Education for Primary Care最新文献

Purpose: To evaluate Australian early-career general practitioners' perceptions of the utility of their prior vocational training in preparing them for independent specialist practice. We hypothesised that in-practice teaching would be perceived as more useful than formal education delivered by Regional Training Organisations (RTOs).

Methods and materials: A cross-sectional questionnaire-based study of early-career general practitioners (RTO 'alumni'). The outcomes were Likert scale ratings of alumni's perceived impact of RTO education versus in-practice training on their preparedness for independent practice. Ratings were compared using Wilcoxon signed-rank tests. Multivariable linear regression was used to establish alumni characteristics associated with perceptions of utility of in-practice versus RTO-delivered education.

Results: Three hundred and fifty-four alumni responded (response rate 28%). In-practice training was rated statistically significantly higher than RTO education for minor procedural skills, teaching skills, professional responsibilities, tolerating clinical uncertainty, and preparing for managing child and adolescent health, aged care, chronic disease, multi-morbidity and mental health. RTO education rated higher than in-practice training for practising evidence-based medicine and Aboriginal and Torres Strait Islander health. For a number of further areas, there was no statistically significant difference in alumni ratings of utility.

Conclusions: In-practice or RTO-led teaching was perceived as more useful for some components of independent practice, whilst for others there was no significant difference. The findings support recognition of the individual educational components of a blended education/training structure.

In March 2020, due to the escalating global coronavirus (COVID-19) pandemic, clinical placements for most medical students in the UK were suspended. A phased resumption of clinical placements started at the beginning of academic year 2020/2021. For the Scottish Graduate Entry Medicine programme (ScotGEM), 2020/21 was the first year that Dundee School of Medicine's comprehensive LIC was extended to all 54 students in the penultimate year of the ScotGEM programme. This cross-sectional qualitative study explored aspects of tutors' experiences of supporting LIC students in their practices. Thematic analysis of the data identified significant themes relating to the effects of the coronavirus pandemic on the organisation of the LIC placements and the experiences of the tutors, and the ways in which they adapted placements to the rapidly changing clinical and social landscapes. The changes necessitated by the pandemic posed significant challenges for practice-based tutors in ensuring that students had valuable educational experiences despite the constraints of social distancing requirements and the reduction in face-to-face consultations. However, tutors also identified several positive aspects of the changes which will be of interest to those involved in the organisation and delivery of both LIC and shorter General Practice based clinical attachments. Positive relationships between LIC students and practices enhanced the success of LIC placements. We will discuss how lessons learned from the experience of tutors in the pandemic could be used in the longer term to enrich the LIC experience and General Practice placements more generally.

Purpose: The benefits of medical humanities in medical education have been extensively cited. The aim of this research was to explore the perspectives of UK GP trainers towards using medical humanities to teach GP trainees in primary care.

Method: Phenomenological, qualitative research designed was used. Semi-structured interviews were conducted with eight GP trainers from across the UK, between April and May 2020. Poems were used as discussion prompts for those participants who lacked experience using medical humanities to teach GP trainees.

Results: Emerging themes were that all participating GP trainers recognised the benefit of medical humanities to GP training, yet only 50% of them were actually using medical humanities in their teaching. An overburdened GP curriculum, a lack of funding and a lack of clinically relevant art and literature resources were identified as barriers for the inclusion of medical humanities into GP training. Furthermore, GP trainers identified the need for peer networks and medical humanities conferences to encourage the use of medical humanities in GP training.

Conclusion: This study provides the perspective of UK GP trainers towards using medical humanities in teaching GP trainees in primary care. GP trainers identified sustainable funding to develop a resource bank of art and literature, peer network events and medical humanities conferences as key interventions to facilitate medical humanities teaching in GP training. Recommendations for future research include robust studies focusing on the effectiveness of various techniques used to integrate medical humanities into GP training, such as poetry.

Clinical placement is an important aspect of undergraduate education in the United Kingdom (UK) but with no national curriculum for primary care teaching, it is important to consider the learning opportunities afforded to students when on these rotations. In earlier years, observing consultations constitutes a large proportion of student experience, with patient consent an integral aspect of this teaching method. This study investigated whether patients consider the gender of a medical student when granting consent for their primary care appointment to be observed and whether this was conditional based on their presenting complaint. In total, 551 adult participants (420 females and 131 males) residing in the UK, aged 18-87 years, responded to an online questionnaire. In total, 229 (41.6%) participants stated that they would be influenced by the student's gender when consenting to observation, notably if the presenting complaint concerned an intimate area or their sexual health. A statistically significant correlation was revealed for consent, participant age and participant gender, with younger female respondents less likely to consent to observation by male students. The findings highlight a potential concern pertaining to equal opportunities between medical students based on gender, with inclusivity and diversity considerations for medical schools and clinicians.

International knowledge exchanges within healthcare have historically been a popular method to provide exposure to practice in other national and international healthcare settings. As the COVID-19 pandemic forced many countries into lockdowns, knowledge exchanges in healthcare were forced into a period of suspension. This provided an opportunity to consider alternative methods of delivery. This scoping review explores virtual knowledge exchanges in healthcare professional education, including their format and related outcomes. Thirty-four virtual knowledge exchanges were identified. These demonstrated viability and subjective participant satisfaction. Virtual methods removed barriers of time, distance and finance associated with traditional exchanges, while still facilitating engagement with other international healthcare colleagues. However these exchanges were heterogeneous in their aims, structure and theoretical underpinnings. An understanding of educational outcomes and their measurement was not always obvious. Applying an overlay of robust pedagogical theory would strengthen and provide structure to the clearly well valued activity of international exchange.

Background: Policy promotes students and doctors becoming GPs, yet there exists little focus on GP trainers' recruitment and retention.

Aim: To explore barriers and enablers facilitating the professional identity formation of a GP becoming a GP trainer.

Design and setting: A qualitative case study within one training programme of the Scottish Deanery.

Method: Data were collected between January and November 2018 via semi-structured interviews with 16 GP trainers and 79 regulatory and policy documents. Thematic analysis was applied whilst a reflexive stance as a previous GP trainer was maintained.

Results: Findings indicate GPs become GP trainers through experiences and events across three predominant identities: 'Becoming a Doctor', 'Becoming a GP' and 'Becoming a GP Trainer'. Impediment at any of these stages acts as a barrier. The GP trainer role suggests tendencies for clinicians to be understated in their achievements and abilities. GP trainers dually enact and role model that of clinician and teacher; time acts as a significant barrier. The Scottish Prospective Educational Supervisor Course (SPESC), or previous iterations, is a significant enabler. Royal College of GP's contributions towards GP trainers is absent. GP trainer associations with out-of-hours services have changed over time. GP trainer/trainee relationships are essential enablers to a continued GP trainer professional identity.

Conclusion: The role of the GP trainer as a teacher needs highlighting. Processes that protect and maximise this role may enhance the positive contributions of being a teacher. Understanding these themes may enhance recruitment and retention of GP trainers.

There is compelling evidence that general practice (GP) is the most effective form of healthcare. However, healthcare policy appears independent of evidence and GP is woefully under-resourced in all countries, and this affects recruitment. Recruitment to GP is proportional to the quantity and quality of undergraduate experience and national and transnational guidelines can improve undergraduate experiences by defining both the desired quantity and quality. There is good evidence that these professionally developed guidelines can be effective in changing Government policy if they are used as a touchstone to collaborate with policymakers.EURACT (European Academy of Teachers in General Practice / Family Medicine) have therefore developed transnational guidelines covering the European region. The guidelines cover the desired quantity, quality and support for undergraduate experience. Three main design principles have been used. Firstly, it is democratic. Secondly it is evidence-based, using extensive literature searching, situational analysis and surveys. Finally, it adopts a 'principles-based approach'. Generalist medicine is articulated as a series of interconnected principles that integrate and then re-focus specialist medicine to achieve the enhanced patient-orientated outcomes of primary-care. This way of articulating generalist practice delivers general principles, which can be used as learning outcomes, that are adaptable to a wide range of learning environments. Most clinical learning documents are irrelevant and are destined for dusty drawers or forgotten digital files. We therefore encourage primary care educators to use these guidelines to work with policy-makers at all levels to advocate for change, strengthening primary care education at local, national and international levels.