Education for Primary Care最新文献

Introduction: Burnout affects the primary care workforce and their educators. Health Education England (HEE) offered resources to Training Hubs to support their primary care educators, through identifying a burnout champion and offering appropriate educational support. This study evaluates these initiatives.

Methods: Data about the educational support was collected through observation of targeted training events and an Integrated Care System (ICS) educational day. The experience of burnout and the support options for educators was explored through a focus group and semi-structured interviews with key stakeholders.

Results: Primary care educators identified the following factors as causing or exacerbating their burnout: excessive workload, insufficient time, isolation, lack of debrief, generational differences and the COVID-19 epidemic. Multiprofessional educators expressed concern about a lack of support and protected time in their working day to attend training in contrast to their perception of the situation for GP educators. Identification of and terminology around multiprofessional educators further exacerbates this disparity. Individuals and their managers had difficulty identifying burnout. Practice managers were seen as central to preventing burnout.

Recommendations and conclusions: Recognising, identifying and supporting the range of educators in primary care is key to offering appropriate help to prevent and manage burnout. Peer networks and multiprofessional faculty groups were considered supportive to all the professionals. Practice managers, training hubs and educational approval processes have a role to play in supporting primary care educators in the constantly changing environment.

Background: Continuity of education (CoE) is a growing area of interest in health professions education, both for its impacts on learning (continuity of curriculum and continuity of supervision; CoS) and for its influence on patient care (continuity of patient care; CoPC). The COVID-19 pandemic offered an opportunity to examine discontinuity of education and the potential impacts of interruption to CoE, a knowledge gap in medical education research.

Methods: We conducted 14 semi-structured qualitative interviews involving participants from a Canadian family medicine programme. We recorded and transcribed interviews conducted on Zoom that were then analysed iteratively using reflexive thematic analysis to identify major themes.

Results: We identified three themes. Theme 1: Changed relationships: an alteration due to mitigation strategies. Theme 2: Preparedness for practice: a decrease despite mitigation strategies. Theme 3: Adaptivity in the face of change: a consequence of mitigation strategies.

Conclusion: This study suggests that there are three main implications resulting from the impacts of disruption to CoE. Faculty development and curricular design are needed to support interrupted relationships, including finding ways to help faculty and residents nurture changed relationships. Physicians in their first 5 years of practice who have experienced disruption in their training may benefit from additional support to address the negative impact on their sense of preparedness for practice. Finally, the positives learned from this study can be used to face future disruptions to CoE.

Background: Recruiting and retaining International Medical Graduates (IMGs) has been identified as a key component in addressing the ongoing workforce crisis in general practice. However, research shows IMG General Practitioners (GPs) face unique challenges compared to their UK-trained counterparts, impacting their welfare, retention in the workforce, and ability to provide patient care.

Aim: This study examined the challenges facing early-career IMG GPs, the help and support they access and want to access, and their perceptions and utilisation of the help and support available.

Design and setting: A mixed-methods study that collected primary data in an online survey and interviews between March and May 2023.

Method: Early-career IMG GPs based in South West England were invited to complete an online survey consisting of 5-point Likert-scale and free-text questions. Interviews were completed with key informants and some survey respondents. Qualitative data were analysed thematically. Data from the survey and interviews were analysed and merged using a convergent parallel design.

Results: Based on 29 survey replies and 9 interviews, four interrelated themes were identified: (i) communication and language, (ii) racism, unequal treatment, and developing coping mechanisms (iii), exclusion and being 'othered', and (iv) adapting to new ways of living and working. Although some IMG GPs access help and support, many feel this is insufficient and poorly accessible.

Conclusion: IMG GPs face interrelated and unique challenges in their personal and professional lives and do not feel adequately supported by the NHS. Addressing this disconnect will be vital to sustaining the general practice workforce.

Menorrhagia is a condition in which the prevalence varies greatly, with some studies estimating that it can impact up to 25% of women. Menorrhagia, or heavy menstrual periods, can be part of a woman's normal menstrual lifecycle, and is impacted by events such as pregnancy and the menopause, as well as other gynaecological conditions such as endometrial cancer. Menorrhagia's definition is now broadly based on the woman's subjective experience of excessive blood loss and impact on quality of life. However, research suggests that women are undereducated about menorrhagia, feel societal pressure to mask their symptoms and may turn to online resources of variable validity in the quest for information.This project sought to understand the adherence of clinicians at a Derbyshire general practice to NICE guidelines regarding history documentation, discussion and provision of resources in patients with menorrhagia from May 2024 to November 2024. Fifty patients were identified following a SystemOne search of the terms 'menorrhagia' or 'excessive and frequent menstruation', 'heavy menstrual period' and 'perimenopausal menorrhagia'.Overall, documentation according to NICE guidelines was poor, often missing the impact of menorrhagia on a woman's quality of life, and there was a lack of documentation regarding the provision of evidence-based resources for patient education. These findings likely represent growing time pressures of practitioners. To combat this, a 'Heavy Periods Passport' has been developed to be uploaded to the patient record to address this gap in the clinical record, ensure patients are provided with accurate information and to improve continuity of care.

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.

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.