Maintaining capacity for in-practice teaching and supervision of students and general practice trainees: a cross-sectional study of early career general practitioners

2018 ◽  
Vol 42 (6) ◽  
pp. 643 ◽  
Author(s):  
Nigel Catzikiris ◽  
Amanda Tapley ◽  
Simon Morgan ◽  
Elizabeth G. Holliday ◽  
Jean Ball ◽  
...  
Keyword(s):  
General Practice ◽  
Medical Students ◽  
Vocational Training ◽  
Current Practice ◽  
Clinical Teaching ◽  
Home Visits ◽  
Early Career ◽  
Workforce Training ◽  
Cross Sectional ◽  
Training Capacity

Objectives Expanding learner cohorts of medical students and general practitioner (GP) vocational trainees and the impending retirement of the ‘baby boomer’ GP cohort threaten the teaching and supervisory capacity of the Australian GP workforce. Engaging newly qualified GPs is essential to sustaining this workforce training capacity. The aim of the present study was to establish the prevalence and associations of in-practice clinical teaching and supervision in early career GPs. Methods The present study was a cross-sectional questionnaire-based study of recent (within 5 years) alumni of three of Australia’s 17 regional general practice training programs. The outcome factor was whether the alumnus taught or supervised medical students, GP registrars or other learners in their current practice. Logistic regression analysis was used to establish associations of teaching and supervision with independent variables comprising alumnus demographics, current practice characteristics and vocational training experiences. Results In all, 230 alumni returned questionnaires (response rate 37.4%). Of currently practising alumni, 52.4% (95% confidence interval (CI) 45.6–59.0%) reported current teaching or supervisory activities. Factors significantly (P<0.05) associated with alumni currently undertaking in-practice clinical teaching and supervision were: Australian medical graduation (odds ratio (OR) for international graduates 0.36; 95% CI 0.14–0.92), working in a regional or remote area (OR 2.75; 95% CI 1.24–6.11) and currently undertaking nursing home visits, home visits or after-hours work (OR 2.01; CI 1.02–3.94). Conclusions Rural–urban and country-of-graduation differences in the engagement of early career GPs in practice-based apprenticeship-like teaching or training should inform strategies to maintain workforce training capacity. What is known about the topic? Projected changes in the demand for and supply of clinical teaching and supervision within Australian general practice will require greater uptake of teaching and supervision by recently qualified GPs to ensure sustainability of this teaching model. Although interest in and undertaking of teaching roles have been documented for GP or family medicine trainees, studies investigating the engagement in these clinical roles by GPs during their early post-training period are lacking. What does this paper add? This paper is the first to document the prevalence of teaching and supervision undertaken by early career GPs as part of their regular clinical practice. We also demonstrate associations of practice rurality, country of medical graduation and undertaking non-practice-based clinical roles with GPs’ engagement in teaching and supervisory roles. What are the implications for practitioners? Establishing current teaching patterns of GPs enables appropriate targeting of new strategies to sustain an effective teaching and supervisory capacity within general practice. The findings of the present study suggest that exploring focused strategies to facilitate and support international medical graduates to engage in teaching during their vocational training, aided by focused supervisor support, may be of particular value.

scholarly journals New alumni EXperiences of Training and independent Unsupervised Practice (NEXT-UP): protocol for a cross-sectional study of early career general practitioners

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e029585 ◽  
Author(s):  
Parker Magin ◽  
Dominica Moad ◽  
Amanda Tapley ◽  
L Holliday ◽  
Andrew Davey ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Vocational Training ◽  
Educational Practice ◽  
Cross Sectional Study ◽  
Educational Programme ◽  
Early Career ◽  
Nursing Home Care ◽  
Independent Practice ◽  
Cross Sectional

IntroductionGeneral practice in Australia, as in many countries, faces challenges in the areas of workforce capacity and workforce distribution. General practice vocational training in Australia not only addresses the training of competent independent general practitioners (GPs) but also addresses these workforce issues. This study aims to establish the prevalence and associations of early career (within 2 years of completion of vocational training) GPs’ practice characteristics; and also to establish their perceptions of utility of their training in preparing them for independent practice.Methods and analysisThis will be a cross-sectional questionnaire study. Participants will be former registrars (‘alumni’) of three regional training organisations (RTOs) who achieved general practice Fellowship (qualifying them for independent practice) between January 2016 and July 2018 inclusive. The questionnaire data will be linked to data collected as part of the participants’ educational programme with the RTOs. Outcomes will include alumni rurality of practice; socioeconomic status of practice; retention within their RTO’s geographic footprint; workload; provision of nursing home care, after-hours care and home visits; and involvement in general practice teaching and supervision. Associations of these outcomes will be established with logistic regression. The utility of RTO-provided training versus in-practice training in preparing the early career GP for unsupervised post-Ffellowship practice in particular aspects of practice will be assessed with χ2tests.Ethics and disseminationEthics approval is by the University of Newcastle Human Research Ethics Committee, approval numbers H-2018-0333 and H-2009-0323. The findings of this study will be widely disseminated via conference presentations and publication in peer-reviewed journals, educational practice translational workshops and the GP Synergy Research subwebsite.

scholarly journals Study protocol: content and perceived educational utility of different modalities of clinical teaching visit (CTV) workplace-based assessments within Australian general practice vocational training: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045643
Author(s):  
Alison Fielding ◽  
Benjamin Eric Mundy ◽  
Amanda Tapley ◽  
Linda Klein ◽  
Sarah Gani ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Teaching ◽  
Educational Practice ◽  
Cross Sectional Study ◽  
Practice Session ◽  
Cross Sectional ◽  
Human Research Ethics ◽  
General Practice Registrar ◽  
Australian General Practice ◽  
The University

IntroductionClinical teaching visits (CTVs) are formative workplace-based assessments that involve a senior general practitioner (GP) observing a clinical practice session of a general practice registrar (specialist vocational GP trainee). These visits constitute a key part of Australian GP training. Despite being mandatory and resource-intensive, there is a paucity of evidence regarding the content and educational utility of CTVs. This study aims to establish the content and educational utility of CTVs across varying practice settings within Australia, as perceived by registrars and their assessors (‘CT visitors’). In addition, this study aims to establish registrar, CT visitor and practice factors associated with CTV content and perceived CTV utility ratings.Methods and analysisThis study will collect data prospectively using online questionnaires completed soon after incident CTVs. Participants will be registrars and CT visitors of CTVs conducted from March 2020 to January 2021. The setting is three Regional Training Organisations across four Australian states and territories (encompassing 37% of Australian GP registrars).Outcome factors will be a number of specified CTV content elements occurring during the CTV as well as participants’ perceptions of CTV utility, which will be analysed using univariate and multivariable regression.Ethics and disseminationEthics approval has been granted by the University of Newcastle Human Research Ethics Committee, approval number H-2020-0037. Study findings are planned to be disseminated via conference presentation, peer-reviewed journals, educational practice translational workshops and the GP Synergy research subwebsite.

scholarly journals Ten books

2007 ◽  
Vol 191 (3) ◽  
pp. 268-270
Author(s):  
Michael King
Keyword(s):  
General Practice ◽  
Medical Students ◽  
Medical School ◽  
Vocational Training ◽  
Junior Doctor ◽  
Psychiatric Training

Choosing ten books that have most influenced my practice is an odd challenge. I wasn't one of those medical students who wanted to do psychiatry since he was 12, or read most of Freud or Jung. In fact throughout medical school, and for several years as a junior doctor, I thought psychiatry and psychiatrists were pretty weird. It was only in my general practice vocational training year that I realised how much of medicine concerned the psychological and began my psychiatric training. This influence came not through books that I read but through the patients whom I saw.

scholarly journals Medical students’ perceptions of stress factors affecting their academic performance, perceived stress and stress management techniques

2018 ◽  
Vol 5 (5) ◽  
pp. 1791 ◽  
Author(s):  
Violet N. Pinto ◽  
Sumit Wasnik ◽  
Sumedha M. Joshi ◽  
Deepa H. Velankar
Keyword(s):  
Academic Performance ◽  
Medical Students ◽  
Stress Management ◽  
Perceived Stress ◽  
Clinical Teaching ◽  
Mother Tongue ◽  
Stress Factors ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Management Techniques

Background: Medical students during their training period to become competent physicians are themselves vulnerable to various stresses which can affect their health and academic performance. The objectives of the study were to study MBBS students perceptions of stress factors affecting their academic performance; to assess the perceived stress in the students; to identify the stress management techniques used by the students.Methods: A cross-sectional was conducted on 169 MBBS students in a private medical college in Navi Mumbai after taking their consent. Data collection was by pretested, pre-coded, semi-structured self-administered questionnaire. Statistical analysis was done by SPSS Version 20.0 and relevant tests for data analysis.Results: The mean PSS score in the students was 26.96 (SD=6.332). Moderate stress and severe stress were present in 37.3% and 1.1% students respectively. Perceived stress was significantly associated with female sex, mother tongue; vastness of curriculum, dissatisfaction with clinical teaching, competition with peers and high parental expectations. More than 50% students felt that they were not able to adequately manage their stress. The most commonly used stress management techniques were social media usage and engaging in hobbies/sports.Conclusions: There is an urgent need for conducting screening programmes for stress in medical students and implementing measures which will equip them with skills to manage their stress.

scholarly journals Evaluating clinical teaching in a pediatric hospital in Iran: View points of academic members and medical students

2020 ◽  
Vol 9 (1) ◽  
pp. 4-4
Author(s):  
Maryam Baradaran Binazir ◽  
Mohammad Barzegar ◽  
Fariba Heidari
Keyword(s):  
Medical Students ◽  
Outpatient Clinic ◽  
Clinical Teaching ◽  
Journal Club ◽  
Pediatric Hospital ◽  
Morning Report ◽  
Evaluation Tool ◽  
Medical Sciences ◽  
Ministry Of Health ◽  
Cross Sectional

Background: Evaluating the state of clinical teaching is a very essential aspect of useful teaching.It helps in determining areas of strength and areas for improvement. Accordingly, the aim of this study was to evaluate clinical teaching activities in a pediatric hospital at the Tabriz University of Medical Sciences, based on standards provided by the Ministry of Health in Iran. Methods: A cross-sectional study was conducted from October to December 2018 in the setting of a pediatric hospital of the Tabriz University of medical sciences. Participants were selected from this hospital: academic members and medical students who were present in the pediatric hospital during this investigation. The evaluation tool was a checklist of standards relating to clinical teaching settings. The outcome measures included four domains, assessed using mean standard scores: teaching round, morning report, journal club, and outpatient clinic. Analysis of variance (ANOVA) was used to compare scores on the checklist among academic members and medical students. Results: A total of 126 participants completed the checklist. Among the participants, 50 (39.6%) were 5th-year medical students, 51 (40.4%) were final-year medical students and 25(19.8%)were academic members. The highest and lowest mean standard scores were 85.3 and 34.5,the morning report and the teaching round by final-year medical students, respectively. No statistically significant differences were found among academic members and medical students’mean standard scores for teaching round (P = 0.983), morning report (P = 0.696), journal club (P= 0.952), and outpatient clinic (P = 0.060). Conclusion: Considering both academic members and medical students, clinical teaching standards were not widely regarded as important in the pediatric wards of the Tabriz University of Medical Sciences. Some interventions are indicated to improve adherence to the Ministry of Health standards.

scholarly journals LeiKA: an optional German general practice teaching project for first-semester medical students: who is taking part and why? A cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032136
Author(s):  
Anne-Kathrin Geier ◽  
Christiane Saur ◽  
Stefan Lippmann ◽  
Melanie Nafziger ◽  
T Frese ◽  
...  
Keyword(s):  
General Practice ◽  
Medical Students ◽  
Cross Sectional Study ◽  
Value Orientations ◽  
Cross Sectional ◽  
First Semester ◽  
Practice Teaching ◽  
Patient Relationships ◽  
University Of Leipzig ◽  
Career Preferences

ObjectivesThis study investigates students’ adoption of LeiKA, a new extracurricular longitudinal general practice (GP) teaching project. LeiKA aims to attract a broad range of students, not only those who are already planning to become GPs. This study compares participants’ and non-participants’ characteristics, career preferences and job-related value orientations to assess the programme’s initial potential to increase the number of students subsequently entering GP careers. Additionally, students’ motives for taking part in the programme were explored.DesignWe analysed administrative data and data from a cross-sectional questionnaire survey for the first three cohorts. LeiKA participants were compared with non-participants regarding baseline characteristics, career intentions and attitudes associated with GP careers. There was also a qualitative analysis of the reasons for taking part.SettingFaculty of Medicine, University of Leipzig, Germany.ParticipantsFirst-semester medical students in the years 2016–2018.ResultsIn the first 3 years, 86 of 90 LeiKA slots were taken, 9.0% (n=86/960) of those eligible to apply. LeiKA participants were a mean of 0.6 years older (LeiKA: 21.5 vs whole cohort: 20.9 years, p<0.001) and slightly more interested in long-term doctor–patient relationships (3.6 vs 3.3, scale from 1 ‘unimportant’ to 5 ‘very important’, p=0.018), but did not differ regarding other characteristics and attitudes. Although more participants definitely favoured a GP career (13.1% vs 4.9%, p=0.001), it was a possible option for most students in both groups (78.6% vs 74.0%). Early acquisition of skills and patient contact were the main motives for taking part, stated by 60.7% and 41.7% of the participants, respectively.ConclusionsThe extracurricular programme was taken up by a broad range of students, indicating its potential to attract more students to become GPs. The reasons for taking part that we identified may guide the planning of other similar projects.

scholarly journals Factors influencing career intentions on completion of general practice vocational training in England: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017143 ◽  
Author(s):  
Jeremy Dale ◽  
Rachel Russell ◽  
Emma Scott ◽  
Katherine Owen
Keyword(s):  
General Practice ◽  
Vocational Training ◽  
Local Level ◽  
Sociodemographic Factors ◽  
Free Text ◽  
Online Questionnaire ◽  
Career Intentions ◽  
Cross Sectional ◽  
Career Plans ◽  
Modifiable Factors

ObjectivesGeneral practice is experiencing a growing crisis with the numbers of doctors who are training and then entering the profession in the UK failing to keep pace with workforce needs. This study investigated the immediate to medium term career intentions of those who are about to become general practitioners (GPs) and the factors that are influencing career plans.DesignOnline questionnaire survey, with quantitative answers analysed using descriptive statistics and free text data analysed using a thematic framework approach.Setting and participantsDoctors approaching the end of 3-year GP vocational training in the West Midlands, England.Results178 (57.2%) doctors completed the survey. Most participants planned to work as salaried GPs or locums rather than entering a general practice partnership for at least the first 5 years post-completion of training; others failed to express a career plan or planned to leave general practice completely or work overseas. Many were interested in developing portfolio careers.The quality of general practice experience across undergraduate, foundation and vocational training were reported as influencing personal career plans, and in particular perceptions about workload pressure and morale within the training practices in which they had been placed. Experience of a poor work–life balance as a trainee had a negative effect on career intentions, as did negative perceptions about how general practice is portrayed by politicians and the media.ConclusionThis study describes a number of potentially modifiable factors related to training programmes that are detrimentally influencing the career plans of newly trained GPs. In addition, there are sociodemographic factors, such as age, gender and having children, which are also influencing career plans and so need to be accommodated. With ever-increasing workload in general practice, there is an urgent need to understand and where possible address these issues at national and local level.

scholarly journals Home-Based Monitoring and Telemonitoring of Complicated Pregnancies: Nationwide Cross-Sectional Survey of Current Practice in the Netherlands (Preprint)

2020 ◽  
Author(s):  
Josephus F M van den Heuvel ◽  
Samira Ayubi ◽  
Arie Franx ◽  
Mireille N Bekker
Keyword(s):  
The Netherlands ◽  
Hospital Admission ◽  
Pregnant Women ◽  
Pregnancy Complications ◽  
Current Practice ◽  
Home Visits ◽  
Cross Sectional ◽  
Advantages And Disadvantages ◽  
Home Based ◽  
Wide Range

BACKGROUND Daily monitoring of fetal and maternal conditions in complicated pregnancies leads to recurrent outpatient visits or (prolonged) hospitalization. Alternatives for hospital admissions include home-based monitoring with home visits by professionals or telemonitoring with self-measurements performed by pregnant women and uploaded for in-clinic assessment. For both alternatives, cardiotocography and blood pressure measurement can be performed at home. It is unknown to what extent, for which reasons, and for which pregnancy complications these strategies are used. OBJECTIVE This study aims to assess the current practice and attitudes concerning home-based monitoring (with daily home visits by professionals) and telemonitoring (using devices and the internet for daily self-recorded measurements) in high-risk pregnancies requiring maternal and fetal monitoring in the Netherlands. METHODS This nationwide cross-sectional study involved sending a web-based survey to the obstetrics departments of all 73 hospitals in the Netherlands to be answered by 1 representative dedicated to pregnancy monitoring per hospital. The primary outcome was the provision of home-based monitoring or telemonitoring using cardiotocography between 1995 and 2018. The survey further addressed perspectives regarding the use of home-based monitoring and telemonitoring, including (contra)indications, advantages, and disadvantages for pregnant women and clinicians. RESULTS The response rate for the provision of either home-based monitoring or telemonitoring was 100%. In 2018, 38% (28/73) of centers in the Netherlands offered either home-based monitoring or telemonitoring or both to pregnant women with complications. Home-based monitoring was offered in 26% (19/73) of the centers; telemonitoring, in 23% (17/73); and both in 11% (8/73). Telemonitoring was first offered in 2009, increasing from 4% (3/73) of hospitals in 2014 to 23% (17/73) in 2018. Responses were received from 78% (57/73) of the invited hospitals and analyzed. Of all 17 centers using telemonitoring, 59% (10/17) did not investigate perinatal outcomes, safety, and patient satisfaction prior to implementation. Other (6/17, 35%) telemonitoring centers are participating in an ongoing multicenter randomized clinical trial comparing patient safety, satisfaction, and costs of telemonitoring with standard hospital admission. Home-based monitoring and telemonitoring are provided for a wide range of complications, such as fetal growth restriction, pre-eclampsia, and preterm rupture of membranes. The respondents reported advantages of monitoring from home, such as reduced stress and increased rest for patients, and reduction of admission and possible reduction of costs. The stated barriers included lack of insurance reimbursement and possible technical issues. CONCLUSIONS Home-based monitoring is provided in 26% (19/73) and telemonitoring, in 23% (17/73) of hospitals in the Netherlands to women with pregnancy complications. Altogether, 38% (28/73) of hospitals offer either home-based monitoring or telemonitoring or both as an alternative to hospital admission. Future research is warranted to assess safety and reimbursement issues before more widespread implementation of this practice.

scholarly journals Feasibility, acceptability and effect of the Mindful Practice curriculum in postgraduate training of general practitioners

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manuel Villarreal ◽  
Petra Hanson ◽  
Amy Clarke ◽  
Majid Khan ◽  
Jeremy Dale
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Vocational Training ◽  
Postgraduate Training ◽  
Cost Effective ◽  
Course Completion ◽  
Early Career ◽  
Psychological Wellbeing ◽  
Evidence Based ◽  
Psychological Measures

Abstract Background Early career general practitioners are known to be at high risk of burnout. There is a need for widely applicable, cost-effective evidence-based interventions to develop trainees’ protective skills and strategies. Results Of 120 eligible trainees, 23 (19.2%) expressed interest in participating, 17 subsequently started the course, and 15 completed at least 5 out of its 6 sessions. All psychological measures were stable for the six-week period prior to commencing the course. Following the course, there were statistically significant (p < 0.05) improvements in wellbeing, resilience, mindfulness, emotional exhaustion, disengagement, and stress scores. Participants described numerous benefits, and most stated that they would recommend it to colleagues. Conclusion Including mindful practice within general practice vocational training is feasible, and in this study it benefited the psychological wellbeing of participants. Further research is needed to explore ways of increasing uptake and course completion, the sustainability of its effects, and the wider applicability of this approach.

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