Education for Primary Care最新文献

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.

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.

A significant proportion of primary care consultations now happen remotely. Although the vast majority occur safely, a recent study highlighted areas of risk which may be compounded by the limited training many GPs have received in remote consulting. To provide safe remote services, consideration needs to be given to adapting practice workflow to optimise remote care. Patients less suitable for remote consulting, either due to disease, extremes of age, disability or for social reasons should be identified and prioritised for face-to-face encounters. Training supports both the development of individual communication skills for remote care, and effective team working. Practice-based group learning events can be used to share experiences, identify resources, and consider the risks in remote care and how they can be mitigated. The paper presents some fictionalised cases, illustrating where patients came to harm, as a result of a remote consultation, and where harm was averted due to actions taken by practice teams. These can be used to support critical thinking and discussion within practice development meetings and tutorials with trainee GPs and other practice staff. Using the paper as a basis for reflection, teaching and action can facilitate the delivery of safer remote care.

Introduction: Lack of diversity in academic staff is a national problem. At an interview for academic GP positions at our institution, there were no applicants of ethnic minority background. This does not represent our undergraduate GP teacher workforce.

Methods: To understand reasons behind the lack of applicant diversity, we held two focus groups of GP teachers at our institution's annual GP teaching fora. These were recorded, transcribed and thematically analysed.

Results: Six key themes emerged. The major theme attributed the barriers to applying for an academic GP post to individual, institutional and cultural factors. Individual factors included a concern of being under-qualified, out of comfort-zone as well as a lack of awareness of the role. Institutional factors noted insufficient ethnic minority academic role models and inaccessible advertising. Cultural factors illustrate increased challenge, disproportionate stress and paucity of contacts. Our participants discussed their recommendations for change and reflected on their positive experiences.

Discussion: Our research highlights the interplay of factors affecting applicant diversity in academic GP posts. Intersectional theory helps explain the disadvantage, and role modelling is a mechanism to break free. Change is achievable. Interventions can be targeted at both individuals and institutions, to provide momentum for cultural rehabilitation.

General practitioners (GPs) are role models with the potential to influence the career choice of medical students. Post-Covid-19, the clinical learning environment in general practice has employed new ways of working, including a greater proportion of telephone consultations. This study aimed to identify teaching solutions and strategies utilised by GP supervisors to create positive learning opportunities for final-year medical students at Brighton and Sussex Medical School (BSMS) during the academic year 2021-22. The data arose from a medical student evaluation survey, with applied thematic analysis used to identify emerging themes. The overarching theme was the use of 'supervised independence' to facilitate learning. Supervised independence involved giving learners responsibility alongside practical support which included integration into the general practice team. Five main types of learning opportunity were identified, all of which are deliverable in general practice placements more widely. The skill of facilitating supervised independence is a key attribute of an inspirational GP supervisor, which should be promoted among prospective teachers during preparation for teaching.