Medical applicant general practice experience and career aspirations: a questionnaire study

BackgroundIncreasing access to general practice work experience placements for school students is a strategy for improving general practice recruitment, despite limited evidence and concerns surrounding equity of access to general practice experiences.AimsTo examine the association between undertaking general practice experience and the perceptions of general practice as an appealing future career among prospective medical applicants. To identify socioeconomic factors associated with obtaining general practice experience.Design & settingCross-sectional questionnaire study in the UK.MethodParticipants were UK residents aged ≥16 years and seriously considering applying to study medicine in 2019/2020. They were invited to take part via the University Clinical Aptitude Test (UCAT). Questionnaire data were analysed using a linear regression of general practice appeal on general practice experience, adjusting for career motivations and demographics, and a logistic regression of general practice experience on measures of social capital and demographics.ResultsOf 6391 responders, 4031 were in their last year of school. General practice experience predicted general practice appeal after adjusting for career motivation and demographics (b = 0.37, standard error [SE] = 0.06, P<0.00001). General practice experience was more common among students at private (odds ratio [OR] = 1.65, 95% confidence interval [CI] = 1.31 to 2.08, P<0.0001) or grammar schools (OR = 1.33, 95% CI = 1.02 to 1.72, P = 0.03) and in the highest socioeconomic group (OR = 1.62, 95% CI = 1.28 to 2.05, P<0.0001), and less likely among students of ‘other’ ethnicity (OR = 0.37, 95% CI = 0.20 to 0.67, P = 0.0011).ConclusionHaving general practice experience prior to medical school was associated with finding general practice appealing, which supports its utility in recruitment. Applicants from more deprived backgrounds were less likely to have had a general practice experience, possibly through lack of accessible opportunities.

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The attitudes, perceptions and experiences of medical school applicants following the closure of schools and cancellation of public examinations in 2020 due to the COVID-19 pandemic: a cross-sectional questionnaire study of UK medical applicants

BMJ Open ◽

10.1136/bmjopen-2020-044753 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044753 ◽

Cited By ~ 1

Author(s):

Katherine Woolf ◽

David Harrison ◽

Chris McManus

Keyword(s):

Public Schools ◽

Medical School ◽

Online Teaching ◽

Questionnaire Study ◽

Online Questionnaire ◽

Medical School Admissions ◽

Cross Sectional ◽

And Performance ◽

The Uk ◽

The University

ObjectiveDescribe the experiences and views of medical applicants from diverse social backgrounds following the closure of schools and universities and the cancellation of public examinations in the UK due to COVID-19.DesignCross-sectional questionnaire study, part of the longitudinal UK Medical Applicant Cohort Study (UKMACS).SettingUK medical school admissions in 2020.Participants2887 participants completed an online questionnaire from 8 April to 22 April 2020. Eligible participants had registered to take the University Clinical Admissions Test in 2019 and agreed to be invited to take part, or had completed a previous UKMACS questionnaire, had been seriously considering applying to medicine in the UK for entry in 2020, and were UK residents.Main outcome measuresViews on calculated grades, views on medical school admissions and teaching in 2020 and 2021, reported experiences of education during the national lockdown.ResultsRespondents were concerned about the calculated grades that replaced A-level examinations: female and Black Asian and Minority Ethnic applicants felt teachers would find it difficult to grade and rank students accurately, and applicants from non-selective state schools and living in deprived areas had concerns about the standardisation process. Calculated grades were generally not considered fair enough to use in selection, but were considered fair enough to use in combination with other measures including interview and aptitude test scores. Respondents from non-selective state (public) schools reported less access to educational resources compared with private/selective school pupils, less online teaching in real time and less time studying during lockdown.ConclusionsThe COVID-19 pandemic has and will have significant and long-term impacts on the selection, education and performance of our medical workforce. It is important that the views and experiences of applicants from diverse backgrounds are considered in decisions affecting their future and the future of the profession.

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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 ◽

10.1136/bmjopen-2020-045643 ◽

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.

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International work and leadership in UK general practice

Leadership in Health Services ◽

10.1108/lhs-01-2013-0003 ◽

2014 ◽

Vol 27 (2) ◽

pp. 87-103 ◽

Cited By ~ 3

Author(s):

Peter Young ◽

Chris Smith ◽

Luisa Pettigrew ◽

Ha-Neul Seo ◽

David Blane

Keyword(s):

General Practice ◽

Clinical Skills ◽

High Income ◽

Service Improvement ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Content Type ◽

International Work ◽

Low Middle Income Countries ◽

The Uk

Purpose – The purpose of this paper is to present an exploration of the leadership competencies developed by UK GPs through having undertaken international work and the ability to transfer these competencies back to the UK. Design/methodology/approach – The approach taken is a cross-sectional survey. Findings – A total of 439 UK-based, ranging from GP specialty trainees to retired GPs who had worked overseas, responded to an online survey of UK general practice and international work. Doctors were asked to report competency development through international work using the domains of the Medical Leadership Competency Framework (MLCF). The most common competencies developed, to a “moderate or significant” degree, related to “personal qualities” (89 per cent) and “working in teams” (87 per cent). To a lesser extent Doctors developed competencies in “setting direction” (60 per cent), “managing services” (59 per cent), and “service improvement” (56 per cent), and found these competencies harder to transfer back to the UK. A common reason for limited transfer of competency was the lack of leadership opportunities for Doctors when returning to UK locum roles. Overseas posts were more common in low/middle income countries, and these Doctors reported a greater range of leadership roles, including in health policy, management and teaching, compared to high-income countries. Most doctors felt that they were able to develop their clinical skills overseas whilst relatively few Doctors performed research, especially in high-income countries. Originality/value – To the authors' knowledge this is the first cross-sectional survey exploring the international work of UK GPs and leadership development using the MLCF domains.

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An Assessment of the Adequacy of Clinical Communication between Clinicians and Radiographers on the Quality of Diagnostic Ultrasound Reports: A Case of the University Teaching Hospital in Lusaka, Zambia

Edelweiss Applied Science and Technology ◽

10.33805/2576-8484.143 ◽

2018 ◽

pp. 225-231

Author(s):

Helen Nampungwe ◽

Foster Munsanje ◽

Titus Haakonde

Keyword(s):

Teaching Hospital ◽

Work Experience ◽

Social Scientist ◽

Clinical Information ◽

Diagnostic Ultrasound ◽

University Teaching ◽

Cross Sectional ◽

Clinical Communication ◽

The University

Background: Clear clinical communication between clinicians and radiographers in confirming of clinical information remains key in the provision of quality healthcare. As per procedure, clinicians make a clinical diagnosis and thereafter, request the radiographers to carry out sonographic examinations and produce Diagnostic Ultrasound Reports (DURs) based on the clinician’s request. Therefore, this study aimed at assessing the adequacy of clinical communication between clinicians and radiographers on the quality of DURs at the University Teaching Hospital (UTH) in Lusaka, Zambia. Methods: A cross-sectional descriptive study design was used. A total of 40 Clinicians were conveniently recruited into the study while 12 radiographers were purposefully sampled. Two types of special semi-structured, self-administered questionnaires were administered. Each type was to a specific professional discipline, i.e. clinicians or radiographers. Data analysis was done using Social Statistical Packages for Social Scientist Version 22. Results: The study revealed that it was a common practice for the radiographers to receive requests from the clinicians demanding for repeat of the DURs. Clinical meetings between clinicians and radiographers were irregularly held. Less than a quarter of the clinicians lacked specialized training in Diagnostic Ultrasound. The study further revealed that practitioners’ gender had no effect on the adequacy of communication between clinicians and radiographers while qualifications and work experience had effect. Conclusion: The study showed that communication between clinicians and radiographers at the UTH was inadequate. The major causes to this inadequacy included the use of unstandardized radiological request forms and lack of regular clinical meetings.

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Surgical consent practice in the UK following the Montgomery ruling: A national cross-sectional questionnaire study

International Journal of Surgery ◽

10.1016/j.ijsu.2018.05.016 ◽

2018 ◽

Vol 55 ◽

pp. 66-72 ◽

Cited By ~ 4

Author(s):

Chris McKinnon ◽

Dafydd Loughran ◽

Roísín Finn ◽

Madeline Coxwell-Matthewman ◽

Deva Sanjeeva Jeyaretna ◽

...

Keyword(s):

Questionnaire Study ◽

Cross Sectional ◽

The Uk

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Revealing the reality of undergraduate GP teaching in UK medical curricula: a cross-sectional questionnaire study

British Journal of General Practice ◽

10.3399/bjgp20x712325 ◽

2020 ◽

Vol 70 (698) ◽

pp. e644-e650 ◽

Cited By ~ 4

Author(s):

Emily Cottrell ◽

Hugh Alberti ◽

Joe Rosenthal ◽

Lindsey Pope ◽

Trevor Thompson

Keyword(s):

General Practice ◽

Career Decisions ◽

Undergraduate Curriculum ◽

Medical Schools ◽

Questionnaire Study ◽

Questionnaire Response ◽

Cross Sectional ◽

Medical Curricula ◽

Future Clinical Practice ◽

Practice Teaching

BackgroundTime in general practice offers medical students opportunities to learn a breadth of clinical knowledge and skills relevant to their future clinical practice. Undergraduate experiences shape career decisions and current recommendations are that 25% of undergraduate curriculum time should be focused on general practice. However, previous work demonstrated that GP teaching had plateaued or reduced in UK medical schools. Therefore, an up-to-date description of undergraduate GP teaching is timely.AimTo describe the current picture of UK undergraduate GP teaching, including the amount of time and resources allocated to GP teaching.Design and settingA cross-sectional questionnaire study across 36 UK medical schools.MethodThe questionnaire was designed based on a previous survey performed in 2011–2013, with additional questions on human and financial support allocated to GP teaching. The questionnaire was piloted and revised prior to distribution to leads of undergraduate GP teaching in UK medical schools.ResultsThe questionnaire response rate was 100%. GP teaching constituted an average of 9.2% of medical curricula; this was lower than previous figures, though the actual number of GP sessions has remained static. The majority (n = 23) describe plans to increase GP teaching in their local curricula over the next 5 years. UK-wide average payment was 55.60 GBP/student/session of in-practice teaching, falling well below estimated costs to practices. Allocation of human resources was varied.ConclusionUndergraduate GP teaching provision has plateaued since 2000 and falls short of national recommendations. Chronic underinvestment in GP teaching persists at a time when teaching is expected to increase. Both aspects need to be addressed to facilitate high-quality undergraduate GP teaching and promotion of the expert medical generalist role.

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Importance of accessibility and opening hours to overall patient experience of general practice: analysis of repeated cross-sectional data from a national patient survey

British Journal of General Practice ◽

10.3399/bjgp18x697673 ◽

2018 ◽

Vol 68 (672) ◽

pp. e469-e477 ◽

Cited By ~ 3

Author(s):

Thomas E Cowling ◽

Azeem Majeed ◽

Matthew J Harris

Keyword(s):

General Practice ◽

Patient Experience ◽

Patient Survey ◽

Cross Sectional ◽

National Patient ◽

General Practices ◽

The Uk ◽

Multilevel Linear Regression ◽

Practice Patient

BackgroundThe UK government aims to improve the accessibility of general practices in England, particularly by extending opening hours in the evenings and at weekends. It is unclear how important these factors are to patients’ overall experiences of general practice.AimTo examine associations between overall experience of general practice and patient experience of making appointments and satisfaction with opening hours.Design and settingAnalysis of repeated cross-sectional data from the General Practice Patient Surveys conducted from 2011–2012 until 2013–2014. These covered 8289 general practice surgeries in England.MethodData from a national survey conducted three times over consecutive years were analysed. The outcome measure was overall experience, rated on a five-level interval scale. Associations were estimated as standardised regression coefficients, adjusted for responder characteristics and clustering within practices using multilevel linear regression.ResultsIn total, there were 2 912 535 responders from all practices in England (n = 8289). Experience of making appointments (β 0.24, 95% confidence interval [CI] = 0.24 to 0.25) and satisfaction with opening hours (β 0.15, 95% CI = 0.15 to 0.16) were modestly associated with overall experience. Overall experience was most strongly associated with GP interpersonal quality of care (β 0.34, 95% CI = 0.34 to 0.35) and receptionist helpfulness was positively associated with overall experience (β 0.16, 95% CI = 0.16 to 0.17). Other patient experience measures had minimal associations (β≤0.06). Models explained ≥90% of variation in overall experience between practices.ConclusionPatient experience of making appointments and satisfaction with opening hours were only modestly associated with overall experience. Policymakers in England should not assume that recent policies to improve access will result in large improvements in patients’ overall experience of general practice.

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Effectiveness of health education materials in general practice waiting rooms: a cross-sectional study

British Journal of General Practice ◽

10.3399/bjgp18x699773 ◽

2018 ◽

Vol 68 (677) ◽

pp. e869-e876 ◽

Cited By ~ 1

Author(s):

Katherine Maskell ◽

Paula McDonald ◽

Priyamvada Paudyal

Keyword(s):

General Practice ◽

Health Education ◽

Cross Sectional Study ◽

Perceived Usefulness ◽

Sectional Study ◽

Waiting Room ◽

Cross Sectional ◽

Health Education Materials ◽

The Uk ◽

University Degree

BackgroundHealth education materials (HEMs) are widely used in general practice. However, there is little information on the variety of HEMs currently available to patients in the UK, or their preferences for accessing educational materials.AimTo assess patients’ perceptions of HEMs, and the variety and accessibility of these materials.Design and settingCross-sectional study conducted in general practices in Brighton and Hove.MethodAn anonymous questionnaire was distributed to patients in the waiting room (WR). Additionally, an audit was conducted to measure the variety of the HEMs. Results were analysed using binary multiple logistic regression.ResultsIn all, 556 participants (response rate 83.1%) from 19 practices took part. The mean age of participants was 49.3 years (SD ±18.9) and 63% were female. Perceived usefulness of HEMs was associated with reading in the WR using written HEMs, and not having a university degree; noticeability was associated with reading in the WR, and being female; attractiveness was associated with not having a university degree and shorter waiting time. On average, WRs contained 72 posters covering 23 topics, and 53 leaflets covering 24 topics, with many outdated and poorly presented materials of limited accessibility.ConclusionThis study found substantial variation in the amount, topicality, and quality of material available in WRs. As most patients notice HEMs and find them useful, available technology could be better utilised to widen access to HEMs. The introduction of wireless free internet (Wi-Fi) to waiting rooms should provide an opportunity to update this area.

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Variations in dementia diagnosis in England and association with general practice characteristics

Primary Health Care Research & Development ◽

10.1017/s146342361700007x ◽

2017 ◽

Vol 18 (03) ◽

pp. 235-241 ◽

Cited By ~ 7

Author(s):

Ian F. Walker ◽

Paul A. Lord ◽

Tracey M. Farragher

Keyword(s):

General Practice ◽

Secondary Data ◽

Dementia Diagnosis ◽

Cross Sectional ◽

Practice List ◽

Dementia Prevalence ◽

Practice Characteristics ◽

Diagnosis Of Dementia ◽

Diagnosis Rate ◽

The Uk

Objectives Improving dementia diagnosis rates in England has been a key strategic aim of the UK Government but the variation and low diagnosis rates are poorly understood. The aim of this study was to explore the variation in actual versus expected diagnosis of dementia across England, and how these variations were associated with general practice characteristics. Method A cross-sectional, ecological study design using secondary data sources and median regression modelling was used. Data from the year 2011 for 7711 of the GP practices in England (92.7%). Associations of dementia diagnosis rates (%) per practice, calculated using National Health Service England’s ‘Dementia Prevalence Calculator’ and various practice characteristics were explored using a regression model. Results The median dementia diagnosis rate was 41.6% and the interquartile range was 31.2–53.9%. Multivariable regression analysis demonstrated positive associations between dementia diagnosis rates and deprivation of the population, overall Quality and Outcomes Framework performance, type of primary care contract and size of practice list. Negative associations were found between dementia diagnosis rates and average experience of GPs in the practice and the proportion of the practice caseload over 65 years old. Conclusion Dementia diagnosis rates vary greatly across GP practices in England. This study has found independent associations between dementia diagnosis rates and a number of patient and practice characteristics. Consideration of these factors locally may provide targets for case-finding interventions and so facilitate timely diagnosis.

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Does it do what it says on the tin? – Evaluation of an established UK University Employability Enhancement Award.

Journal of Teaching and Learning for Graduate Employability ◽

10.21153/jtlge2017vol8no1art654 ◽

2017 ◽

Vol 8 (1) ◽

pp. 152-171 ◽

Cited By ~ 2

Author(s):

Toni Wright ◽

Sarah Jeffries-Watts

Keyword(s):

Focus Groups ◽

Survey Data ◽

Work Experience ◽

Qualitative Data ◽

Self Report ◽

Graduate Employment ◽

Perception Of Self ◽

Experience Survey ◽

The Uk ◽

The University

University employability awards, in the UK particularly, aim to assist students to develop career related skills and attributes and thus increase their potential to achieve graduate level employment. Self-report quantitative and qualitative data were collected at intervals via questionnaires, interviews and focus groups from two cohorts (N = 212) of a well-established career development and employability award at a large civic UK university. Findings indicated increases in confidence and aspiration, and in the ability to articulate and apply skills and abilities; also that the award may convey similar benefits to work experience. Survey data from award completers indicated that they had changed their career related behaviour, and students who have completed the award show a consistent small increase in their level of graduate employment when compared to the graduate employment figure for the university as a whole in the UK university destinations data.Employability related values, attitudes and behaviour may all change as a result of award experience. Reported changes implied a sense of improved resourcefulness. It is hypothesised that the award may enhance student employability somewhat via development of psychosocial resources, producing a shift in the student’s perception of self and identity.

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