Education for Primary Care最新文献

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.

Belonging is increasingly recognised as an important component of successful medical education. It affects academic achievement, wellbeing, and professional identity formation. This article examines how this concept applies to undergraduate students on community clinical placements and postgraduate vocational general practice (GP) trainees. Additionally, we consider the broader impact of belonging beyond the learner - on patient safety and quality of care. We explore how structural, cultural and relational factors can promote or hinder a sense of belonging. The shift towards competency-based training, reductions in continuity of care, and changes in the primary care infrastructure and workforce, complicate traditional notions of belonging. This highlights the need for holistic, flexible and inclusive educational practices. Key themes that promote belonging include the importance of connection through peer networks, mentorship, continuity, an inclusive learning environment which fosters psychological safety, and learner autonomy to accommodate differing needs and interests. Forming high quality relationships strengthens all of these. We propose centring a sense of belonging in medical education through a more relational approach. This can better support the development of resilient, reflective and connected general practitioners prepared to meet the evolving needs of primary care.

What was the educational challenge?: Create a new GP teaching day based at the university hospital site that inspires medical students to perceive GP lecturers as academics with a view to following primary care as a future career.

What was the solution?: Technifying and gamifying GP teaching. Collaboration with the digital education team using new technology including virtual reality (VR) headsets and immersive projector room to embed innovative teaching practices into traditional GP teaching. Also used a gamification approach to introduce quality improvement and emphasise the importance of communication between healthcare teams.

What lessons were learned?: Students highly rated this teaching. Written feedback suggested it was valued far more than lecture-based teaching due to its immersive and interactive nature. Students strongly felt it prepared them for placement.

What are the next steps?: Further evaluation of this year's student feedback and a follow-up study of perceptions of clinical and academic general practice as career options. Working with the digital technology team to enhance the current teaching further and disseminating this work across the medical school.