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Educ Prim Care ; 30(5): 317-318, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31551007


There is increasing interest in LICs. However for use in the UK and Europe, both the name and nature of LICs need considerable adaption.

Popul Health Manag ; 22(6): 529-535, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30942658


Audit and feedback is an effective method to improve attending physician performance. However, there are limited data on how audit and feedback impacts care provided by resident physicians. The authors conducted a 3-arm randomized clinical trial among internal medicine resident physicians to examine the impact of an audit and feedback intervention on ambulatory quality measures (AQMs). Residents in all 3 groups received an email containing the contact information of a population health coordinator and a list of AQMs (control). In addition, the Practice Target group received individual AQM data compared to the target AQM goals for all primary care practices. The Peer Comparison group received information on individual AQM data compared to the average performance of residents in the same postgraduate year. Residents in each intervention group received updated information 6 months later. Ten AQMs related to diabetes care, hypertension management, lipid control, and cancer screening, as well as a composite quality score, were examined at baseline, 6 months, and 13 months. At 13 months follow-up, the Practice Target group had statistically significant improvement in cervical cancer screening rate (77% vs. 65.3%), colorectal cancer screening rate (72.5% vs. 64.6%), and composite quality score (71.7% vs 65.4%) compared to baseline. Providing internal medicine residents with individual AQMs data compared to target goal for the practice led to statistically significant improvement in cancer screening rates and the composite quality score. Audit and feedback may be a relatively simple yet effective tool to improve population health in the resident clinic setting.

Br J Gen Pract ; 67(657): e248-e252, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28246097


BACKGROUND: It has been suggested that the quantity of exposure to general practice teaching at medical school is associated with future choice of a career as a GP. AIM: To examine the relationship between general practice exposure at medical school and the percentage of each school's graduates appointed to a general practice training programme after foundation training (postgraduate years 1 and 2). DESIGN AND SETTING: A quantitative study of 29 UK medical schools. METHOD: The UK Foundation Programme Office (UKFPO) destination surveys of 2014 and 2015 were used to determine the percentage of graduates of each UK medical school who were appointed to a GP training programme after foundation year 2. The Spearman rank correlation was used to examine the correlation between these data and the number of sessions spent in placements in general practice at each medical school. RESULTS: A statistically significant association was demonstrated between the quantity of authentic general practice teaching at each medical school and the percentage of its graduates who entered GP training after foundation programme year 2 in both 2014 (correlation coefficient [r] 0.41, P = 0.027) and 2015 (r 0.3, P = 0.044). Authentic general practice teaching here is described as teaching in a practice with patient contact, in contrast to non-clinical sessions such as group tutorials in the medical school. DISCUSSION: The authors have demonstrated, for the first time in the UK, an association between the quantity of clinical GP teaching at medical school and entry to general practice training. This study suggests that an increased use of, and investment in, undergraduate general practice placements would help to ensure that the UK meets its target of 50% of medical graduates entering general practice.

Educação de Graduação em Medicina , Medicina Geral/educação , Clínicos Gerais/educação , Faculdades de Medicina , Estudantes de Medicina/estatística & dados numéricos , Escolha da Profissão , Currículo , Educação de Graduação em Medicina/métodos , Educação de Graduação em Medicina/organização & administração , Clínicos Gerais/provisão & distribução , Humanos , Reino Unido , Recursos Humanos
Regul Toxicol Pharmacol ; 76: 7-20, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26708083


The relative wealth of bacterial mutagenicity data available in the public literature means that in silico quantitative/qualitative structure activity relationship (QSAR) systems can readily be built for this endpoint. A good means of evaluating the performance of such systems is to use private unpublished data sets, which generally represent a more distinct chemical space than publicly available test sets and, as a result, provide a greater challenge to the model. However, raw performance metrics should not be the only factor considered when judging this type of software since expert interpretation of the results obtained may allow for further improvements in predictivity. Enough information should be provided by a QSAR to allow the user to make general, scientifically-based arguments in order to assess and overrule predictions when necessary. With all this in mind, we sought to validate the performance of the statistics-based in vitro bacterial mutagenicity prediction system Sarah Nexus (version 1.1) against private test data sets supplied by nine different pharmaceutical companies. The results of these evaluations were then analysed in order to identify findings presented by the model which would be useful for the user to take into consideration when interpreting the results and making their final decision about the mutagenic potential of a given compound.

Modelos Estatísticos , Mutagênese , Testes de Mutagenicidade/estatística & dados numéricos , Mutação , Relação Quantitativa Estrutura-Atividade , Algoritmos , Animais , DNA Bacteriano/efeitos dos fármacos , DNA Bacteriano/genética , Bases de Dados Factuais , Técnicas de Apoio para a Decisão , Humanos , Reprodutibilidade dos Testes , Medição de Risco , Software
Br J Gen Pract ; 65(635): e409-17, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26009536


BACKGROUND: Health care is increasingly provided in general practice. To meet this demand, the English Department of Health recommends that 50% of all medical students should train for general practice after qualification. Currently 19% of medical students express general practice as their first career choice. Undergraduate exposure to general practice positively influences future career choice. Appropriate undergraduate exposure to general practice is therefore highly relevant to workforce planning AIM: This study seeks to quantify current exposure of medical students to general practice and compare it with past provision and also with postgraduate provision. DESIGN AND SETTING: A cross-sectional questionnaire in the UK. METHOD: A questionnaire regarding provision of undergraduate teaching was sent to the general practice teaching leads in all UK medical schools. Information was gathered on the amount of undergraduate teaching, how this was supported financially, and whether there was an integrated department of general practice. The data were then compared with results from previous studies of teaching provision. The provision of postgraduate teaching in general practice was also examined. RESULTS: General practice teaching for medical students increased from <1.0% of clinical teaching in 1968 to 13.0% by 2008; since then, the percentage has plateaued. The total amount of general practice teaching per student has fallen by 2 weeks since 2002. Medical schools providing financial data delivered 14.6% of the clinical curriculum and received 7.1% of clinical teaching funding. The number of departments of general practice has halved since 2002. Provision of postgraduate teaching has tripled since 2000. CONCLUSION: Current levels of undergraduate teaching in general practice are too low to fulfil future workforce requirements and may be falling. Financial support for current teaching is disproportionately low and the mechanism counterproductive. Central intervention may be required to solve this.

Currículo , Educação de Graduação em Medicina , Medicina Geral/educação , Estudantes de Medicina/estatística & dados numéricos , Escolha da Profissão , Estudos Transversais , Educação de Graduação em Medicina/métodos , Humanos , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Reino Unido/epidemiologia
Educ Prim Care ; 24(4): 237-43, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23906166


The opening of a new medical school is a cause for celebration. Starting with a clean slate often gives the opportunity to adopt more modern teaching practices. However, encouraging large numbers of clinicians to start teaching and to adopt these new methods brings its own set of challenges. During the expansion phase of a new medical school, it was often noted that new teachers seemed to have considerable difficulties, and often expressed these as negativity towards student placements. This did not chime with much of the work from established schools, which seemed to evaluate expansion of teaching more positively. We wanted to better understand the issues involved. Semi-structured interviews were conducted involving GPs who had received medical students over the first four years of a newly established medical school. The aims were to assess the impact of the students on the new teachers, and to try to better understand why some teachers were experiencing difficulties. We collected qualitative and quantitative data at the interviews. The qualitative data were analysed using grounded theory which aims to link emerging themes together. The findings suggest that as the quantity of teaching medical students increases, the enjoyment and commitment to teaching may decrease. Concerns over the administration of teaching may begin to predominate. Two factors may help to reduce this: 1 Adequate investment in manpower and premises to reduce time and space constraints on teaching. 2 Practices considering themselves as teaching practices where education is a part of the practice identity.

Docentes de Medicina/organização & administração , Medicina Geral/educação , Motivação , Faculdades de Medicina/organização & administração , Carga de Trabalho/psicologia , Humanos , Relações Interpessoais , Entrevistas como Assunto , Desenvolvimento de Pessoal , Fatores de Tempo