Education for Primary Care最新文献

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.

Background: Since 2013, CEPNs-and, from 2018, Training Hubs-have provided locally led, multi-professional mechanisms for workforce education in primary and community care, aiming to match training supply and skill mix to population health needs.

Aim: To synthesise the development, evolution, and impact of CEPNs/THs and assess their strategic alignment with the NHS 10-Year Health Plan (July 2025).

Discussion: Evidence from local evaluations and national guidance indicates CEPNs/THs expanded placement capacity, supported interprofessional learning, integrated new roles into primary care, and improved links between education providers and employers-albeit against a backdrop of regional variability and short-termism in funding. The 10-Year Plan's 'three shifts' (community-first, digital enablement, prevention) map directly to Training Hub functions, but require stronger place-based embedding, stable investment, and outcomes-focused evaluation.

Conclusion: With explicit policy backing, multi-year funding, and standardised impact measures, Training Hubs can function as the operational bridge between national strategy and local delivery for the decade ahead.

Background and aims: Rural longitudinal medical programmes immerse students in rural communities for extended periods to help foster a rural-focussed medical workforce. There is limited evidence on how medical students undertaking the same curriculum across different geographic locations perform in Objective Structured Clinical Exams (OSCEs). We aimed to investigate if there were variations in OSCE performance between students at different sites of the Flinders University Doctor of Medicine Programme.

Methods: We retrospectively reviewed data from OSCEs undertaken by all third year graduate entry students at Flinders University in 2024. Quantitative data on overall performance, discipline- and domain-level performance were compared between students based in Metropolitan South Australia, Rural South Australia and the Flinders Northern Territory (NT) Medical Programme.

Results: Data from 172 students was included, with 102 (60%) from SA metropolitan areas, 33 (20%) from the SA rural stream and 37 (20%) from the NT rural stream. Overall OSCE performance was not different between training locations. Students from rural training locations performed better in communication (mean score 84% vs 67%, p < 0.001) than those from metropolitan sites. Variations in performance in Medicine, Acute Care and Primary Care disciplines were seen between locations (p < 0.001).

Conclusion: Medical students who underwent extended periods of training in rural locations performed similarly in standardised OSCEs compared to those from metropolitan locations. Variations in domain- and discipline-level performance were seen across locations, with rural students performing better in communication skills. Further research exploring the impact of diverse training exposures on OSCE performance is required.