Education for Primary Care最新文献

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.

Human touch holds an important role in field of medicine promoting empathy, trust and connection between doctors, patients and students. This teaching exchange digs into the complex dynamics of 'Human Touch' in medical education and clinical practice exploring its positive, negative and ambiguous aspects. A comforting touch can convey compassion, enhance patient care, alleviate pain and can build trust. However, an uninvited or misinterpreted touch can breach personal boundaries, evoke discomfort or can even be perceived as harassment. The cultural context particularly in Pakistan, adds layers of meaning and sensitivity to such interactions, as societal norms and recent changes influence perceptions of physical contact. Ambiguity in human touch often stems from environmental shifts, such as the COVID-19 pandemic, evolving cultural norms and individual past experiences. With the growing hypersensitivity, driven by movements like #MeToo and increasing societal awareness, the need for clear guidelines on consent and appropriate touch in healthcare settings has become more critical. This Teaching Exchange emphasises the necessity for healthcare educators to cultivate a respectful, empathetic and professional environment. By addressing power imbalances, improving awareness and employing innovative teaching methods, medical institutions can ensure human touch remains a tool for compassion and learning, not contention.

Background: The Danish GP postgraduate training programme includes a 2.5-year hospital rotation, where trainees rotate across several hospital departments. However, challenges such as relevance to primary care settings, limited supervision and competing clinical demands often affect the learning effect of these rotations. This study investigated GP trainees' perceptions of hospital rotations, evaluated the impact of implemented educational and well-being initiatives and identified strategies for further improvements.

Methods: This qualitative study used surveys and semi-structured interviews to collect data. All current and past GP trainees (between 2021 and 2024) and current educational leads were invited to participate. Data were analysed using Braun and Clarke's thematic analysis framework.

Results: Results revealed challenges for GP trainees, including high workloads, limited supervision and lack of understanding of their role. While initiatives like peer-to-peer sparring and return days were appreciated by trainees, many faced barriers such as lack of prioritisation and scheduling conflicts, leading to reduced impact. Despite some successes, these initiatives were often discontinued due to low attendance or scheduling problems.

Conclusion: This study highlighted the value of hospital rotations for GP trainees, offering broad clinical exposure. However, tensions between clinical duties and educational opportunities were evident, and trainees felt that educational initiatives were deprioritised. The potential for more structured educational opportunities and increased outpatient work were seen positively, though feasibility concerns remain. Targeted changes and collaboration are essential to balance service delivery and trainee development.

Background: Family Medicine residency programmes are essential for training competent physicians. Patients generally view the involvement of family medicine residents in their care positively, but there is a gap in understanding residents' roles and training levels.

Objectives: Evaluate patients' perceptions when consulting family medicine residents.

Methods: Conducted in nine teaching Family Health Units in Portugal, 314 patients who had both consultations with their family doctor and a resident participated. They completed an anonymous 33-question self-administered questionnaire divided into seven sections with multiple-choice and 5-point Likert scale questions. Data included socio-demographic information, knowledge about residents' training, perceptions of residents' communication skills, confidence, satisfaction, and strategies to improve adherence to consultations with residents. Likert questions were scored from 1 (strongly disagree) to 5 (strongly agree).

Results: Approximately 71.9% of participants knew that a resident had completed their medical degree, and 77.5% correctly identified residents as doctors in training. Patients rated residents' communication skills highly (mean score: 4.9 ± 0.5) and expressed high confidence (4.3 ± 0.5) and satisfaction (4.6 ± 0.6). Most participants (64.9%) reported no disadvantages in consulting a resident, with the primary advantage being their contribution to the training of future family doctors (80.9%). Key strategies for improving adherence included the family doctor introducing the resident and discussing the treatment plan together.

Conclusion: Patients generally have positive perceptions of family medicine residents, trust their decisions, and are satisfied with their involvement. Introducing residents and involving family doctors in consultations can enhance adherence, emphasising the importance of the family doctor-patient-resident triad in primary healthcare.