Table 3. The context–mechanism–outcome configurations for the study

	Configuration	Context	Mechanism	Outcome
Engagement	1	Tutor offers opportunities for student to practise remote consultations	Student engagement through participationReduced student apprehension with remote consulting	Increased student confidence with remote patient consultationsImproved knowledge and skills
Engagement	2	Observational learning with remote consultationLimited opportunity to practise remote consultations	DisengagementDifficulty establishing tutor-student rapport	Dissatisfaction with learning opportunityReduced feedback from tutor to student
Isolation	3	Lack of team interactionLack of acknowledgement	Feeling of student isolationLack of patient physical examinations	Negative perception of general practice
Preparation	4	Inadequate student training for examining remote patients	Uncertainty with remote patient examinations	Lack of confidence with examining patients remotely
Preparation	5	Appropriate patient selection avoiding follow-ups, medication reviews, and patients with language barriers	Team organisation	Effective teaching
Supervision	6	Tutor offers opportunities for student to practise remote consultationsThe absence of the patient	Student has more time to prepare	Increased quantity and quality of tutor feedback
	7	Sequential supervision styleFinal-year medical students	Student engagementLess student pressure when not directly observedStudent independence	Time consuming for tutorsPromotes confidence, and patient rapport
	8	Parallel supervision style	Student anxietyDisrupted consultation	Reduced patient rapportTime effective for tutors
Skills	9	Lack of physical patient examinations	Difficulty establishing rapport with patient	Reduced skill acquisition
	10	Technological setbacks with video consulting	Disrupted consultation	Reduced use of video consultingLittle or no exposure to video consulting skills
	11	Lack of non-verbal cues	Less memorable experience	Reduced reflective practice