially be distressing or intrusive for some patients but not with those they had seen
• Two found it an emotional upheaval and “draining” to relive their experiences	• Most GPs reported no adverse effects on patients
• One said it could be potentially intrusive to some (but not to herself)	• A few said that occasionally patients were distressed and needed debriefing but had no apparent lasting consequences
• Another said it might encourage some to worry about their ailments (but not himself)	• Some of the distressed patients had reported overall beneficial effects
	• One general practitioner said that distress may be more likely in patients who were more unwell, and another that distress was more likely in those who lacked insight
	• A few general practitioners said that teaching made it more difficult to maintain boundaries, encouraging an uncomfortable sense of obligation towards patients