The value of 'expert trainees' in primary care postgraduate education.

Peer-led teaching is well established within many undergraduate medical courses but relatively underutilised in postgraduate training, despite the fact it can be useful for both teachers and learners. A significant number of doctors training to be GPs bring expertise and experience from other specialities and in this paper we explore the potential of using 'expert trainees' to teach their peers on postgraduate GP training programmes. A GP trainee with expertise in Lifestyle Medicine taught alongside local and national experts and delivered workshops to her peers. Questionnaires were used to establish the acceptability and quality of 'expert trainee' peer-led education. This was a positive experience for the 'expert trainee' who felt valued both as a trainee and as someone with expert knowledge, and for her peers with excellent feedback on her workshop. The knowledge and skills of 'expert trainees' represent an untapped resource which could be more systematically and effectively used within GP education.

Can the arts enhance postgraduate GP training?

The value of arts-based medical education is becoming increasingly well established in undergraduate curricula. However, little is known about its value, and acceptability, to qualified doctors undertaking postgraduate training. In this work we examined GP trainees' views on whether arts-based education was useful for their professional development and, if so, what they perceived its value to be. All first and second year GP trainees on the Dorset Vocational Training Scheme attended a one day course which showcased how the arts (film, poetry, painting, photography, theatre) could enhance their professional development as doctors. GP trainees rated the day as interesting, enjoyable and thought proving. The majority felt that the arts could contribute to making them more competent and humane doctors. Following this, we ran a mandatory six months arts based course for six GP trainees, and evaluated their feedback through qualitative analysis of a focus group discussion. Overall, GP trainees found the course enjoyable and valuable to their learning. It not only gave them a deeper appreciation of the patient's perspective, but also encouraged them to think about their own health and wellbeing.

GP trainees' experience, knowledge and attitudes towards caring for refugees, asylum seekers and undocumented migrants.

Context: According to the World Health Organisation 'more people are on the move now than ever before with an estimated 1 billion migrants in the world today and 68 million forcibly displaced people'. GPs are on the frontline of healthcare in the UK and have a responsibility to provide free and equitable access for everyone. Aim: The main aim of our work was to assess GP trainees' current experience, knowledge and attitudes towards caring for refugees, asylum seekers and undocumented migrants. Description: 30 final year GP trainees on the Dorset Vocational Training Scheme (VTS) were asked to participate by completing a questionnaire. Outcomes: The results show that GP trainees lack knowledge regarding migrants health needs, rights to care, including whether there is a duty to disclose an illegal immigrant and what to do if a patient could not provide proof of identification. They lacked experience and confidence in caring for this group of patients, with the biggest perceived challenge being language barriers. Conclusions: Education in primary care needs to respond to meet the challenge of population movement (5), and this project highlighted a need to improve education on migrants' rights to care, local support groups, as well as common health problems. In response, we have reviewed our curriculum and introduced an education session on refugee health for all our GP trainees in Dorset.

Using photography to enhance GP trainees' reflective practice and professional development.

The capacity and the commitment to reflect are integral to the practice of medicine and are core components of most general practitioners (GP) training programmes. Teaching through the humanities is a growing area within medical education, but one which is often considered a voluntary 'add-on' for the interested doctor. This article describes an evaluation of a highly innovative pedagogical project which used photography as a means to enhance GP trainees' reflective capacity, self-awareness and professional development. Photography was used as a tool to develop GP trainees' skills in recognising and articulating the attitudes, feelings and values that might impact on their clinical work and to enhance their confidence in their ability to deal with these concerns/issues. We submit that photography is uniquely well suited for facilitating insight and self-reflection because it provides the ability to record 'at the touch of a button' those scenes and images to which our attention is intuitively drawn without the need for-or the interference of-conscious decisions. This allows us the opportunity to reflect later on the reasons for our intuitive attraction to these scenes. These photography workshops were a compulsory part of the GP training programme and, despite the participants' traditional scientific backgrounds, the results clearly demonstrate the willingness of participants to accept-even embrace-the use of art as a tool for learning. The GP trainees who took part in this project acknowledged it to be beneficial for both their personal and professional development.

Refugee, Migrant and Asylum Seekers' Experience of Accessing and Receiving Primary Healthcare in a UK City of Sanctuary.

The World Health Organisation estimate there are about 1 billion migrants in the world today. The scale of population movement and a global refugee crisis presents an enormous challenge for healthcare provision, and too often the specific health needs of refugees and migrants are not met. This study assessed refugee, asylum seeker and vulnerable migrants' (AMRs') experience of front line primary healthcare in a region of the United Kingdom designated as a 'City of Sanctuary'. A questionnaire study explored the views of people seeking refuge and third sector workers supporting them. The majority of AMRs were registered with a GP and positive about their consultations. The views of third sector workers provided a less favourable window into their experience of primary care. In conclusion, the work highlighted patchy experience of primary care, even in a region of the UK designated as a 'City of Sanctuary' for people seeking refuge. There is a need for further education of rights to care in the UK, information for people on how to navigate local healthcare systems, consistent access to routine health checks and translation services.

The views and experiences of female GPs on professional practice and career support.

National GP demographic data demonstrate an increasing 'feminisation' of the workforce. With female GP specialty trainees continuing to outnumber males, this trend is set to continue. The changing composition of the workforce presents challenges in terms of how best to support the long-term career and educational development needs of this sector of the workforce in an evolving healthcare context. The aim of this work was to capture female GPs' experiences of working in general practice and their expectations concerning their career and educational development. Participants were surveyed and completed a semi-structured questionnaire, which generated qualitative and quantitative data. The sample comprised GP registrars, principals and sessionals. This study has generated an important dataset on working patterns, educational experiences and long-term career intentions of female GPs. Despite increased representation in the GP workforce, female GPs (particularly those with young children) appear less likely to be involved in education and training than their male counterparts, and even less likely to be involved in roles linked to primary care trusts, medico-political issues, hospital service delivery, special clinical interests or deanery education management. younger GPs reported significantly more difficulties in managing their childcare needs than older colleagues. Marital status, number of children and employment status did not moderate the effect of these difficulties. Female GPs reported working more hours with increasing age, but were not necessarily represented in a range of educational and/or training posts as a consequence.

A qualitative evaluation of a novel approach to extended training for general practice in Wessex.

Recent calls for specialty training for general practice to be lengthened have reopened the debate as to the role and value of extensions to training. The literature on extensions and recent developments in the debate are reviewed in this paper, followed by an evaluation report of a novel approach to an extension scheme which ran in Wessex. The scheme was specifically designed not to be 'more of the same' experience as in the final GPST3 year, instead participants worked in two contrasting practices as well as participating in a full day of bespoke 'Learning Set' education. The scheme was evaluated with participants reporting the main outcomes to be increased confidence and 'readiness' to practise, better ability to identify learning 'blind spots' and feeling better prepared to embark on a career in general practice.