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1.
BMC Prim Care ; 25(1): 306, 2024 Aug 15.
Article in English | MEDLINE | ID: mdl-39148026

ABSTRACT

BACKGROUND: To address the declining numbers of general practitioners (GPs) in rural areas and a lack of medical students pursuing a career in primary care, a general practice-based curriculum coupled with additional university admissions for students has been established at three universities in Hesse, Germany. This study aims to analyze potential topics which students striving to become a GP will benefit from. Teaching such topics will prepare them for their chosen career and working in rural areas. We aimed to explore the views of both specialists and GPs on chief topics and necessary skills in primary care. METHODS: In our study we used semi-structured interviews with outpatient specialists and specialists in clinical practice and semi-structured group interviews with GPs in training. The topic guide addressed contents of the curriculum for medical students with an extracurricular focus (addressing additional topics) on primary care. Data analysis was carried out using qualitative content analysis according to Mayring. RESULTS: GPs in training and specialists agreed on the importance of knowledge in the fields of medical history, physical examination, communication as well as common diseases in primary care. Essential competences mentioned were: inducing medical treatment, decision-making and triage, conducting structured conversations, having patient knowledge (hard skills) as well as an interest in continuous learning, empathy, personal commitment, listening and down-to-earthness (soft skills). Case reports, symptom-based learning, practical training, lessons with simulated patients and the integration of role models were regarded as useful teaching methods. CONCLUSIONS: General practice-based curriculums should not only focus on the transfer of knowledge. Equally important is the training of soft and hard skills to prepare future GPs for their work in primary care. Special teaching methods as well as practical training should be the heart of a newly established curriculum.


Subject(s)
Curriculum , General Practice , Qualitative Research , Students, Medical , Humans , General Practice/education , Germany , Students, Medical/psychology , Male , Female , General Practitioners/education , Clinical Competence , Primary Health Care , Interviews as Topic , Career Choice , Attitude of Health Personnel , Adult
2.
BMC Med Educ ; 24(1): 809, 2024 Jul 29.
Article in English | MEDLINE | ID: mdl-39075437

ABSTRACT

BACKGROUND: Basic sciences are crucial for clinical medicine, yet studies focusing on their perceived utility among general practitioners (GPs) are sparse. Considering the broad scope of GPs' practice, an in-depth understanding of basic sciences is fundamental for making informed clinical decisions. This study evaluated GP registrars' retention and perceptions of the utility of basic sciences in clinical practice. METHODS: Using sequential explanatory mixed methods study design, knowledge retention was assessed by a multiple-choice question (MCQ) examination followed by interviews on the perception of the relevance and utility of basic sciences among GP registrars at James Cook University's (JCU) General Practice Training (GPT) program. Descriptive and inferential statistical analyses were conducted on the MCQ exam data, while thematic analysis was employed for the qualitative interview data. RESULTS: Sixty-one GP registrars participated in the MCQ exam, while 11 of them were involved in the interviews. The highest mean score was obtained in biochemistry (75.1 ± 2.23) while the lowest mean score was in anatomy (56.07 ± 3.16). Key performance predictors included the formative clinical examination scores (ß = 0.83, 95% CI: 0.45 to 1.2, p < 0.001) and gender (ß = -9.7, 95% CI: -17 to -2.3, p = 0.011). The qualitative data analysis revealed five themes, including the backbone of clinical medicine, varying utility over time and by specialty, clinical synthesis integrates encapsulated knowledge, professional pressures hinder revisitation of knowledge and knowledge renewal enhances updates. CONCLUSION: Basic sciences were considered relevant in clinical practice. Development of continuing professional development (CPDs) sessions and clinically relevant online resources were measures proposed to enhance the retention of knowledge. Future research could focus on innovative educational strategies for GPs.


Subject(s)
Clinical Competence , General Practice , Humans , Male , General Practice/education , Female , Educational Measurement , General Practitioners/education , Adult , Attitude of Health Personnel , Qualitative Research
3.
Can Med Educ J ; 15(2): 6-13, 2024 May.
Article in English | MEDLINE | ID: mdl-38827909

ABSTRACT

Introduction: Rural communities have poorer health compared to urban populations due partly to having lesser healthcare access. Rural placements during medical education can equip students with the knowledge and skills to work in rural communities, and, it is hoped, increase the supply of rural physicians. It is unclear how students gain knowledge of rural generalism during placements, and how this can be understood in terms of place-based and/or sociocultural educational theories. To gain insight into these questions we considered the experiences of pre-clerkship medical students who completed two mandatory four-week rural placements during their second year of medical school. Methods: Data was collected using semi-structured interviews or focus groups, followed by thematic analysis of the interview transcripts. Results: Rural placements allowed students to learn about rural generalism such as breadth of practice, and boundary issues. This occurred mainly by students interacting with rural physician faculty, with the effectiveness of precepting being key to students acquiring knowledge and skills and reporting a positive regard for the placement experience. Discussion: Our data show the central role of generalist physician preceptors in how and what students learn while participating in rural placements. Sociocultural learning theory best explains student learning, while place-based education theory helps inform the curriculum. Effective training and preparation of preceptors is likely key to positive student placement experiences.


Introduction: Les communautés rurales sont en moins bonne santé que les populations urbaines, en partie parce qu'elles ont moins accès aux soins de santé. Les stages de médecine en milieu rural peuvent permettre aux étudiants d'acquérir les connaissances et les compétences nécessaires pour travailler dans les communautés rurales et, on l'espère, augmenter le nombre de médecins y travaillent. On ne sait pas clairement comment les étudiants acquièrent des connaissances sur le généralisme rural au cours de leurs stages, et comment cela peut être compris en termes de théories éducatives socioculturelles et/ou basées sur le lieu de travail. Pour répondre à ces questions, nous avons étudié les expériences d'étudiants en médecine au pré-clinique qui ont effectué deux stages obligatoires de quatre semaines en milieu rural au cours de leur deuxième année d'études de médecine. Méthodes: Les données ont été recueillies au moyen d'entrevues semi-structurées ou de groupes de discussion, suivis d'une analyse thématique des transcriptions des entrevues. Résultats: Les stages en milieu rural ont permis aux étudiants de se familiariser avec le généralisme rural, notamment l'étendue de la pratique et les questions de limites. L'efficacité du préceptorat est essentielle pour que les étudiants acquièrent des connaissances et des compétences et qu'ils aient une expérience de stage positive. Discussion: Nos données témoignent du rôle central que jouent les médecins généralistes précepteurs quant au contenu et modes d'apprentissage des étudiants lorsqu'ils participent à des stages en milieu rural. La théorie de l'apprentissage socioculturel est celle qui explique le mieux l'apprentissage des étudiants, tandis que la théorie de la formation fondée sur le lieu contribue à orienter le programme d'études. Une formation et préparation efficace des précepteurs est probablement la clé d'une expérience de stage positive pour les étudiants.


Subject(s)
Students, Medical , Humans , Students, Medical/psychology , Students, Medical/statistics & numerical data , Rural Health Services , Preceptorship , Rural Population , Focus Groups , Education, Medical, Undergraduate/methods , General Practice/education , Female , Interviews as Topic , Male , Learning
4.
BMC Med Educ ; 24(1): 636, 2024 Jun 06.
Article in English | MEDLINE | ID: mdl-38844972

ABSTRACT

BACKGROUND: General practitioner interns need to acquire the expected clinical, communication, personal and professional competencies. Internship evaluations use qualitative evaluation tables to assess competency acquisition. However, there is no standardised evaluation table used in France. Some faculties use the exhaustive, precise, and manageable Exceler evaluation tool. We aim to evaluate opinions of General practice interns in Brest about the acceptability and feasibility of using the Exceler evaluation tool to monitor competency acquisition during internships. METHODS: This qualitative study used intern focus groups. Six-open ended questions with optional follow-up questions were asked. Cards from the Dixit® game were used to guide and facilitate discussion. Open, axial, then integrative analysis of the verbatim was performed. RESULTS: This is the first study to evaluate intern opinions about GP internship evaluations using focus groups. Participants felt that the quality of existing evaluations was insufficient, and it was difficult to monitor their progress. Adapting evaluations to individual profiles and backgrounds seemed necessary. Exceler appeared to be a possible solution due to its content validity, flexibility of use and accessibility. However, there were comments about possible modifications. CONCLUSIONS: Analysing opinions of tutors, supervisors and other practice centers could help identify potential barriers and reveal solutions to facilitate its implementation and use. TRIAL REGISTRATION: Not applicable.


Subject(s)
Clinical Competence , Feasibility Studies , Focus Groups , General Practice , Internship and Residency , Qualitative Research , Humans , Internship and Residency/standards , Clinical Competence/standards , General Practice/education , Educational Measurement/methods , Male , Female , Adult , France , Attitude of Health Personnel
5.
Br J Gen Pract ; 74(suppl 1)2024 Jun 20.
Article in English | MEDLINE | ID: mdl-38902056

ABSTRACT

BACKGROUND: Recruitment and retention of undergraduate (UG) GP educators is vital, they are essential to educating the next generation of doctors. The expected loss of GPs as they retire and leave the profession means clinical delivery is under tension; adding to the strain on the number of GP educators. With GP educators numbers decreasing and student numbers increasing, the pressure on the system is growing. AIM: To explore the experience of the GP educator, investigate the impact participation in UG medical education has, the barriers there are, and what support educators need to continue. METHOD: This qualitative study uses individual semi-structured interviews of four active GP educators with at least 4 years of experience teaching medical students in a primary care setting; these were then transcribed and thematically analysed. RESULTS: One of the most surprising results showed that GPs' enjoyed their work as educators as it allowed them t'o be seen and heard'. One participant stated; I want 'my blood, sweat and tears to mean something to somebody [the students]'. It also allowed the GPs' to reflect on their life's work and gave them a platform to demonstrate this. CONCLUSION: The Wass report, 2016 showed that students' exposure to GPs in UG education plays a significant role in choosing a career in general practice. This exposure needs GPs to act as positive role-models. Further research is required to examine the GP educators' need to 'be seen and heard', and if this can be used to recruit/retain GP educators.


Subject(s)
Education, Medical, Undergraduate , Faculty, Medical , General Practitioners , Qualitative Research , Humans , General Practitioners/education , General Practice/education , Attitude of Health Personnel , Male , United Kingdom , Career Choice , Students, Medical/psychology , Female
6.
Br J Gen Pract ; 74(suppl 1)2024 Jun 20.
Article in English | MEDLINE | ID: mdl-38902059

ABSTRACT

BACKGROUND: GP confidence and competence in relation to gender diversity and the discussion of related matters remains relatively unknown. Despite increasing demand on primary care in dealing with matters of gender identity; contention and confusion are unfortunately widely reported amongst doctors. AIM: We sought to formally evaluate the level of GP training and gauge desire for further training in relation to the discussion of pronouns with patients. METHOD: We used a structured questionnaire that was sent out to GPs in Oxfordshire, facilitated by a mailing list used by the Primary Care Undergraduate Teaching Department at the University of Oxford. Additionally, we performed structured individual interviews with GPs in Oxford, who provided their contact details and expressed interest when completing the questionnaire. RESULTS: Fourty-four GPs responded and completed the questionnaire, five of whom agreed to participate in a structured interview. Most GPs (61%) had not received any formal training. Despite this, 68% of GPs did not want more formal training in the field of gender incongruence and pronoun usage. Only one GP routinely asked patients their pronouns (2%). CONCLUSION: Our findings highlight that a significant proportion of GPs have no formal training in relation to discussing pronouns and gender incongruence. We believe GPs should have the skills necessary to appreciate, understand and provide structured support to those with concerns in relation to their gender identity. With waiting times for gender clinics frequently exceeding 2 years, our findings emphasise the increasing importance of GP specific training in the field of gender identity.


Subject(s)
Physician-Patient Relations , Primary Health Care , Humans , Female , Male , Surveys and Questionnaires , Gender Identity , Attitude of Health Personnel , General Practitioners/education , General Practice/education , Clinical Competence
7.
Br J Gen Pract ; 74(suppl 1)2024 Jun 20.
Article in English | MEDLINE | ID: mdl-38902078

ABSTRACT

BACKGROUND: Giving students more responsibility for real patients during medical school may help prepare them for their transition to clinical practice. Student-led clinics (SLCs) may facilitate this. Within SLCs, students take the lead role in delivering patient care while being supported and supervised by qualified clinicians. A general practice SLC was established in Dundee, with four final-year medical students and one GP involved in each clinic. AIM: This study aimed to explore students' and educators' experiences and perceptions of this SLC. METHOD: This was an exploratory case study. Semi-structured interviews were conducted with 11 students and three educators, and 18 hours of observation were conducted over six clinics. Interview transcripts and fieldnotes were integrated and thematically analysed. RESULTS: Overall, students' and educators' experiences and perceptions were positive. Students thrived in their lead role in patient care, gaining a sense of empowerment and developing confidence in their abilities. Both students and educators felt comfortable with students having this level of responsibility due to the students' stage of training and the supervision provided by educators. Teaching within the SLC involved individual discussions and group debriefs. Students felt a sense of belonging as a result of their relationships with their peers and educators. Challenges arose when the clinic ran behind schedule due to unexpected complex patients or lengthy individual discussions. CONCLUSION: The findings suggest that giving students responsibility for real patients is beneficial and feasible when adequate support is provided, and that it is possible for one GP to supervise multiple students successfully.


Subject(s)
Education, Medical, Undergraduate , General Practice , Students, Medical , Humans , Students, Medical/psychology , General Practice/education , Attitude of Health Personnel , Female , Student Run Clinic , Male , Faculty, Medical/psychology , Qualitative Research , Scotland
8.
Br J Gen Pract ; 74(suppl 1)2024 Jun 20.
Article in English | MEDLINE | ID: mdl-38902095

ABSTRACT

BACKGROUND: There exists a significant body of literature on the benefits of Peer Assisted Learning (PAL). Near-peer (NP) teaching can be defined as teaching delivered by senior students to younger year students. There are numerous examples in the literature of PAL projects in a non-clinical setting but little research in a clinical setting and even less in primary care. Postgraduate literature suggests that potential benefits include promotion of general practice as a career as well as increasing teaching capacity.A successful pilot led to the development of a new undergraduate NP teaching Student Selected Component (SSC) in a primary care setting. AIM: To explore the experiences of medical students and GP tutors who participated in this SSC. METHOD: Semi-structured interviews were carried out with year 5 NP student teachers, GP tutors, and year 3 students. Thematic analysis was used to analyse the qualitative data generated. RESULTS: As well as increasing teaching capacity and consolidating their own knowledge, the findings suggest an impact on the professional identity formation of NP student teachers helping them to prepare to be future doctors. The NP teaching fostered an environment of psychological safety for all students, although there was an additional element of risk management and supervision when teaching with patients. CONCLUSION: Undergraduate NP teaching has advantages for student learners, NP student teachers, GP tutors, and practices. The increased teaching capacity has implications for recruitment of practices for teaching and may promote general practice as a future career.


Subject(s)
Education, Medical, Undergraduate , General Practice , Peer Group , Qualitative Research , Students, Medical , Teaching , Humans , Education, Medical, Undergraduate/methods , Students, Medical/psychology , General Practice/education , Primary Health Care , Male , Female , Attitude of Health Personnel , Faculty, Medical
9.
BMC Med Educ ; 24(1): 679, 2024 Jun 19.
Article in English | MEDLINE | ID: mdl-38898478

ABSTRACT

BACKGROUND: This study aims to determine the satisfaction and future training needs of general practice residents participating in a novel model of ambulatory teaching aligned with the specifications for standardized residency training in outpatient management issued by the Chinese Medical Doctor Association (CMDA). METHODS: A cross-sectional survey of the satisfaction and training needs was conducted among general practice residents at West China Hospital, Sichuan University. Patient characteristics and preceptors' feedback on the residents' performance were also analyzed. RESULTS: The study involved 109 residents (30.28% men) and 161 patients (34.78% men; age: 52.63 ± 15.87 years). Residents reported an overall satisfaction score of 4.28 ± 0.62 with the ambulatory teaching program. Notably, residents scored lower in the Subjective-Objective-Assessment-Plan (SOAP) evaluation when encountering patients with the greater the number of medical problems (P < 0.001). Residents encountering patients with a shorter duration of illness (< 3 months) achieved higher scores than those with longer illness durations (≥ 3 months, P = 0.044). Residency general practitioners (GPs) were most challenged by applying appropriate and effective patient referrals (43/109; 39.45%). GPs expressed a strong desire to learn how to make decisions when facing challenging patient situations (4.51 ± 0.63). CONCLUSION: This study suggests selecting patients with multiple comorbidities for ambulatory teaching and enhancing training on practical problem-solving abilities for GPs. The findings provide insights for the development of future ambulatory teaching programs.


Subject(s)
Ambulatory Care , General Practice , Internship and Residency , Humans , Cross-Sectional Studies , China , Male , General Practice/education , Female , Middle Aged , Adult , Clinical Competence , Education, Medical, Graduate
10.
Fukushima J Med Sci ; 70(3): 133-140, 2024 Jul 24.
Article in English | MEDLINE | ID: mdl-38925959

ABSTRACT

BACKGROUND: We previously reported the impact of general practice/family medicine training on postgraduate training in Japan using evaluation criteria standardized nationwide. However, there is a possibility that new insights may be gained by analyzing the reflective reports written by these residents. METHODS: Junior residents who participated in one-month general practice/family medicine training at one of five medical institutions with full-time family medicine specialists between 2019 and 2022 were enrolled in this study. They were assigned to submit a reflective report on their experiences and thoughts every day during the training. We analyzed these reflective writings using text mining and created a co-occurrence network map to see the relationship between the most frequently used words. RESULTS: Ninety junior residents participated in the study. The words that appeared most frequently in the sentences referring to clinical ability included "symptoms," "medical examination," "consultation," "treatment," and "examination." The words of "family" and "(patient) oneself" showed strong association in the co-occurrence network map. CONCLUSION: It was suggested that general practice/family medicine training greatly contributes to the acquisition of clinical abilities and deepens the learning of junior residents not only about patient care but also about family-oriented care.


Subject(s)
Data Mining , Family Practice , General Practice , Internship and Residency , Family Practice/education , Japan , Humans , General Practice/education , Writing , Male , Female , East Asian People
12.
BMC Prim Care ; 25(1): 171, 2024 May 18.
Article in English | MEDLINE | ID: mdl-38762452

ABSTRACT

The landscape of general practice has experienced notable transformations in recent decades, profoundly influencing the working conditions of general practitioners (GPs). This study aimed to examine the most salient changes affecting GPs' daily practices. Through semi-structured qualitative interviews with 15 end-of-career GPs, the study explored how these changes affected work organization, equipment, working hours, work-life balance, job satisfaction, training, patient relationships, and reputation. The interviews revealed that these changes were perceived as barriers, opportunities, or a complex interplay of both for general practice. While the interviewed GPs valued technological advancements and reported positive developments in working conditions, challenges included a gradual reduction in the range of tasks, growing administrative burdens, and less practical training for young physicians. Other changes, such as new doctor-patient dynamics, the transition from single to group practice, and differing professional expectations of the younger generation, were seen as both challenging and strengthening for general practice. By combining these factors and trade-offs observed by end-of-career GPs in our study over the past few decades with general societal changes, we provide ideas for the design of future framework conditions in general practice that might enhance the attractiveness of the profession. These insights offer key considerations that can guide future strategies for general practice and medical education.


Subject(s)
General Practitioners , Job Satisfaction , Work-Life Balance , Humans , Male , Female , General Practitioners/psychology , General Practitioners/education , Middle Aged , Adult , Attitude of Health Personnel , General Practice/education , Physician-Patient Relations , Qualitative Research , Workload/psychology , Interviews as Topic , Intergenerational Relations , Working Conditions
13.
Educ Prim Care ; 35(1-2): 52-56, 2024.
Article in English | MEDLINE | ID: mdl-38754447

ABSTRACT

It is well-established that GP trainees do not feel confident when transitioning to independent practice. In 2019, the Nottinghamshire GP Phoenix Programme Trainee Transition Scheme (TTS) was established to improve this transition and encourage local retention of newly qualified GPs. The TTS has been evaluated by surveying a total of 344 trainees from August 2022 to August 2023 using an electronic Google Form. Two-thirds of the trainees surveyed felt the mix of TTS-led non-clinical topics and trainee-led clinical topics taught during their locality time were useful for their learning. 72% felt that the TTS would influence their decision to remain working locally after qualification. Based on these positive findings, it is proposed that the TTS should be adopted in other areas to improve both transition and retention of newly qualified GPs.


Subject(s)
General Practice , General Practitioners , Humans , General Practice/education , General Practitioners/education , Surveys and Questionnaires , Education, Medical, Graduate/methods
14.
Nurse Educ Pract ; 78: 103973, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38788616

ABSTRACT

AIMS AND OBJECTIVES: To evaluate: (a) the effectiveness of an infographic poster compared with an e-learning program on general practice nurses' knowledge about chronic kidney disease risk factors and best practice screening procedures and (b) the effectiveness of an infographic poster compared with an e-learning program on general practice nurses' learning time and learning efficiency. BACKGROUND: The screening and early detection of chronic kidney disease is essential in reducing its burden on the health system and those affected by it. General practice nurses are well-positioned to assist in its early detection. DESIGN: Parallel-group, single-blinded, pre-post interventional randomised control design. METHOD: This study was reported in accordance with the Consolidated Standards of Reporting Trials (CONSORT). Participants were registered or enrolled nurses working in general practice settings across Australia. The intervention group (n = 173) received an infographic poster about chronic kidney disease risk factors and best practice screening procedures, whereas the control group (n = 170) received an interactive e-learning program. Data were collected using an 8-item pre-post knowledge evaluation instrument. Time spent learning were collected through a self-reported log and a login/logout method. RESULTS: The overall intervention effect demonstrated no statistical significance in knowledge scores from the baseline scores between the intervention and control group. The intervention group demonstrated higher learning efficiency in comparison to the control group. CONCLUSION: The study demonstrated an infographic poster is as effective as an e-learning program on improving knowledge scores. However, in comparison to an e-learning program, an infographic poster is a more efficient way of learning. RELEVANCE TO CLINICAL PRACTICE: Infographic posters can be an efficient educational modality to enhance healthcare professionals' knowledge and could be used as public health campaigns in clinical settings to educate the community.


Subject(s)
Mass Screening , Renal Insufficiency, Chronic , Humans , Renal Insufficiency, Chronic/nursing , Renal Insufficiency, Chronic/diagnosis , Female , Male , Adult , Australia , Risk Factors , Middle Aged , Single-Blind Method , Computer-Assisted Instruction/methods , Health Knowledge, Attitudes, Practice , General Practice/education , Clinical Competence/standards , Education, Nursing, Continuing , Education, Distance
16.
Med J Aust ; 220(9): 461-465, 2024 May 20.
Article in English | MEDLINE | ID: mdl-38699842

ABSTRACT

OBJECTIVES: To investigate the views of the general practice training sector about responding to recruitment challenges, with the aim of identifying effective initiatives and other solutions. STUDY DESIGN: Qualitative study; focus group discussion of recommendations from a medical educator workshop. SETTING, PARTICIPANTS: An initial online appreciative enquiry workshop for medical educators followed by focus group discussions by a broader selection of people involved in general practitioner training (Royal Australian College of General Practitioners fellows, supervisors, practice managers, medical educators, registrars). MAIN OUTCOME MEASURES: Key overarching themes and major recommendations for increasing recruitment derived from focus group responses to workshop recommendations, based on qualitative descriptive analysis. RESULTS: The 26 medical educators at the workshop made four major recommendations: increase the number of student and junior doctor clinical placements in general practice; increase exposure of students and junior doctors to general practitioner teachers and educators; improve general practitioner trainee pay and entitlements; and improve the integration of general practice and hospital patient care and professional relationships. Thirty-four semi-structured focus group participants broadly supported the recommendations, provided that supervisors and training practices were adequately compensated for the effects on workloads, income, and patient care. Two overarching themes infused participant responses: "rescuing the profession we love" (reflecting participants' passion for general practice and their sense of threat), and "no idea what general practitioners do" (perceptions of being misunderstood and misrepresented by hospital-based practitioners). CONCLUSIONS: Clinicians, educators, and policy makers should work together to increase the number of high quality, adequately supported student and junior doctor placements in general practice, improve intra-professional relationships, and trial new models of general practitioner trainee payment and conditions.


Subject(s)
Focus Groups , General Practice , Qualitative Research , General Practice/education , Humans , Australia , Faculty, Medical , General Practitioners/education , Career Choice , Attitude of Health Personnel , Personnel Selection , Female
17.
BMC Med Educ ; 24(1): 550, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38760775

ABSTRACT

BACKGROUND: A recent study found that ethnic minority General Practice (GP)-trainees receive more negative assessments than their majority peers. Previous qualitative research suggested that learning climate-related factors play a pivotal role in unequal opportunities for trainees in post-graduate medical settings, indicating that insufficient inclusivity had put minority students at risk of failure and dropout. STUDY OBJECTIVES: We aimed to develop broadly supported strategies for an inclusive learning climate in Dutch GP-specialty training. METHODS: We employed Participatory Action Research (PAR)-methods, incorporating Participatory Learning and Action (PLA)-techniques to ensure equal voices for all stakeholders in shaping Diversity, Equity, and Inclusion (DEI)-strategies for GP-specialty training. Our approach engaged stakeholders within two pilot GP-specialty training institutes across diverse roles, including management, support staff, in-faculty teachers, in-clinic supervisors, and trainees, representing ethnic minorities and the majority population. Purposeful convenience sampling formed stakeholder- and co-reader groups in two Dutch GP-specialty training institutes. Stakeholder discussion sessions were based on experiences and literature, including two relevant frameworks, and explored perspectives on the dynamics of potential ethnic minority trainees' disadvantages and opportunities for inclusive strategies. A co-reader group commented on discussion outcomes. Consequently, a management group prioritized suggested strategies based on expected feasibility and compatibility. RESULTS: Input from twelve stakeholder group sessions and thirteen co-readers led to implementation guidance for seven inclusive learning environment strategies, of which the management group prioritized three: • Provide DEI-relevant training programs to all GP-specialty training stakeholders; • Appoint DEI ambassadors in all layers of GP-specialty training; • Give a significant voice to minority GP-trainees in their education. CONCLUSION: The study's participatory approach engaged representatives of all GP-specialty training stakeholders and identified seven inclusive learning climate strategies, of which three were prioritized for implementation in two training institutions.


Subject(s)
Education, Medical, Graduate , General Practice , Humans , Cultural Diversity , Ethnicity , General Practice/education , Learning , Minority Groups/education , Netherlands , Stakeholder Participation
18.
BMC Prim Care ; 25(1): 166, 2024 May 16.
Article in English | MEDLINE | ID: mdl-38755553

ABSTRACT

BACKGROUND: Understanding how the general practice medical workforce defines cultural safety may help tailor education and training to better enable community-determined culturally safe practice. This project seeks to explore how Australian general practice registrars define cultural safety with Aboriginal and Torres Strait Islander patients and alignment with an Australian community derived definition of cultural safety. METHODS: This mixed method study involved a survey considering demographic details of general practice registrars, questionnaire, and semi-structured interviews to explore how general practice registrars defined cultural safety and a culturally safe consultation. RESULTS: Twenty-six registrars completed the survey. Sixteen registrars completed both the survey and the interview. CONCLUSION: This study shows amongst this small sample that there is limited alignment of general practice registrars' definitions of cultural safety with a community derived definition of cultural safety. The most frequently cited aspects of cultural safety included accessible healthcare, appropriate attitude, and awareness of differences.


Subject(s)
Attitude of Health Personnel , Australian Aboriginal and Torres Strait Islander Peoples , Cultural Competency , Adult , Female , Humans , Male , Middle Aged , Australia , Cultural Competency/education , Culturally Competent Care , General Practice/education , Surveys and Questionnaires
19.
Educ Prim Care ; 35(1-2): 57-61, 2024.
Article in English | MEDLINE | ID: mdl-38615345

ABSTRACT

There is need for a greater connection between General Practice and GP trainees in their hospital component of training. Currently, in Scotland, there are no national education programmes specifically designed for GP trainees during their hospital component of training. Our aim was to develop and evaluate the feasibility of a national online 'bitesize' education programme delivered live for GP trainees in their hospital component of training. The study also aims to assess the barriers to attending these teaching sessions and whether they made trainees feel more connected to General Practice. Weekly one hour 'Bitesize' teaching sessions, delivered virtually, were organised by NHS Education for Scotland (NES) GP Medical Education Fellows during a four-week period. Eligible attendees were GP trainees (GPST1s and GPST2s) working in the hospital component of their training. An end of program questionnaire, gathering quantitative and qualitative data, was used for evaluation. There was a strong support for this programme from the attendance numbers and the questionnaire feedback responses, with GP trainees feeling more in touch with general practice and more confident in managing primary care focused topics. GP trainees agreed that a weekly, one-hour, online lunchtime session suits them. The most common barrier to attendance were work commitments and conflicts with local teaching. This pilot has emphasised the need for a structured teaching programme for GP trainees in the hospital component of training.


Subject(s)
General Practice , Primary Health Care , Humans , Scotland , Pilot Projects , General Practice/education , Surveys and Questionnaires , Program Evaluation , Education, Medical, Graduate/methods
20.
Scand J Prim Health Care ; 42(3): 442-449, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38602196

ABSTRACT

OBJECTIVE: Many countries experience challenges in recruiting and retaining general practitioners (GPs) as supervisors for medical students in clinical placements. We aimed to investigate the opportunities, capacities and limitations of Norwegian GPs to become supervisors. DESIGN: Web-based cross-sectional questionnaire study. SETTING: Norwegian general practice. SUBJECTS: All GPs in Norway, including locums and those on leave, both active supervisors, and GPs who are not presently supervising medical students. MAIN OUTCOME MEASURES: GPs' terms of salary, office facilities, limiting factors, capacity and needs for becoming or continuing as supervisors. RESULTS: Among 5145 GPs, 1466 responded (29%), of whom 498 (34%) were active supervisors. Lack of a dedicated student office was the most reported limitation for both active supervisors (75%) and other GPs (81%). A high proportion (67%) of active supervisors reported that they could host more students per year, given financial support for equipped offices and higher salaries. With this kind of support, 48% (n = 461) of the GPs who were not supervisors for medical students were positive about a future supervisor role. By adjusted regression analysis, female GPs had lower likelihood of being supervisors, OR (95% CI) 0.75 (0.59-0.95) than male colleagues. GPs in the North, Mid and West regions had higher odds (OR 3.89, 3.10 and 2.42, respectively) than those in the South-East region. Teaching experience also increased the odds (2.31 (1.74-3.05). CONCLUSIONS: There seems to be capacity among both active and potential supervisors if increased salaries and financial support for office facilities are made available.


Undergraduate training by clinical placements is important for the recruitment of doctors to general practice, and depends on a sufficient number of GPs as supervisors.The study shows that there is sufficient capacity among Norwegian GPs to host medical students in clinical placements.Many potential supervisors among Norwegian GPs report that they have not been approached by a university to supervise medical students.Many supervisors state that they need increased salaries and financial support for facilities and expenses in order to supervise medical students.


Subject(s)
General Practice , General Practitioners , Students, Medical , Humans , Norway , Female , Male , Cross-Sectional Studies , Surveys and Questionnaires , General Practice/education , General Practitioners/education , Adult , Middle Aged , Salaries and Fringe Benefits , Attitude of Health Personnel , Sex Factors
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