Education for Primary Care最新文献

Introduction: Participation in research activities during undergraduate education can enhance health students' understanding of Primary Health Care (PHC) and encourage future practice in underserved rural areas.

Objective: To explore the perceptions of health sciences students regarding PHC after their involvement in data collection for a research project in rural communities of Amazonas, Brazil.

Methods: A qualitative study was conducted with 17 nursing and physiotherapy students who participated in data collection for the SAPPA project. Four focus groups were held, recorded, and transcribed. Thematic analysis was performed using ATLAS.ti 9®.

Results: The analysis generated one central category - Influence of the SAPPA Study on Student Training - and four subcategories: Contribution to Professional Life, Contribution of the Research, Facilitators for Data Collection, and Challenges and Barriers. Students reported that their involvement provided a deeper understanding of PHC, fostered critical reflection, and stimulated professional growth. Direct interaction with users in rural communities contributed to a shift in perspective regarding healthcare practice and the importance of humanised care. Despite logistical and infrastructural challenges, the students highlighted the value of the experience for their academic and professional development.

Conclusion: The study demonstrated that engaging students in rural PHC research strengthens their practical skills and promotes social commitment. Such initiatives can help shape professionals more prepared to work in remote and underserved contexts, highlighting the relevance of including field research in health education curricula.

In Australia's apprenticeship-style model of general practice training, experienced general practitioner supervisors oversee individual registrars' training in accredited training practices. In addition to providing formal in-practice education to registrars, supervisors have informal teaching and clinical support functions, including being called in by registrars seeking in-consultation advice/assistance. These ad hoc encounters are important learning opportunities but can be challenging to negotiate in the busy clinical environment and require registrars' assistance-seeking to be judiciously managed by supervisors. This study aimed to estimate variability between training practices in relation to registrars having recourse to supervisory in-consultation advice/assistance. The study used a cross-sectional analysis from the Registrar Clinical Encounters in Training project, an ongoing prospective cohort study of Australian registrars' in-consultation clinical and educational practise. Analyses used 2010 to 2021 data with outcome factor 'supervisor provided advice/assistance'. Inter-practice variability was estimated by intra-class correlation coefficients and median odds ratios within a Bayesian modelling framework. 4642 registrars contributed details of 1,026,330 problems/diagnoses 69,114 (6.73%; 95% confidence interval: 6.69-6.78%) involved in-consultation supervisory advice/assistance. On multivariable analysis, adjusting for confounding, the intra-class correlation coefficient for provision of supervisory advice/assistance was 0.043 (95% credible interval: 0.038-0.049), the median odds ratio was 1.523 (95% credible interval: 1.480-1.569). This analysis can be interpreted as a registrar randomly moving from one training practice to another will have a median of 52% increase in the odds of a registrar seeking (and a supervisor providing) in-consultation advice/assistance for a particular problem/diagnosis. These findings raise policy and practice questions about developing a consistent response to ad hoc supervisory encounters.

Background: Simulated Consultation Assessment (SCA) preparation is critical for GP trainees, with the traditional approach relying on trained medical actors. However, limited actor availability, scheduling constraints and high costs often restrict practice opportunities. This evaluation aimed to assess a conversational artificial intelligent (AI) system as an educational tool for GP consultation skills training, examining its acceptability, perceived educational impact and implementation considerations for training.

Methods: We conducted an educational innovation evaluation with GP trainees and educators (n = 22) following implementation of a conversational AI simulation system for SCA preparation. The evaluation employed a mixed-methods design incorporating validated educational assessment measures across four domains: clinical authenticity, educational utility, user experience and technical performance. Participants' perspectives were captured through structured questionnaires and open-ended feedback. Implementation considerations were assessed through cost-comparison analysis with traditional training methods.

Results: This educational innovation demonstrated strong acceptability among users, with particularly positive evaluations for clinical content authenticity (median 4.5, IQR 4-5) and educational value (median 4.5, IQR 4-5). Qualitative feedback revealed that the innovation successfully addressed key training needs, particularly around accessibility and practice frequency. More experienced educators (11+ years) rated the innovation significantly higher for educational utility (p < 0.05), suggesting potential for curriculum integration. The implementation analysis revealed resource advantages, with 24-84% cost reductions compared to traditional methods.

Conclusion: This conversational AI innovation offers GP educators a practical, cost-effective solution to training challenges, potentially addressing the modality mismatch between face-to-face training and video-based examinations. Implementation should focus on integration as a complementary curriculum tool, with ongoing evaluation of educational outcomes.

Over 50 Academic Clinical Fellows (ACF) undertake Integrated Academic Training in General Practice (GP) annually. A formal curriculum for this programme is in place. Underneath formal curricula lie hidden curricula, which students learn without being formally taught. Although this is well documented in undergraduate medical education, the hidden curriculum for academic trainees is relatively unexplored. We sought to discover the perceived hidden curriculum for ACFs to inform programme improvement.A questionnaire exploring experiences was sent to all 56 GP ACFs in London, Kent, Surrey, and Sussex and responses were thematically analysed. These themes informed a topic guide for a focus group held online with five (9%) participants, chosen through opportunity sampling of eligible individuals. Discussion was transcribed and thematically analysed to produce themes and subthemes.From the 18 (32%) survey responses and focus group discussion, four main themes were identified: management of time pressures, unequal valuation of clinical and academic work, personal development, and pressure and support.Overall hidden curriculum learning outcomes were mixed; the programme provided opportunity to develop personal skills, yet trainees gained a perceived belief that academic work is underappreciated, and that time management is challenging. Changes to the programme have been suggested. Whilst this exploratory study was limited to a geographic region of the UK, it is likely similar experiences are shared by all ACFs in GP. It would be useful to extend this work by studying hidden curricula of primary and secondary care ACFs across the UK.

As general practice (GP) training increasingly emphasises holistic care, it becomes essential to address not only the clinical but also the emotional, social and cultural dimensions of patient care. Traditional GP training often focuses on clinical skills, potentially neglecting these broader aspects, leading to a disconnect between healthcare providers and patients. This teaching exchange paper explores the integration of storytelling into GP training as a means to enhance narrative competency and empathy, key components of holistic care. The GP Specialty Trainees (GPSTs) were guided through engaging deeply with patient stories during personalised one-on-one training sessions, learning how to reflect on their experiences and seeing patients as persons with complex lives. This led to a significant shift in approach taken by trainees in the way consultations were conducted - from purely clinical to increasingly patient-centred. The intervention underlined the centrality of narrative competence for achieving culturally sensitive and empathic care, thus suggesting storytelling as one of the crucial tools of GP education. Qualitative insights of the intervention confirm that it holds the potential to prime future GPs for care not only clinically sound but also deeply integrated with the personal and cultural context of the patient.

Background: Evidence shows that early clinical experience (ECE) within general practice (GP) has multiple benefits for medical students. Yet barriers to implementation mean that efforts to expand ECE have stalled. Remote consultations, and video footage of consultations, provide a route to expand GP ECE.

Objectives: We aimed to explore the extent to which different video formats, when used as part of GP ECE, influenced students' engagement with learning, their perceptions of the authenticity of the experience and their understanding of complexity in primary care.

Methods: Early-stage medical students at Newcastle University had 4 'virtual' GP visits that drew on video footage from three different formats; pre-recorded from a national database, locally recorded, and recorded 'live' on the day. A mixed methods approach was employed. Post-session questionnaires explored opinions on authenticity, learning opportunities and format preference. Semi-structured focus groups enabled deeper exploration of students' perspectives. Questionnaire data was analysed using descriptive statistics. Focus group data was analysed using inductive thematic analysis.

Results: All formats were recognised by students as being authentic, enjoyable and relevant. However, perceptions of authenticity, and depth of student engagement, was greater when locally recorded footage was employed, most of all with live footage. Near-live footage highlighted the complexity of GPs' work, but requires deliberate, structured debrief to enable students to make sense of the consultations that they had observed.

Conclusions: Comparison of the educational value of different video formats used for GP ECE showed that virtual patient contact using locally recorded footage is most valued by students.