Hospital-based paediatric training for general practice trainees in Ireland.

Abstract

Background: Paediatric presentations represent 25% of General Practice consultations in Ireland [1]. The 'Under 6' GP scheme saw a further increase of 25% within paediatric consultations [2]. GP trainees spend 4 months on a dedicated paediatric rotation, representing 5.7% of the 4-year scheme.

Aims: To establish trainee exposure to paediatric presentations during a summer-time rotation; and, whether such presentations satisfy the requirements of the GP curriculum, as it currently stands.

Methods: A real-time observational study at Mayo University Hospital.

Results: Five hundred paediatric patients presented to the PDU during the 7-week period within a summer-time rotation demonstrating a 45% reduction in opportunities for clinical encounters on a day-to-day basis as compared to a winter-time rotation. 72% (n = 41) of presentations currently listed on the GP curriculum were encountered by SHO-level NCHDs (n = 8) collectively, with each SHO seeing an average of 35.75 patients over a 7-week period (i.e. 5.1 per week, or 0.72 per day over a 7-day week), representing 57.2% of total presentations.

Conclusion: GP paediatric teaching is experiential, opportunistic, and seasonal. The GP curriculum, as it relates to paediatrics, may benefit from relevant updates via modified Delphi study. Paediatric rotations could be bolstered by use of validated e-learning tools [3], audio-visual material and evidence-based simulation to develop diagnostic accuracy via deliberate practice without a clinical encounter.