Australian Journal of General Practice最新文献

Background: The adjustment to general practice experienced by registrars is inevitable and can be confronting. The training for independent specialist practice occurs in unique clinical environments and circumstances. If not accounted for, the transition process might prove an insurmountable barrier resulting in burnout and attrition from the training program.

Objective: This paper provides an understanding of the transition process and explores specific contributing factors, including uncertainty. Registrars, supervisors and medical educators will be provided with practical strategies to navigate these factors.

Discussion: Although the adjustment is inevitable, adversity is not. Rather, this experience can be formative given the right support and environment. Acknowledging the presence and impact of uncertainty, having adequate supervision within a supportive community of practice, being exposed to a varied case mix, engaging with shared decision-making processes and using safety netting are all important in ensuring the transition process is formative.

Background and objectives: Research examining medical trainee burnout has typically not focused within specialties. The present study therefore explored perspectives and experiences of registrar burnout among Australian general practice training stakeholders.

Method: Registrars, supervisors, training coordinators and educators (n = 47) from a single training organisation completed interviews and participated in focus groups. Data were iteratively analysed using template analysis and grounded theory.

Results: Risk factors for burnout were categorised into three themes: (1) lack of personal and/or job resources; (2) high demand or workload; and (3) unsupportive psychosocial context. Registrar subgroups (ie junior/senior, rural/urban) faced further specific risk factors.

Discussion: Identified themes highlight the complex nature of burnout development, including factors pertinent to the Australian general practice context. The findings highlight key areas for interventional design, including optimising supervision and educational practices to meet registrars' needs and easing the adjustment to general practice from hospital settings.

Background: Hypertriglyceridaemia is commonly encountered in clinical practice and is associated with an increased risk of cardiovascular disease and acute pancreatitis. General practitioners play a central role in treating patients with hypertriglyceridaemia, ultimately with the aim of preventing associated complications.

Objective: The aim of this paper is to provide a contemporary approach to the management of patients with hypertriglyceridaemia in Australian primary care.

Discussion: Hypertriglyceridaemia is often attributable to secondary causes, which should be identified and addressed. Healthy lifestyle modifications targeting diet, exercise, alcohol consumption and weight are fundamental. Statins should be prescribed according to cardiovascular risk assessment and can reduce triglyceride levels. Icosapent ethyl is subsidised on the Pharmaceutical Benefits Scheme and is recommended to reduce cardiovascular risk in statin-treated patients with cardiovascular disease and mild-to-moderate fasting hypertriglyceridaemia (1.7-5.6 mmol/L). In patients with severe hypertriglyceridaemia (>5.6 mmol/L), intensive triglyceride-lowering with lifestyle modifications and pharmacotherapy is recommended to reduce pancreatitis risk. Specialist referral should be considered for severe cases of hypertriglyceridaemia or when primary genetic causes are suspected.

Background: Artificial intelligence (AI) is increasingly being integrated into various sectors, including healthcare and education, offering transformative potential to enhance learning, assessment and professional development. In medical education, AI presents opportunities to enhance educational content and delivery. AI is also having a significant impact more generally in the medical sector. However, its adoption raises ethical, privacy and accessibility concerns that must be carefully addressed.

Objective: This article explores a range of potential uses of AI in medical education, as well as highlighting some potential risks and pitfalls associated with this emergent technology.

Discussion: AI enhances medical education through personalised learning, simulations and efficient assessments, improving both content delivery and student outcomes. However, ethical concerns, data privacy and over-reliance on technology pose challenges. By addressing these issues through robust governance, human oversight and balanced integration, AI can complement traditional methods, fostering a more innovative and inclusive learning environment for future healthcare professionals.

Background: Protecting travellers from vaccine-preventable diseases is an essential part of pre-travel healthcare. With new vaccines available and others in development, the options for travellers are expanding.

Objective: This review focuses on pre-travel vaccination principles; outlines routine, required and recommended vaccines for travellers; and highlights emerging options.

Discussion: General practitioners play a crucial part in preparing travellers. This article outlines a comprehensive approach to pre-travel vaccination that considers individual needs, trip-related factors and recent updates to vaccine recommendations. It emphasises the importance of disease prevention over treatment and addresses practical aspects of pre-travel consultations, including administration of multiple vaccines, timing of doses and management of complex travel itineraries. A case study is included to illustrate the application of these principles in a real-world scenario.