Evaluation of eConsult use by Defence Primary Healthcare primary care clinicians using a mixed-method approach.

INTRODUCTION: eConsult has recently been introduced into Defence Primary Healthcare to allow Service Personnel of the British Armed Forces and their dependants improved access to healthcare. This review sought the views of primary care clinicians using eConsult. METHOD: An 18-item survey was constructed after an initial scoping survey. This was then distributed to primary care clinicians in Defence Primary Healthcare to assess the broader applicability of the themes identified. Data synthesis of this alongside free-text responses from respondents was undertaken to explore advantages and disadvantages of eConsult. RESULTS: Four themes were identified: accessibility, effects on working practices, impact on the dynamics of the consultation and training/administrative support. eConsult did not save time for clinicians but was generally more convenient for patients. eConsult was often used in conjunction with telephone and face-to-face follow-up, forming a 'blended consultation'. Accessibility was improved, but cultural factors may affect some patients engaging. CONCLUSIONS: eConsult improves accessibility for patients but does not reduce workload. It should be used alongside conventional access methods, not instead of. It was found to be useful for straightforward clinical and administrative problems but less useful for more complex cases unless part of a 'blended consultation'. Future use could be modified to provide greater data gathering for occupational health and chronic disease monitoring and should be monitored to ensure it is inclusive of all demographic groups.

Use of Web 2.0 tools and social media for continuous professional development among primary healthcare practitioners within the Defence Primary Healthcare: a qualitative review.

INTRODUCTION: Alongside traditional attendance at learning, general practitioners use social media and Web 2.0 tools in the UK for continuous professional development (CPD). Research has demonstrated, however, barriers to their uptake and use, as well as a requirement for training. Primary care doctors working for the Defence Primary Healthcare (DPHC) use similar technologies, but it is not known what factors affect the uptake. This qualitative research aimed to explore the knowledge and attitudes of this demographic further. METHODS: An online questionnaire was distributed to DPHC doctors via email and a social networking service (SNS) tool. Questions included demographic and open free-text response boxes. These were subjected to thematic analysis to identify initial concepts subsequently grouped into categories. RESULTS: DPHC doctors are already using Web 2.0 and social media for education. The benefits of convenience are recognised, but protected time is required to maximise impact. They also identified attendance at learning events, better quality information technology (IT) and further training as important enablers for their CPD. CONCLUSIONS: The results reaffirmed previous findings that while there is engagement with online learning and Web 2.0 technologies, training in Web 2.0 use and substandard IT infrastructure were barriers to greater uptake. Attended learning events are also popular due to the peer-to-peer networking that takes place, but also as they allow protected time out of the office. The use of Web 2.0 for CPD and of SNS should be given equal status to allow the development of a DPHC doctors' 'community of practice'.

Determining the educational impact of the introduction of practice-based small group learning within an intraprofessional group of doctors.

INTRODUCTION: Practice-Based Small Group Learning (PBSGL) is a system for continuing professional development introduced into Wessex Region Defence Primary Healthcare (DPHC) as the Salisbury Plain PBSGL group in 2012. This is a mixed intraprofessional group comprising general practitioners (GPs), GP trainers, general practice specialist registrars (GPSTs) and general duties medical officers (GDMOs). METHODS: An anonymised online questionnaire and thematic analysis was undertaken to assess the educational impact of PBSGL in such a mixed-role group reflecting military general practice. RESULTS: A positive effect of PBSGL was demonstrated and further enhanced by the intraprofessional composition. Positive peer support effects were demonstrated for all members of the cohort regardless of role. CONCLUSION: PBSGL is an essential pillar for supporting all doctors working within DPHC. Further qualitative evaluation of cohorts of GDMOs, GPSTs and mixed-role groups as well as the development of standardised questionnaires is recommended.