Education for Primary Care最新文献

{"title":"Unreachable patient safety in GP speciality training: a practical intervention to close risk when contact fails.","authors":"Waseem Jerjes, Azeem Majeed","doi":"10.1080/14739879.2026.2673952","DOIUrl":"10.1080/14739879.2026.2673952","url":null,"abstract":"<p><p>When patients cannot be reached yet risk exists, GP trainees must make proportionate safety decisions without the stabilising anchor of a live consultation. This 'unreachable patient' problem is common in results handling, radiology follow-up, medication monitoring, and safeguarding, but is rarely taught explicitly as a clinical skill. The Unreachable Patient Algorithm (UPA) is a structured educational intervention that trains trainees to treat reachability as a variable in clinical reasoning. It combines rapid risk stratification, a graded action ladder, and a documentation standard that supports confidentiality, accountability, and loop closure. Supervisors introduce a single trigger (for example, a critical laboratory alert, abnormal imaging report, or safeguarding concern) and ask trainees to state the risk tier, the minimum safe action, the escalation threshold, and the fallback plan if contact remains unsuccessful. Teaching occurs through inbox simulation, case-based tutorials, and supervised 'pause and plan' moments in real clinics. A one-page note template and brief portfolio prompts reinforce consistency across placements. Early reflections suggest trainees escalate more appropriately, write clearer contingency plans, and rely less on vague statements such as 'tried to call'. UPA is low-cost, fits routine GP training, and offers a replicable method to reduce avoidable harm when contact fails in practice.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"232-236"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Student and teacher views of using GenAI in GP undergraduate medical education: 'to complement not replace'.","authors":"Millie Ramsay, Hugh Alberti","doi":"10.1080/14739879.2026.2690642","DOIUrl":"10.1080/14739879.2026.2690642","url":null,"abstract":"<p><p>The use of Generative Artificial intelligence (GenAI) in both health care and medical education has generated great excitement and a plethora of research. However, little work has been done in the area of undergraduate general practice education. We aimed therefore to explore the experiences and views of students and teachers of GenAI use in medical education. This was a multi-method UK study involving a national survey of GP heads of teaching, focus groups of medical students and interviews with GP teachers and heads of GP teaching. Interviews and focus groups were transcribed verbatim and thematically analysed. Only 5 of 19 GP heads of teaching (40% response rate) who responded report formal use of GenAI, with 11 of 19 reporting informal use within their institutions. Three overarching themes were constructed from the qualitative results. Firstly, positivity towards GenAI use: teachers and students demonstrated enthusiasm for generative AI, with improved efficiency and time-saving consistently identified as the most significant benefits across both groups. Secondly, concerns about GenAI use: these included inaccuracies, de-skilling, data protection and the environmental impact. Thirdly, a shared view that AI should complement rather than replace human expertise. Our study has revealed consensus between GP teachers and students acknowledging AI's unavoidable role in the future of medical education and healthcare, alongside a variety of challenges. A number of current uses are presented specific to the undergraduate GP education context. The underlying consensus emphasised complementing rather than replacing the doctor's role when implementing AI into practice.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"247-250"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel programmatic assessment model set in primary and secondary clinical settings: perceptions of teachers and students.","authors":"Matthew Keir, Olivia Fishwick, Caitlin Thompson, Hugh Alberti","doi":"10.1080/14739879.2026.2667743","DOIUrl":"10.1080/14739879.2026.2667743","url":null,"abstract":"<p><strong>Introduction: </strong>Programmatic assessment is being increasingly used in medical education with an expanding evidence base. The aim of the study was to explore student and teacher perspectives of a novel clinical, programmatic assessment model set within a Longitudinal Integrated Clerkship (LIC) across both primary and secondary care settings.</p><p><strong>Methods: </strong>An explorative, interpretative approach was taken to explore participants' views and experiences of the assessments, including focus groups of undergraduate medical students and interviews of faculty.</p><p><strong>Results: </strong>A total of 14 students participated in two focus groups and nine faculty members were interviewed: four based in primary care and five in secondary care. In general, the new assessment model was perceived by teachers and students to be a positive step, with both benefits and challenges highlighted. Three key themes emerged: the impact on student well-being was complex and variable; predominantly positive attitudes towards programmatic assessment; and challenges of exam practicalities.</p><p><strong>Discussion: </strong>Our study has explored student and teachers' views of a novel, clinical, programmatic assessment; both sets of participants generally valued increased opportunities for feedback and positive impacts on well-being due to the reduced stress of lower-stakes assessments. However, there was some acknowledgement that it 'spread the stress' throughout the clinical year and that there were some challenges related to the introduction of a new form of assessment. We would commend this and similar forms of programmatic assessment to colleagues in other undergraduate healthcare professional institutions.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"207-212"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching IMP (Impact, Meaning, Priorities): supporting meaningful psychosocial exploration and tailored management planning in GP training.","authors":"Geronde Mary Ward","doi":"10.1080/14739879.2026.2690649","DOIUrl":"10.1080/14739879.2026.2690649","url":null,"abstract":"<p><p>General practice trainees are routinely encouraged to explore patients' psychosocial context as part of patient-centred care. However, educators frequently observe that this exploration can become superficial or formulaic, with questions about work, home life, or concerns functioning as tick-box exercises that do not meaningfully inform clinical decision making. Trainees may gather contextual information without understanding its relevance to patient priorities or to the development of tailored management plans.This article describes the use of IMP (Impact, Meaning, Priorities) as a practical educational intervention to support trainees in discovering psychosocial context with purpose. IMP provides a simple scaffold to help trainees explore how illness affects patients' lives (Impact), what personal significance patients attach to their symptoms (Meaning), and how this shapes what matters most to them at that point in time (Priorities). By foregrounding impact and meaning, IMP is intended to help illuminate patient priorities and support the creation of patient-centred, negotiated management plans.Drawing on established consultation models and informed by Helman's Folk Model of Illness, IMP has been used in GP training teaching sessions and simulated consultations as a complement to existing frameworks. This paper describes the educational rationale for IMP, outlines how it has been used in GP training and reflects on educators observations when used in teaching practice. It reflects on educators' observations regarding trainee confidence, depth of psychosocial exploration, and use of contextual information in clinical management.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"237-240"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demonstrating the therapeutic value of physical examination and the art of reassurance to undergraduate medical students.","authors":"Maxwell John Cooper","doi":"10.1080/14739879.2026.2673586","DOIUrl":"10.1080/14739879.2026.2673586","url":null,"abstract":"<p><p>The therapeutic value of history and physical examination has long been recognised but little evidence exists to support its teaching in the undergraduate context. This article describes demonstrating therapeutic examination to year four students at Brighton and Sussex Medical School. A student volunteer is invited to be the patient. The presentation is clearly marked as a 'middling case' of sore throat, i.e. one where the condition is painful but not dangerous. In this example I explain that the patient has a Centor score of 2-3 and that my examination seeks to be therapeutic to the patient and the GP. The demonstration highlights the importance of practical preparation (one's clinical equipment laid out), physical touch (e.g. starting with the hands/pulse as non-threatening), some 'technology' (e.g. pulse oximeter), demonstrating thoroughness and using reassuring language during the examination. Students are reminded that therapeutic examination may elicit important clinical signs, e.g. atrial fibrillation or hypertension. The session consistently receives positive quantitative and qualitative feedback. The latter reveals that some students would prefer teaching focused on specific diagnoses (rather than their absence). Here I present my own model of the 'craft' of general practice called TPAP: Trust built upon implementing the Process (history, examination, basic tests, incremental management etc), Art (thinking strategically) and Practice ('knowing one's tools') of medicine. Finally, this article considers the important notion of 'conserving clinical energy' and makes the claim that effort expended upon the physical examination reaps benefits later in the consultation and in forging long term therapeutic relationships.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"226-231"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Livestreaming clinical education in general practice: practical lessons from implementation across seven UK medical schools.","authors":"Kelvin Gomez, John McKeown, Ben Jackson, Sara Fairclough, Duncan Rogers, Catherine Neden, Jaspal Taggar, Kathryn J Harrison, Alex Harding, Lindsey Pope","doi":"10.1080/14739879.2026.2673398","DOIUrl":"10.1080/14739879.2026.2673398","url":null,"abstract":"<p><p>General practice placements are facing increasing pressure from global clinician shortages, rising workload and limited physical space. Meanwhile, medical school cohorts continue to expand to support the global clinician shortfall. This mismatch creates a growing bottleneck for authentic patient-based learning and has intensified interest in digital placement models of education. Livestreamed Clinical Experiences (LCEs) - real-time broadcast consultations between clinicians and patients - offer a potential way to extend access to clinical learning, increase exposure to diverse cases and enable participation by rural or underserved communities. However, despite growing interest, educators currently lack practical guidance on how to implement LCEs in general practice in ways that are ethically robust, technically feasible and pedagogically purposeful. Drawing from educator experience, literature and pilot data, we outline key practical considerations across five themes: planning and governance, technical setups, patient-centred consent, pedagogically purposeful delivery, and sustainable evaluation and scale-up. Our aim is to provide a concise, practice-oriented narrative reflecting what worked, what proved challenging and what may support others to implement effective LCEs. We include a practical implementation checklist and an LCE facilitation model to guide educators through the planning, ethical and technical stages of delivery.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"220-225"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Listening….","authors":"Simon Gay","doi":"10.1080/14739879.2026.2708647","DOIUrl":"10.1080/14739879.2026.2708647","url":null,"abstract":"","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"iii"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 'law of curriculum drift from generalism to specialism': addressing the 'generalist deficit' in undergraduate teaching.","authors":"Max Cooper","doi":"10.1080/14739879.2026.2646891","DOIUrl":"10.1080/14739879.2026.2646891","url":null,"abstract":"<p><p>This article explores how undergraduate curricula in medicine become dominated by specialist facts at the expense of general practice (family medicine). This 'generalist deficit' arises largely from assessment focused upon diagnoses and a need for clinical certainty. The law of curriculum drift from generalism to specialism states that 'effort expended upon improving the quality of assessment in medical education incrementally transforms learning from overarching generalist principles (\"time as a tool\", incremental management, trial of treatment etc) to detailed specialist facts (diagnoses, tests and interventions)'. In their evaluation and expectations of curriculum content, students demand expansion of specialist factual teaching to help pass these assessments. Curriculum reform towards specialism is further driven by school performance in national assessments and by 'metrics-based' quality assurance of curricular content. Specialist content incrementally supplants important learning about the wide range of 'normal' presentations in healthy people, clinical restraint and compassionate patient-centred care. Alongside increasing financial cost, administrative workload and student stress, the processes above leave graduates unprepared for the real-world challenges of practising medicine and being a doctor. This reflective piece also considers wider factors like 'tariff' funding, challenges in defining general practice and a failure to recognise that general practice is an 'approach of practical problem-solving'. The author calls for assessment and teaching throughout undergraduate medical education to embrace clinical uncertainty. This is essential for preparing tomorrow's doctors to work in the National Health Service in both primary and secondary care.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"189-192"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of international medical graduates into primary care settings - a systematic review and narrative synthesis.","authors":"Adedoyin Alao, Bryan Burford, Hugh Alberti, Uchechukwu Eleazu, Gillian Vance","doi":"10.1080/14739879.2026.2673589","DOIUrl":"10.1080/14739879.2026.2673589","url":null,"abstract":"<p><strong>Background: </strong>International Medical Graduates(IMGs) play a crucial role in the primary care workforce. However, they experience challenges that may affect their career progression, satisfaction,and retention.</p><p><strong>Aim: </strong>To synthesise the literature on IMG experiences of, and integration into primary care settings, and identify factors that support or hinder this process.</p><p><strong>Design & setting: </strong>Systematic review of primary studies examining IMG integration in primary care, and narrative synthesis of evidence.</p><p><strong>Method: </strong>Eight databases were searched from inception to July 2025, alongside grey literature and reference checks. Eligible studies presented primary research involving IMGs across all career stages working in primary care. A narrative synthesis was conducted following quality appraisal.</p><p><strong>Results: </strong>Forty studies were included. IMGs reported challenges across cultural adjustment, communication, educational processes, and understanding of UK primary care systems. Systemic bias, social isolation, and limited professional support contributed to poor well-being and career progression. Integration was facilitated by mentorship, culturally sensitive feedback, and targeted training. IMGs also used self-directed coping strategies such as proactive learning, reflection and peer networking.</p><p><strong>Conclusion: </strong>IMGs face multifaceted challenges in primary care. Addressing system and educational barriers through targeted support for both trainees and trainers may enhance integration, reduce differential attainment, and support workforce sustainability. Organisational and individual-level strategies to support integration are proposed. Research on long-term impact of support strategies is recommended.</p><p><strong>How this fits in: </strong>This review identifies common barriers and enablers of IMG integration, offering insights for policymakers, educators, and supervisors to better support development of a diverse primarycare workforce.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"193-206"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinitalk: evaluation of a web-based feedback platform supporting consultation skill development in UK GP training.","authors":"Anwar Ali Khan, Nicholas Boeckx, Nicola Turner, Roger Neighbour, Peter Salmon, Robin Simpson","doi":"10.1080/14739879.2026.2690645","DOIUrl":"10.1080/14739879.2026.2690645","url":null,"abstract":"<p><strong>Background: </strong>Consultation skills are central to general practice and the MRCGP Simulated Consultation Assessment (SCA). Clinitalk is a digital platform enabling GP trainees to record and reflect on consultations, supported by AI-generated feedback to facilitate deliberate practice.</p><p><strong>Aim: </strong>To evaluate Clinitalk using Kirkpatrick's four-level model of training evaluation, focusing on user satisfaction, learning outcomes, behavioural change, and alignment with professional standards.</p><p><strong>Methods: </strong>This descriptive evaluation analysed anonymised data from over 13,000 Clinitalk recordings from GP trainees across the UK. Quantitative metrics included clinician talk time, open-to-closed question ratio, timing of management initiation, and consulting behaviour ratings. Qualitative feedback from trainees, trainers, and RCGP examiners was analysed using inductive thematic analysis. User surveys assessed helpfulness and SCA preparedness.</p><p><strong>Results: </strong>At Kirkpatrick Level 1 (Reaction), surveys (<i>n</i> = 124) reported mean helpfulness of 9.3/10, with all users feeling better prepared for the SCA. At Level 2 (Learning), qualitative analysis identified increased self-awareness, enhanced patient-centredness, and improved understanding of consultation structure. At Level 3 (Behaviour), average clinician talk time reduced by 18% over 20 months, management was initiated 1.1 minutes earlier, and higher open-to-closed question ratios correlated with lower talk time and improved tailored management ratings. RCGP examiner review showed 96.4% agreement with Clinitalk's ratings.</p><p><strong>Conclusion: </strong>Clinitalk is associated with positive outcomes across the first three Kirkpatrick levels. Digital feedback tools may enhance reflective practice, promote patient-centred care, and support equitable GP training in resource-constrained settings.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":" ","pages":"213-219"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}