Education for Primary Care最新文献

Giving students more responsibility for patients during medical school may help prepare them for their transition to clinical practice. Student-led clinics (SLCs) could facilitate this. Within SLCs, students take the lead role in delivering patient care, with support and supervision from clinicians. A general practice SLC was established in Dundee, Scotland, with four final-year medical students and one general practitioner (GP) involved in each clinic. Our qualitative case study aimed to explore students' and educators' (GPs') experiences and perceptions of this SLC. Semi-structured interviews were conducted with 11 students and three educators, and 18 hrs of observation were conducted over six clinics. Interview transcripts and fieldnotes were integrated and thematically analysed, revealing five main themes. Overall, students' and educators' experiences and perceptions were positive. Students thrived in their lead role in patient care, gaining a sense of empowerment and developing confidence in their abilities. Both students and educators felt comfortable with students having this level of responsibility due to students' seniority and the supervision provided by educators. Teaching in the SLC involved individual discussions and group debriefs. Students developed a sense of belonging as a result of their positive relationships with peers and educators and the environment of the Student Hub. Challenges arose when the clinic ran behind schedule due to unexpectedly complex patients or lengthy individual discussions. Our findings suggest that giving students responsibility for real patients is beneficial and feasible when adequate support is provided and that it is possible for one GP to supervise multiple students successfully.

The healthcare needs of transgender patients are unique and not accounted for within dominant narratives of medical care. This article explores care challenges faced by two transgender individuals navigating healthcare systems and medical school curriculum in Canada. Medical education has a critical role to play in addressing the invisibility of gender and sexually diverse patients, and the inclusion of diverse patients' stories in medical education can help train emerging medical professionals to apply affirming lenses to their care practices and foster a more inclusive and supportive environment for all.

Within Canada, 25% of physicians are international medical graduates (IMGs) who completed medical school outside of Canada. While they may share similar cultural backgrounds with Canada's multi-cultural population, they have been trained abroad. The purpose of this study was to identify the rewards and challenges experienced by IMG family physicians when caring for patients of the same cultural background as the physician. Using a descriptive qualitative approach, we conducted in-depth, semi-structured interviews with 18 practicing, licenced IMG family physicians in Edmonton and Calgary, Alberta, Canada. The interview questions addressed the rewards and challenges of providing culturally concordant care. Audiotaped interviews were transcribed and subject to qualitative latent content analysis. The study findings revealed that the rewards of caring for patients of the same cultural background as the IMG family physician included: shared cultural values; a common language; and establishment of patient rapport and trust. The challenges associated with caring for patients of the same cultural background as the IMG physician included: concerns with patients crossing boundaries; communication challenges; and perception of appointments being longer. Understanding these dynamics can help better prepare IMGs for family practice, particularly in navigating professional boundaries, which should be emphasised during IMG training and induction into the healthcare system.

Background: Medical school curricula have seen an expansion of teaching in the community. A rural primary care setting may offer students a variety of patient interactions and opportunities to improve their clinical skills within small teams. GP recruitment remains challenging, especially in rural areas but exposure to such settings during training may positively influence career intentions. There is a lack of research into students' perceptions of their rural primary care placements. This study aimed to increase our understanding of medical students'experiences of rural primary care placements.

Methods: An Interpretative Phenomenological Approach explored students' lived experiences through semi-structured interviews with five final-year medical students.

Results: Interview transcripts were analysed to identify multiple Personal ExperientialThemes which led to the development of four higher-level Group Experiential Themes: adjusting to rural living; relationship with GP supervisor and team; autonomy; and developing as a doctor.

Discussion: Students'experiences were significantly influenced by their adjustment to the rural environment. With basic needs met students began to develop a sense of belonging which facilitated learning. Relationships with GP supervisors and team members were crucial, fostering a student's sense of autonomy and professional growth. Rural placements offered students the chance to integrate into small teams, to feel valued and assume 'almost doctor' roles, providing diverse patient consultations, and preparing them for independent practice.

Background: The Simulated Consultation Assessment (SCA) replaced the Recorded Consultation Assessment (RCA) as the summative clinical component of the Membership of the Royal College of General Practitioners (MRCGP) examination for the United Kingdom (UK) general practice licencing assessment in 2023. The SCA consists of 12 online consultations with trained role players, with candidates based in their own surgery. This study aimed to gather views of stakeholders on the new assessment before its introduction.

Methods: We conducted a cross-sectional online survey. Stakeholders completing the survey included pre-RCA and post-RCA GP trainees and educator/lay stakeholders. The survey questionnaire included Likert scaled responses and free text options. Analysis included descriptive statistics, scale development measuring positivity towards SCA, a multivariable model showing factors related to this, and qualitative assessment of free text responses.

Results: There were 3,174 responses from 1,533 pre-RCA trainees, 920 post-RCA trainees, and 721 educator/lay stakeholders. Responders overall were positive about the design of SCA in terms of setting, validity, preparation and fairness. Multivariable analysis showed that International Medical Graduates (IMGs) were significantly more positive compared to UK graduates (B 0.19, 95% confidence interval 0.12-0.25, p < 0.001) with no other differences by stakeholder group, age or ethnicity. Qualitative analysis identified four themes relating to setting requirements and contingency planning, acceptability and fairness to candidates, ability to assess consultation skills and the need for evidence for the new assessment.

Conclusion: Stakeholders, while positive overall, expressed suggestions relating to practice setting, the assessment's acceptability and fairness, its ability to assess consultation skills and the need for further evaluation.

With the need for an increase in non-medical prescribers (NMPs) in the NHS, there is a lack of designated prescribing practitioners (DPPs) in place to supervise trainee NMPs. An educational five-session course was developed using the Royal Pharmaceutical Society's (RPS) competency framework to support allied healthcare professional groups (HCPs) in fulfilling the role. The aim of this study was to evaluate the knowledge and confidence of learners after their attendance, on the competencies required to become a DPP. Pre and post training questionnaires were used after sessions, identifying pre-existing knowledge and confidence in the competency framework, alongside changes after the sessions, using Likert 1-10 scales, along with job details and previous DPP experience. This study was ethically approved. Responses (n = 80) represented all HCPs including pharmacists, nurses and paramedics. The average knowledge levels increased 4.08 after the session, from 5.09 for all HCPs to 9.17 (p< 0.0001). The average confidence levels increased 3.71 from 5.49 to 9.20 for all HCP's (p< 0.0001). Over half (64%, n = 52) stated they were very likely to become DPPs following this course. Almost all (90%, n = 72) stated that they did not require any other additional training. Additional roll outs of this educational course could help increase the number of NMPs in the NHS, aligning well with the aims and objectives of the NHS Long-term and access recovery plan. A notable increase was felt by the HCPs in their knowledge and confidence from the sessions, therefore this study shows the benefit of running such a programme.