Education for Primary Care最新文献

Introduction: Near-peer teaching offers mutual benefits for clinical trainees and the students they teach. However, General Practice Speciality Trainees (GPSTs) are typically less involved in community-based teaching than their hospital-based peers and often do so without formal pedagogical training. This study details the immediate and longer-term evaluation of a teaching skills course delivered to final year GPSTs. It addresses a gap within existing near-peer literature which, although extensive, is predominantly hospital-based and limited to short-term outcomes.

Methods: The course was designed and delivered to all local final year GPST schemes. Pre- and post-course questionnaires scoring confidence, comfort, and understanding of teaching roles were analysed across two years' delivery. Furthermore, individual interviews of participants 4-6 months after attendance were thematically analysed to explore how GPSTs translated course content into practice.

Results: GPSTs reported a decline in their teaching activities as they embarked on their final year of GP teaching. Immediate post-course teaching-related confidence and knowledge scores increased. However, follow-up interviews revealed that GPSTs' initial enthusiasm was short-lived and outweighed by competing demands within an intensive short-duration training scheme. They expressed concerns about their own learner status as they themselves developed competency in a vast and varied speciality, and cited a lack of support from their trainers.

Conclusions: Teaching skill courses alone are insufficient to address the ongoing challenges of enhancing the teaching role of GPSTs. Further work is now needed to explore multi-level interventions to promote the role of GPSTs as near-peer teachers to harness the mutual benefits to all involved.

Longitudinal Integrated Clerkships (LICs) prioritise longitudinal relationships with faculty, patients, and place. Research shows that LICs benefit students and faculty, but most medical schools have limited LIC programmes. This is likely due to perceptions that LICs are more costly and complex than traditional block rotations (TBRs). The perceived cost versus evidence-based value related to clerkship education has not been examined in detail. Until recently, no 'All-LIC' medical school exemplars existed in the US, limiting the value of this model as well as the ability to examine relative cost and complexity. In this paper, we draw on our experience launching three 'All-LIC' medical schools in the United States - schools in which the entire clerkship class participates in a comprehensive clerkship-year LIC. We propose that the known benefits of LICs coupled with cost-mitigation strategies related to running an 'All LIC' model for core clinical clerkships, rather than block and LIC models simultaneously, results in a higher value for medical schools.

Mentoring plays a crucial role in increasing the attractiveness of primary care careers for medical students. Based on a literature review and structured group discussions, the authors developed a primary care mentoring platform centred on undergraduate medical students' needs. All second- to sixth-year students were invited to enrol into the programme by choosing a mentor from an online platform, which was pilot tested during one academic year (2021-2022) with 16 mentors. Fifteen mentees enrolled into the pilot programme. The evaluation assessed the procedures' feasibility as well as the student-centeredness and acceptability of the programme. Mentees completed a quantitative survey evaluating satisfaction and the mentoring relationship's personal and content aspects. Mentors' feedback was collected during focus groups discussing the programme's acceptability and practical aspects. Both mentees and mentors expressed high levels of satisfaction with the programme. Mentees rated their mentoring relationships highly across most aspects. Mentees' content-related needs included postgraduate training, meeting an inspiring person, work-life balance, and questions about running a private practice. Mentors described the programme as a rewarding experience. They enjoyed the flexible structure that allowed them to adapt to the mentees' individual needs. Maintaining the relationship was mostly the mentors' responsibility. Further structured guidance from the programme coordinators was identified as potentially beneficial for future implementation. The findings highlight the feasibility and the advantages of a flexible, student-centred mentoring programme. The programme attracted students interested in primary care from all levels of undergraduate education. Such programmes may contribute to fostering students' interest in primary care careers.

UK general practice faces workforce challenges. The pandemic, and cost-of-living crisis are felt hardest by our most deprived communities. The Scottish Government is keen to tackle Scotland's high drugs-related deaths. The perceptions and experiences of GP specialist trainees who have trained in deprived communities are already known. This qualitative study explored the perceptions and experiences of trainees from affluent practices and how this training may affect their future career. One-to-one in-depth interviews were conducted and analysed using grounded theory methods. Seven participants were interviewed. Five themes were constructed: training practice choices, perceptions of working in deprived areas, unmet learning needs for working in deprived areas, other sources of deprivation exposure and future working intentions. Most did not choose their training practice because of its affluence. They perceived that working in a deprived area would have challenges: less staff, higher rates of pathology, communication challenges, poorer patient health literacy. Addiction care was a significant unmet learning need. Most lacked confidence to work in deprived areas, and were likely to work in their training practice or similar, upon completion of training. This research has implications for ensuring equity of GP workforce provision and whether GP Specialty Training fulfils its intention of producing 'a GP who is capable of working independently in a variety of primary care settings'. Those training in highly-affluent settings may not feel able to meet this aim. Training providers should consider this limited experience and whether rotations, involving affluent and deprived area practices, would prepare future GPs to work with a range of socioeconomic populations.

Background: There is a workforce crisis in General Practice (GP) within the United Kingdom (UK). High-quality clinical placement experiences in GP influence medical students' interest and likelihood to enter this speciality. GP trainees often express a desire to teach, yet teaching does not feature significantly within their current practice. This study aims to explore outcomes, barriers, and facilitators of GP trainees teaching medical students through a rapid review of published literature.

Methods: MEDLINE, EMBASE, PsychINFO, Web of Science were searched for articles relating to GP trainees teaching. Studies conducted in the UK and Australia, between January 2000 and October 2022 were included. The Medical Education Research Study Quality Index and the Critical Appraisal Skills Programme checklist were used to assess quality.

Results: Twenty-seven publications, 11 qualitative, six quantitative, three mixed-methods and seven opinion pieces, were identified. Many studies have methodological limitations. Empirical studies show that there are benefits of near-peer teaching, but these are limited by trainees' capacity and capability to teach, and GPs' confidence in trainees' teaching. The culture within the practice influenced whether trainees were seen solely as learners or also as teachers for students.

Discussion: When GP trainees teach there are positive outcomes for medical students and trainees. Teaching was considered an activity that trainees did in 'addition to' rather than 'part' of' their training. Appropriate teaching opportunities, and relevant training, were key to trainees' competence and confidence in teaching. Resources and recognition and a strong teaching culture are needed to support GP trainees to teach.

Purpose: This paper aims to provide knowledge on medical trainees' considerations about specialisation as they move from undergraduate to postgraduate medical education; especially their interest in general practice compared to other specialities.

Method: We developed and content-validated a questionnaire to examine medical trainees' speciality considerations and conducted a descriptive, cross-sectional study. All medical trainees initiating their internship in Denmark in 2022 (N = 1,188) were invited to participate in the study. Medical specialities were categorised as hospital service specialities, internal medicine specialities, primary care, psychiatry specialities and surgery and emergency specialities. Descriptive statistics were used to describe the cohort and examine the participants' speciality considerations by assigning them to one of the following three orientations: committed, undecided or non-committed to a speciality.

Results: The response rate was 38.8% (n = 461), and participants' mean age was 27.4 years with a majority of females (68.1%). Nearly 25% of the participants had general practice as speciality preference, and only 13.9% had excluded general practice for future specialisation. Overall, around half of the participants had general practice as a first, second or third preference for specialisation.

Conclusion: Danish medical trainees show considerable interest in general practice at the time of their transition from undergraduate to postgraduate education. However, to meet future demands on the primary care, further recruitment of general practitioners is still needed. This knowledge of the specialities' recruitment potential will likely be of interest to medical educators and healthcare planners alike.

There is need for a greater connection between General Practice and GP trainees in their hospital component of training. Currently, in Scotland, there are no national education programmes specifically designed for GP trainees during their hospital component of training. Our aim was to develop and evaluate the feasibility of a national online 'bitesize' education programme delivered live for GP trainees in their hospital component of training. The study also aims to assess the barriers to attending these teaching sessions and whether they made trainees feel more connected to General Practice. Weekly one hour 'Bitesize' teaching sessions, delivered virtually, were organised by NHS Education for Scotland (NES) GP Medical Education Fellows during a four-week period. Eligible attendees were GP trainees (GPST1s and GPST2s) working in the hospital component of their training. An end of program questionnaire, gathering quantitative and qualitative data, was used for evaluation. There was a strong support for this programme from the attendance numbers and the questionnaire feedback responses, with GP trainees feeling more in touch with general practice and more confident in managing primary care focused topics. GP trainees agreed that a weekly, one-hour, online lunchtime session suits them. The most common barrier to attendance were work commitments and conflicts with local teaching. This pilot has emphasised the need for a structured teaching programme for GP trainees in the hospital component of training.

The journey of transitioning from a GP trainee to a portfolio GP is a complex and transformative process. This article explores the multi-dimensional roles that GP trainers play in guiding trainees through this key transition. This article, also, aims to challenge readers to consider how GP trainers can further enhance their role in minimising barriers and maximising opportunities for trainees, inviting contributions to the educational discussion on this topic.Serving as mentors, GP trainers navigate trainees through the particulars of general practice, ensuring they are equipped with both skills and resilience. They also play the role of confidantes, offering emotional and psychological support in times of doubt and uncertainty. As anchors, GP trainers provide stability, helping trainees find their footing in the vast domain of general practice and instilling core professional values. Furthermore, bridging the gap between academic knowledge and real-world practice, GP trainers guide trainees in effectively applying theoretical knowledge in clinical scenarios.Despite the inherent challenges, the bond between trainer and trainee is rewarding, ensuring a holistic evolution into competent portfolio GPs, thereby significantly influencing the future of primary care and patient outcomes.