Cultural Attitudes towards General Practice within Medical Schools: Experiences of GP Curriculum Leaders.

IF 1.5 Q3 PRIMARY HEALTH CARE Education for Primary Care Pub Date : 2023-09-01 Epub Date: 2023-07-12 DOI:10.1080/14739879.2023.2225477
Emily Cottrell, Hugh Alberti
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Abstract

Introduction: UK undergraduate medical curricula are under pressure to become more community-focused and generalist in approach to equip all future doctors with generalist skills and increase recruitment to generalist specialities like general practice. However, the amount of general practice teaching in UK undergraduate curricula is static or falling. Undervaluing, in the form of general practice denigration and undermining, is increasingly recognised from a student perspective. However, little is known about the perspectives of academics working within medical schools.

Aim: To explore the cultural attitudes towards general practice within medical schools as experienced by general practice curriculum leaders.

Methods: A qualitative study using semi-structured interviews of eight general practice curriculum leaders in UK medical schools. Purposive sampling for diversity was used. Interviews were analysed using reflexive thematic analysis.

Findings: Seven themes were identified covering 'a kaleidoscope of attitudes towards general practice', 'overt everyday denigration of general practice', 'a hidden curriculum of undervaluing general practice', 'valuing general practice: representation, recognition and respect', 'relating to others, relating to oneself', 'power, empowerment and vulnerability', and 'the pandemic as an opportunity'.

Conclusions: Cultural attitudes towards general practice were diverse: a spectrum varying from valuing general practice to overt denigration, with a 'hidden curriculum' of subtle undervaluing of general practice. Hierarchical, tense relationships between general practice and hospital were a recurring theme. Leadership was identified as important in setting the tone for cultural attitudes, as well as indicating general practice is valued when general practitioners are included within leadership. Recommendations include a shift in narrative from denigration to mutual speciality respect between all doctors.

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医学院对全科医学的文化态度:全科医生课程领导者的经验。
导言:英国医学本科课程正面临着压力,必须更加注重社区和全科教学,使所有未来的医生都具备全科技能,并增加全科专业(如全科)的招生人数。然而,英国本科课程中的全科教学量却没有变化,甚至还在下降。从学生的角度来看,越来越多的人认识到全科医学的价值被低估,表现为对全科医学的诋毁和破坏。然而,人们对在医学院工作的学者的观点知之甚少。目的:探讨全科医学课程负责人所经历的医学院对全科医学的文化态度:方法:对英国医学院的八位全科医学课程负责人进行半结构化访谈,进行定性研究。采用了多样性有目的抽样。采用反思性主题分析法对访谈进行分析:确定了七个主题,包括 "对全科医学态度的万花筒"、"日常对全科医学的公开诋毁"、"低估全科医学价值的隐性课程"、"重视全科医学:代表性、认可和尊重"、"与他人相关、与自己相关"、"权力、授权和脆弱性 "以及 "大流行病是一个机会":对全科医生的文化态度多种多样:从重视全科医生到公开诋毁,不一而足,还有一种 "隐性课程 "微妙地低估了全科医生的价值。全科医生与医院之间等级森严的紧张关系是一个反复出现的主题。领导层被认为是为文化态度定调的重要因素,当全科医生被纳入领导层时,也表明全科医生受到重视。建议包括所有医生之间从诋毁转为相互尊重。
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来源期刊
Education for Primary Care
Education for Primary Care PRIMARY HEALTH CARE-
CiteScore
2.30
自引率
15.40%
发文量
51
期刊介绍: Education for Primary Care aims to reflect the best experience, expertise and innovative ideas in the development of undergraduate, postgraduate and continuing primary care education. The journal is UK based but welcomes contributions from all over the world. Readers will benefit from the broader perspectives on educational activities provided through the contributions of all health professionals, including general practitioners, nurses, midwives, health visitors, community nurses and managers. This sharing of experiences has the potential for enhancing healthcare delivery and for promoting interprofessional working.
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