Education for Primary Care最新文献

Different views exist about the training needs of new clinical educators and how they might be met. This contributes to the variably of early professional development offerings. One area of contention concerns the value of educational theory. A paper published in this journal questioned the importance of educational theory in delivering effective GP training and the authors claimed that they had been unable to find an explicit exploration of this issue. If we look to another field - teacher training - the place of educational theory has been thoroughly explored. Leading teacher educators have reported how unsuccessful the 'theory-first' approach has been in influencing teachers' practice and improving pupils' education. 'Realistic teacher education' is proposed as an alternative, which starts from student teachers' practical experiences and the needs and concerns that arise from them. This 'theory-later' approach has influenced novel forms of professional development for clinical educators, where theory is introduced if it is perceived as being relevant to the teaching and learning problems under discussion. This requires facilitators who are comfortable in working from practice to theory. Forsaking a 'theory-first' approach in foundational courses should not make educational theory disappear but prompts course designers to ask if it is better placed in subsequent professional development offerings when clinical educators have had some teaching experience.

Introduction: Increasing numbers of doctors training in the United Kingdom (UK) have specific learning differences (SpLDs) which may affect performance in licencing examinations. There is limited evidence for how and why SpLDs affect performance in licencing exams. We explored perceptions of General Practice Speciality Trainees (GPSTs) with SpLDs on the challenges of UK licencing examinations and workplace-based assessment, and strategies for overcoming these.

Methods: We used a qualitative design employing Systematic Grounded Theory with inductive methods to inform theory development. Individual semi-structured interviews were conducted, transcribed and analysed using three steps of open, axial and selective coding. We recruited from UK general practice training schemes with purposive sampling to include participants of different sex, stage of training and UK or overseas primary medical qualification.

Findings: We interviewed 18 GPSTs with a SpLD, four male and 14 female, at various stages of training, who had undergone primary medical training in the UK or overseas. We identified four core themes from the analysis: 1 Importance of early detection, screening and referral; 2 Understanding the intersection of SpLDs, culture and language; 3 Educational and organisational approaches to GP trainees with SpLDs; and 4 Addressing emotional and wellbeing impacts.

Conclusion: This study has identified tailored strategies to support learning and assessment for GPSTs with a SpLD, which could improve learning experiences, wellbeing and outcomes.

In this paper, we to share our development of feedback and supervision methods using video. During the last 32 years, we have developed methods of supervision in the consultation lab on Kalymnos, Greece, with more than 5,000 Danish and Swedish GPs attending. We describe how to supervise video of role-plays, real-life consultations and a new method, supervision of supervision. This work is significant because nobody - to our knowledge - has done this both in depth and extensively. 'Five Bullets': Development of methods of video-based feedback and supervision on Kalymnos; Examining the conversation as it were 'under the microscope' - First step: Training consultation skills using video-recorded patient roleplays - Second step: Supervision of 'real life' consultations on video - Third step: Recording the supervision process and reviewing it afterwards.

Background: Medical trainees experience occupational stress, prompting increasing research to explore wellbeing interventions. To date, few meta-analyses have evaluated intervention effects, and none have focused on trainees in family medicine or general practice (FM/GP), specifically. Aim: To synthesise available literature on psychosocial interventions to promote wellbeing, and subsequently reduce ill-being or burnout, among FM/GP specialty trainees.

Methods: Preferred Reporting Items for Systematic Review and Meta-Analysis were followed and online databases (Embase, Medline, PsycINFO, ProQuest, Scopus) systematically searched (no date limits) for published studies and dissertations. The methodological quality of included studies was reviewed (Mixed Methods Appraisal tool, GRADE assessment), and pre-post changes (Hedges' g) pooled using random effects modelling.

Results: Eleven independent studies, involving 182 FM/GP trainees, were included in this review. Evaluated studies varied in their design and the results were characterised by imprecision. Interventions differed in their content, delivery, and length. The data did not favour a single type of intervention, although supporting individuals to monitor their wellbeing did produce significant, positive effects.

Conclusions: There is a lack of evidence about the best ways to promote wellbeing in FM/GP trainees. Both the methodology and design of training and educational initiatives for FM/GP need careful consideration in order to progress this research.

Medical students are expected to explain and display the importance of professional development and lifelong learning and demonstrate commitment to this. Studies have identified that students desire additional opportunities for professional development outside of that provided by their medical school's curriculum. The University of Nottingham's General Practice Society professional development scheme was designed to address a current gap in extracurricular activities provided to students with an interest in a career in general practice. Medical students were invited to 8 development sessions between January and March 2024, covering topics such as medical education, leadership, research, and networking. The sessions were delivered by practising General Practitioners (GPs) and students. Feedback surveys evaluated aspects of personal and professional development and course satisfaction. 10 students attended at least 6 sessions and completed surveys. Mean scores for all questions improved after the scheme (p ranging < 0.001-0.005), including an increase in the likelihood of students pursuing a career in general practice (mean score 3.40 pre-scheme to 4.00 post-scheme, p = 0.005). This study demonstrates that the professional development scheme produced a statistically significant increase in student's knowledge of how to pursue a career in general practice, knowledge of what a career in general practice entails, and confidence in leadership, medical education and networking. Similar schemes have the potential to not only increase the number of students progressing towards general practice as a career, but also to develop students' skill set and meet their desire for extracurricular professional development.

Interprofessional collaboration (IPC) among the health professions is recognised as a vital component of efficient health systems and comprehensive healthcare teams. Interprofessional education for collaborative practice (IPECP) is foundational for health professional students to gain an understanding of professional roles, responsibilities, and the value of other professions to patient care. Oral health professionals are highly skilled and knowledgeable experts who recognise the oral-systemic health link. However, they have been largely excluded from, and underutilised within primary healthcare settings and interprofessional teams. Given that oral health is a key indicator of overall health and wellbeing, there is a need mobilise oral health professionals within primary healthcare practice. Yet, advancements for IPECP in oral health education face significant barriers which impede the integration of the oral health professions within interprofessional teams. Collaborative approaches across health programmes to devise intentional, authentic, and transformative strategies for IPECP are needed to bridge gaps in patient care and to dismantle problematic perceptions of 'oral health' as distinct from overall health and wellbeing in contemporary healthcare practice.

This article describes the Academic Department of Military General Practice's experiences of the Defence Medical Services General Practice Specialist Training operational preparedness training programme, which culminates in an immersive simulation exercise. Our premise is that additional training is required to close the delta between the civilian GP training pathway and the military operational role on completion of training. Specifically, effective preparatory training optimises a clinicians' performance, while safeguarding their mental and physical health, thereby improving patient outcomes. A key focus has been to facilitate the development of a personal growth mindset in response to adversity, and in so doing contribute to workforce resilience and enduring mission success.The course has been developed using feedback from the General Practice Specialist Trainees, simulated patients and an external independent observers. We present a consolidated educational approach to medical operational preparedness training, through experiential learning. We believe that many of the lessons identified from adopting this approach are transferrable to the Defence educational and training community, our international partner forces and wider civilian humanitarian medical providers. We have concentrated on co-creating an immersive educational environment that utilises a formative assessment approach, capitalising on emergent learning opportunities provided by contemporary operations.

Introduction: Advance care planning (ACP) aims at empowering patients with chronic progressive disease to express and communicate their preferences for future care, but is not yet consistently applied in general practice. We explored GP residents' experiences with practicing ACP conversations through virtual simulation and its educational value.

Methods: Our study with Dutch GP residents in their first year of training used a hermeneutic phenomenological approach. Eleven participants were observed while engaging in virtual simulation, followed by an in-depth interview. Data was analysed in an iterative manner, starting from the first interview.

Results: Although the virtual simulation was mostly experienced as not realistic because it lacked the possibility of nuanced wording and personal adjustments, the GP residents did find it valuable to learn what topics can be addressed and how. The learning experience was primarily shaped by GP residents' prior real-life ACP experiences.

Discussion: Virtual simulation is a valuable part of a blended curriculum, facilitating residents to get started with or refresh the basic knowledge and skills of ACP. It is crucial that virtual simulation is followed by critical reflection with peers and supervising GPs and practice with actors or real patients to ensure GP residents can further develop their skills regarding ACP conversations.