Education for Primary Care最新文献

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.

Nationally and internationally, medical students have a strong track record of engagement with sustainability and sustainable healthcare, notably through the development and implementation of the student-led international Planetary Heath Report Card initiative. The Medical Schools Council has endorsed a specific curriculum statement for integration of aspects of sustainable healthcare into undergraduate teaching and the General Medical Council has included the topic in Outcomes for Graduates. The Three Counties Medical School (TCMS) is a new medical school admitting its inaugural cohort in September 2023, and we are committed to supporting the development of doctors who are socially responsible, global citizens. We used the Planetary Health Report Card (PHRC) to complete the first loop of an evaluation of the new TCMS MBChB degree programme. Generally, the PHRC is used by medical schools around the world to score, and ultimately rank, performance in integrating aspects of sustainability in health into teaching and learning. We used the PHRC to help evaluate our curriculum planning to date and in so doing highlighted areas we might not otherwise have considered. This project was part of the University of Worcester Green Impact Project scheme, which funded a student-assessor (a GIPA) to participate with us in evaluating our progress, seek out gaps and use the tool to plan the next steps in curriculum design.

Growing patient demand, changing patient need, technological advancements and workforce challenges have resulted in a complex healthcare system in the United Kingdom (UK) that is unable to meet the needs of its populations. Consequently, reform is needed to 'fix the broken National Health Service (NHS)'. In response, the UK government published its 10-year Health Plan, identifying strategic shifts to overcome the challenges, including from hospital to community, from sickness to prevention, and from analogue to digital. These changes in priorities for the NHS now provide an opportunity to reimagine the way in which not just general practice (GP) but education in primary care is both structured and delivered to undergraduate medical students. This article explores ideas for designing 'fit for the future' primary care education against this political backdrop. In doing so, the opportunities are discussed for training provided by the broader non-GP healthcare professional team, collaboration and co-creation of curricula with community partners or third-party healthcare organisations, and the role of heath informatics and technology enhanced learning for workforce development. Furthermore, the importance of consolidating and rationalising education curricula in parallel to growth and innovation is highlighted, to ensure they remain at the forefront of primary care whilst continuing to provide meaningful learning experiences.