Background and Aims Respondents related frequent and significant adverse effects of their rural experience upon marital and other close relationships. Despite all these stressors, GP registrars were generally positive regarding the vocational value of their rural terms. Most respondents felt that there had been increases in their levels of clinical competence and confidence well beyond that which would be gained during an urban term. The principle determinant of registrars perceiving their rural term to be a constructive training experience was the educational and clinical support received within the practice.
Teaching strengths and gaps at a regional level and at a program level eg Gaps include: disability (RACGP), occupational health (RACGP), IM/IT (ACCRM), palliative care (ACCRM). Strengths include: chronic disease (RACGP), adult medicine (ACCRM) Background: General Practice Education and Training (GPET) encourages Regional Training Providers (RTPs) to assess the performance of all registrars at the commencement of their training to determine their particular needs. It would be useful to RTPs, if an existing assessment tool could be used as part of the evaluation of the learning needs of new registrars. Aim: Method: A retrospective cohort study was undertaken as a quality assurance project, using existing data from 98 registrars from the 2004 to 2007 cohorts. Selection interview scores, both individual and global were compared with a number of outcomes from clinical teaching visits and written assessment activities. The data were analysed using SPSS version 14. Results: Although there were correlations between some interview and first clinical teaching visit (CTV) scores, it was not possible to identify the lowest CTV achievers from the interview scores. Registrars with low total interview scores were more likely to achieve low assessment activity results. Conclusions: Interview scores do not reliably predict which registrars will perform poorly in the basic term. There may be some value in adding them to current performance measures when deciding which registrars need extra assistance.
Academic Stream B - Wednesday 27 August 2008 01:30pm
"GP CLUB": AN INNOVATIVE APPROACH TO ATTRACTING STUDENTS AND PREVOCATIONAL DOCTORS TO A CAREER IN GENERAL PRACTICE
Ms Carmel Northwood 1, 2, Dr Parker Magin 1, 2, Prof Dimity Pond 2, Dr Kevin Sweeney 1, Dr Cathy Regan 1
1General Practice Training - Valley To Coast, 2 The University of Newcastle, Discipline of General Practice
Background
Many medical students do not see General Practice as an attractive career option. This is partly due to the strong hospital and specialist focus during their training.
“GP Club” is an initiative to provide medical students with an opportunity to meet and interact socially with GPs and GP registrars with a view to challenging students’ preconceptions about general practice and to highlight the diverse career options as a GP. Club events incorporate talks by GPs and GP registrars showcasing their rich and varied professional lives, along with professional skills training sessions conducted by GPs and GP registrars.
Methods
Questionnaires were administered to student attendees eliciting students’ ratings of club activities. Student suggestions for future club activities were also surveyed.
Results
Undergraduate students make up 68% of attendees, GPs and GP registrars 22%, prevocational doctors 3%, 7% special guests and support staff. Ten GP Club events have been held. Attendance has risen from 44 at the first event in September 2006 to 105 in March 2008. Survey responses have been received from 138 students. Responses have been strongly favourable. 93% of students rated GP/GP registrar speakers as 4 or 5 on a Likert scale (of 1-5). 87% rated professional skills training as 4 or 5. Qualitative responses reinforcing these findings will be presented. Most-requested future activities are professional skills training, speakers, social interactions and mentoring opportunities.
Conclusion
Attendance and positive feedback indicate GP Club is a successful initiative. Further evaluation needs to investigate GP Club’s impact upon students’ career plans.
PLAY DOUGH, BARBIE DOLLS AND BUBBLE WRAP - LEARNING AIDS FOR THE TRICKY STUFF IN GENERAL PRACTICE
Dr Nicola Holmes
North Coast GP Training
Ever struggled with remembering the attachments of the rotator cuff? Can’t remember the difference between a macule and a papule? Do you forget which contraceptive pills do what in terms of benefits and side effects? Or have you noticed how a doctor’s brain turns off when ever they are presented with a rash, and how they suddenly forget how to take a history before trying to make a diagnosis?
Well worry no more!
Nicola Holmes, medical educator with North Coast GP Training has developed a number of simple but brilliantly effective learning aids to assist registrars (and their trainers) to remember some of the more difficult to retain, yet important medical information.
Through ingenious use of play dough, barbie dolls, rainbows, bubble wrap and textas (not to mention her own children at times), Nicola will demonstrate her simple, cheap and effective learning aids to assist in teaching and learning about dermatology, musculo-skeletal medicine, and women’s health.
This is a paper not to miss. It may change the way you teach for ever.
POLICY OPTIONS FOR STRENGTHENING AN AUSTRALIAN GENERALIST PRIMARY CARE WORKFORCE
Dr Lucio Naccarella 1, Professor Jane Gunn 1, Professor Peter Brooks 1,2
1The University Of Melbourne, 1The University of Queensland
Objective
To conduct a systematic narrative literature review of the place of generalism in the 2020 primary care team in order to identify potential policy options to strengthen a generalist primary care workforce in Australia.
Methods
A systematic narrative review of generalism and generalist approaches was conducted to identify the essential dimensions of generalism as they applied to medical care practiced in the community setting.
Results
To strengthen a generalist primary care workforce we identified three interdependent policy options within a strategic framework, namely: increasing the importance and status of generalists; enhancing the educational content and settings that strengthen a generalist primary care workforce; and building and transferring evidence about strategies that strengthen generalism in the 2020 primary care team.
Conclusion
With primary health care workforce development being a national government priority, and the newly established Australian Health Workforce Institute, the time is right to transform an evidence-informed strategic framework into an agreed National Operational Action Plan to strengthen Australia’s generalist primary care workforce.
FACTORS CONTRIBUTING TO REGISTRARS' PERCEPTIONS OF QUALITY OF EXPERIENCE IN RURAL TERMS: RESULTS FROM A QUALITATIVE STUDY
Dr Sarah Bayley 1, Jennifer Sweatman1, Dr Cathy Regan1 2, Dr Parker Magin1 2
1 General Practice Training - Valley To Coast
2 Discipline of General Practice, University of Newcastle
All General Practice registrars are required to undertake a minimum of six months of their vocational training in a rural setting. Rural training placements can be a challenging prospect for GP registrars. This study aimed to explore GP registrars’ experiences during rural training terms, and to establish factors affecting the perceived quality of their rural training experience.
Methods
This was a qualitative study employing a modified grounded theory approach. Study participants were recruited from the cohort GPTVTC registrars who had completed a rural term within the previous 12 months. Purposive sampling ensured a range of participant demographics (gender, age, location of rural terms, country of origin and degree of rural background). Data collection was via semi structured interviews. Interviews were audio tape recorded and transcribed verbatim. The transcripts were subjected to thematic analysis. Data collection and analysis were concurrent, employing a process of constant comparison. Data collection continued until thematic saturation was achieved. Validity of analysis was enhanced by comparative coding of a representative sample of greater than 50% of transcripts.
Results
16 semi-structured interviews were conducted, achieving thematic saturation. Major themes centred on challenges inherent in rural practice, and structures and measures within practices that facilitated meeting these challenges. Challenges included spousal circumstances, especially spousal employment, and child-rearing responsibilities. Other challenges that respondents faced were isolation from family and other social support and professional isolation. The GP workload and level of work responsibility were found to be singularly challenging – and were thought to be especially taxing in an environment lacking in these family social and professional support networks.
Conclusions
Rural terms can provide an intense and rich, but challenging, learning and training experience. In this study, General practice registrars’ perceptions of the value of their rural placements were influenced by the level of educational and clinical support they received from the practice. However, influences external to practice and training environment had the potential to seriously and adversely impact upon registrars rural experiences.
KNOWING WHAT WE KNOW NOW: RISK IDENTIFICATION FROM A LEARNING NEEDS ANALYSIS
Dr Carolyn O'Shea
Department Of General Practice, The University of Melbourne
Aim
To identify if information obtained in a multifaceted learning needs analysis (LNA) that may indicate significant educational risk during the training program.
Method
LNA are completed by Victorian Metropolitan Alliance GP registrars (GPRs) just prior to commencing a Basic term. This project will retrospectively compare the LNA of GPRs who are identified at significant educational risk and the LNA of their cohort of GPRs to identify any common factors that may discriminate between the groups. The group at significant education risk will be defined as GPR who have subsequently failed the RACGP exam or required formal remediation. The groups will be compared about perceived learning needs, MCQ paper scores and ratings of video vignettes of consultations.
Results
The results will be presented and discussed.
Academic Stream C - Wednesday 27 August 2008 01:30pm
WHAT ARE WE TEACHING? LESSONS FROM INTEGRATION AND TRACKING ACROSS THE CURRICULA
Dr Denise Findlay, Ms Jodi Holland
Western Australian General Practice Education and Training (WAGPET)
Introduction
Western Australian General Practice Education and Training (WAGPET) has implemented an integrated Learning Management System to support general practice vocational training.
Brief methodology
In 2008 all in-practice teaching is being logged online by the GP registrar and presented as a visual matrix against the curricula of both colleges. In addition a visual Personal Education Matrix maps all central, regional, online education as well as in-practice teaching for the registrar.
WAGPET has logged online all practice teaching data from 2006.2 to 2008.1. Once logged all in-practice teaching is automatically tracked and mapped as an online visual matrix against the curricula of both colleges.
Findings
Currently over 80% of basic registrars are logging their in-practice teaching and registrars are being encouraged to use this and their personal education matrix to identify gaps in curriculum coverage for their learning plans.
Following a pilot in 2008.1 all practices will be submitting their in-practice teaching online and will view the curriculum matrix instantaneously. Feedback indicates that most practices perceive this tool as valuable for reflecting on their teaching, identifying coverage of the curricula and streamlining administration.Having inputted 18 months of in-practice teaching data online and commenced analysis we have identified the:
Conclusion
These online tools allow the registrar and the GP supervisors and regional educators to dynamically view curricula coverage, identify education gaps and plan learning. They also provide WAGPET with a dynamic view of in-practice teaching delivery, whole program delivery and identify program gaps, which informs future development.
Dr Denise Findlay, Ms Jodi Holland
Western Australia General Practice Education and Training (WAGPET)
Background
The RACGP and ACRRM require supervisors of general practice registrars to attend 18 hours of education annually to develop their skills as an educator and demonstrate commitment to teaching.
Aims
Having developed a supervisor education framework, the Western Australian GP Training Program (WAGPET) undertook a survey to identify: supervisor experience; supervisor self-assessment of their level of knowledge and skills across the areas identified in the framework; their likelihood to attend core education and proposed independent activities; and their perception of the annual education requirement.
Methods
A survey was developed and piloted. The final survey was made available online and also distributed by mail to 110 supervisors.
Results
Fifty-five (55) supervisors returned the survey (50%) to date. Of these, 21 (38%) had been involved in teaching for ten years or more and the remainder averaged 4.3 years of teaching registrars. Many had additional medical qualifications, only three had an education qualification.
On average supervisors felt that nine (9) hours of education annually was appropriate. Independent activities and online activities were perceived as very useful/useful by two-thirds but there was great variation between activities or areas selected.
Conclusion
At abstract submission the survey results are still being analysed. Full results with correlations against actual experience, perceived knowledge and skills and other parameters will be presented at the conference along with the implications for future education development. The results have lead to modification of the framework and expansion of independent options available.
THE ELECTRONIC LEARNING FOLDER (ELF): EVALUATION OF A NOVEL CLINICAL RESOURCE AND LEARNING TOOL FOR REGISTRARS
Dr Belinda Guest 1, Dr Parker Magin 1, 2
1General Practice Training Valley To Coast, 2Discipline of General Practice, The University of Newcastle
Background
GP registrars are faced with an overwhelming array of electronic desktop resources to aid clinical decision-making. The challenge is to find high quality, relevant, useful information which is easily accessed from all work stations. Flexibility to suit a registrar’s stage of training and personal learning preferences and needs is also vital. In response to this challenge, we have developed the Electronic Learning Folder (ELF), This is a USB device loaded with a selection of clinical resources including patient handouts and diagnostic and treatment algorithms. Registrars also record clinical questions as they arise, which assists with learning plan formation, and then document the findings of their research into these clinical questions, thus providing a durable study resource.
Methods
We performed a cross-sectional questionnaire-based study to assess term one registrars’ experience with the ELF.
Results
We will be presenting the final results of our study, analysing the usefulness and predictors of registrars’ engagement with the ELF. Pilot findings are of the ELF being rated a useful resource, with the clinical reference material and patient hand outs being the most useful aspects.
Conclusion
The ELF is a valuable registrar clinical practice resource. It has the flexibility to continue to be useful throughout training and in subsequent practice. It also has the capacity to assist in identification and achievement of learning needs in a dynamic and relevant way. The device has potential to be modified to meet future changes in registrar training and to be adapted to the needs of other regional training providers.
SELECTION INTERVIEW SCORES AS A PREDICTOR OF LATER PERFORMANCE
Dr Anne Eastwood
Institute Of General Practice Education Inc
To determine whether there is any relationship between selection interview scores and assessments of performance made during the IGPE program.
WHERE ARE THEY NOW? A FOLLOW UP STUDY OF REMOTE VOCATIONAL TRAINING SCHEME REGISTRARS
Dr Susan Wearne, Dr Patrick Giddings, Jeanette McLaren, Catherine Gargan
Remote Vocational Training Scheme
The Remote Vocational Training Scheme (RVTS) trains doctors for remote communities in remote communities. The aim is to support comprehensive high quality service delivery during training and promote retention after training.
RVTS trains isolated doctors who could not otherwise complete vocational training except by leaving their communities. The program offers training towards Fellowship of the RACGP and ACRRM and by extension, for Vocational Recognition (VR) with Medicare Australia. RVTS receives funding from the Commonwealth Department of Health and Ageing.
The RVTS program accommodates the circumstances of remote practice through remote supervision and innovative information and telecommunication technologies. Registrars devise individual learning plans and learn the clinical and procedural skills needed for the extended scope of remote clinical practice.
In 2007 all past RVTS registrars were contacted to complete an online survey.
This paper will present the resulting data on the number of RVTS registrars who have achieved vocational registration, their current location and services provided and a global assessment of the preparation for clinical practice provided by RVTS training.