Education for Primary Care最新文献

{"title":"The digital Balint: using AI in reflective practice.","authors":"Marcus Lewis, Benedict Hayhoe","doi":"10.1080/14739879.2024.2372606","DOIUrl":"https://doi.org/10.1080/14739879.2024.2372606","url":null,"abstract":"<p><p>Reflective practice is fundamental to postgraduate general practitioner (GP) training and ongoing professional development. However, real-world challenges like time constraints and professional isolation often limit meaningful engagement with this critical skill. This article proposes that large language models (LLMs), sophisticated artificial intelligence systems, may have potential for enhancing reflective practice. We present three case studies, in which we explore the ability of LLMs to generate thought-provoking questions, which could prompt GPs to consider new angles, address underlying factors, and bridge the gap between theory and practice. Our findings suggest that LLMs could help reframe experiences and foster deeper self reflection, particularly for isolated practitioners. While ethical concerns regarding privacy, over reliance, and potential biases exist, we consider the possibility of responsibly integrating LLMs into reflective practice. For trainees, AI-generated questions might complement personal reflection under guidance. For GPs working in isolation, LLMs present an opportunity to enhance reflective practice, challenging us to consider a place for this technological innovation without diminishing the human aspects essential to medical practice.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044180","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":"Preparing GP registrars for leadership in multidisciplinary primary care.","authors":"Waseem Jerjes, Azeem Majeed","doi":"10.1080/14739879.2024.2383433","DOIUrl":"https://doi.org/10.1080/14739879.2024.2383433","url":null,"abstract":"","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009660","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 qualitative evaluation of trainee and educator experiences of Integrated Training Posts in one Vocational Training Scheme.","authors":"Michelle Higgs, Hilary Neve","doi":"10.1080/14739879.2024.2384697","DOIUrl":"https://doi.org/10.1080/14739879.2024.2384697","url":null,"abstract":"<p><p>Integrated Training Posts (ITPs) were conceived in the 1990s and have recently increased in the Southwest of England. Most ITP evaluations have been small and undertaken over 13 years ago, so do not reflect the current training landscape. This qualitative study aimed to explore the views and experiences of ITPs amongst general practice trainees and educators. The location has increasing numbers of general practice trainees, International Medical Graduates (IMGs) and less-than-full-time trainees. Semi-structured interviews were undertaken with six trainees and two educators; all had experienced at least one ITP. Recordings were transcribed verbatim and coded. Thematic analysis was undertaken. Three themes were identified: 'The role: expectations versus reality', 'Relevance of ITPs to future GP role' and 'Educational Challenges'. Most trainees valued the additional clinical experiences ITPs offered, as well as being able to trial 'portfolio' working. Trainee and educator expectations varied considerably, particularly whether the role was primarily service or observational. Working across multiple settings could limit contact between educator and trainee and make it difficult to identify a struggling trainee. There is a need to clarify the roles of trainees and educators involved in ITPs and whether and how this might vary between posts. Further studies could explore whether choice of ITP influences retention of general practitioners, and whether all trainees including those working less-than-full-time or IMGs benefit from ITPs.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917722","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":"Power failure; an uncomfortable teaching initiative?","authors":"Grainne P Kearney, Helen Reid, Mairead Corrigan","doi":"10.1080/14739879.2024.2384069","DOIUrl":"https://doi.org/10.1080/14739879.2024.2384069","url":null,"abstract":"<p><strong>Background: </strong>Introducing medical students to the concept of Cultural Humility, we devised a teaching initiative for students to consider how power manifests through the use of language in clinical communication, with a focus on General Practice. Cultural Humility is a pedagogical framework, introduced by Tervalon and Murray-Garcia, to address what they consider as the limitations of the Cultural Competence model.</p><p><strong>Approach: </strong>Our teaching initiative specifically focused on power in clinical communication, both oral consultations and written notes. The session was delivered to third-year medical students during their first 'clinical' year, where they regularly witness and are involved in clinical communication across primary and secondary care placements. Ethical approval was in place to analyse students' reflections on the session.</p><p><strong>Evaluation: </strong>Students who attended engaged well. They evaluated the session positively as increasing their awareness of the power of clinical language in negatively stereotyping and dehumanising patients. They demonstrated Cultural Humility in their reflections of the unintentional harm of clinical language commonly used for the doctor-patient relationship. However, most striking for us, and where our learning as educators lies, was the low attendance at the session, despite our attempts to underline clinical relevance and importance for development as future doctors.</p><p><strong>Implications: </strong>This article offers a framework for educators interested in Cultural Humility. The implications of this initiative are how (or how not) to develop and deliver training in this space. More consideration is required as educators, including around our own language, as to how to engage students to think around the complex topic of power.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907969","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":"Perceptions and experiences of trainers and trainees of UK workplace-based assessment for general practice licensing: a mixed methods survey.","authors":"A Niroshan Siriwardena, Viet-Hai Phung, Kim Emerson, Tom Anstey","doi":"10.1080/14739879.2024.2379525","DOIUrl":"https://doi.org/10.1080/14739879.2024.2379525","url":null,"abstract":"<p><strong>Background: </strong>Workplace-Based Assessment (WPBA) forms a major component of the UK General Practitioner (GP) licensing, together with knowledge and clinical skills examination. WPBA includes Case-based Discussion, Consultation Observation Tool, Mini-Consultation Exercise, Multisource Feedback, Patient Satisfaction Questionnaire, Clinical Examination and Procedural Skills, Clinical Supervisor's Report, and Educational Supervisor Review. We aimed to investigate GP trainees' and trainers' perceptions and experiences of WPBA regarding validity and fairness.</p><p><strong>Methods: </strong>We used a national online survey, with Likert-scaled and free-text responses, to a convenience sample of GP trainees and trainers, on perceptions and experiences of WPBA. Analysis included descriptive statistics, scale development, and regression models to investigate factors associated with attitudes towards WPBA, with thematic analysis of free text responses supported by NVivo 12.</p><p><strong>Results: </strong>There were 2,088 responses from 1,176 trainees and 912 trainers. Both groups were generally positive towards WPBA, with trainers more positive or similar to trainees towards individual assessments. In a multivariable regression model, accounting for sex, ethnicity and country of primary medical qualification, trainees were significantly less positive (<i>p</i> < 0.001) while international medical graduates (IMGs) trained outside the European Economic Area (EEA) were significantly more (<i>p</i> < 0.001) positive towards WPBA. Qualitative analysis revealed varying concerns about validity and relevance, assessment burden, potential for bias, fairness to protected characteristics groups, gaps in assessment, and perceptions of individual assessments.</p><p><strong>Discussion: </strong>Trainers' greater positivity towards elements of WPBA accords with their role as assessors. Despite concerns about bias, IMGs from outside the EEA were significantly more positive towards WPBA.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903150","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":"Students' experiences of a GP escape room.","authors":"Kevin McConville, Clara White","doi":"10.1080/14739879.2024.2364885","DOIUrl":"https://doi.org/10.1080/14739879.2024.2364885","url":null,"abstract":"<p><strong>Background: </strong>Educational escape games have become more common, yet their effectiveness needs to be evaluated to establish whether or not they are a constructive pedagogical tool.</p><p><strong>Aim: </strong>This study explored students' experiences of a general practice (GP) based escape game to uncover whether it deserves a place in a medical school's curriculum.</p><p><strong>Design and setting: </strong>A mixed methods case study within one Scottish Medical School.</p><p><strong>Method: </strong>Data were collected during March 2020 via 32 video recordings of an Escape Room Game, combined with participant, post-game questionnaire analysis. Video footage was reviewed in an ethnographic manner and thematic analysis conducted.</p><p><strong>Results: </strong>Fourteen team events constituting 718 minutes were analysed. From the footage, five themes with fourteen subthemes emerged. The five main themes were: teamwork, leadership, clinical thinking, numeracy, and gamification. From the student questionnaires (<i>n</i> = 131), it was reported that the GP escape room was predominantly an extremely positive educational experience.</p><p><strong>Conclusion: </strong>Educational escape games appear invaluable in medical education. They can promote the growth of non-technical skills such as teamwork, leadership, and clinical thinking; all essential to working in a multidisciplinary team and enabling patient safety. Our participants struggled with numeracy in this high-pressured environment, this must be addressed to reduce potential mistakes made in the workplace. Results are supportive of educational escape games being worthy of a space within a medical school's curriculum. A GP-orientated escape room allows for early GP exposure from a different perspective, as well as equipping students with the skills to be successful in this field.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793752","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":"An overview and evaluation of the differential attainment champion role in the North West of England GP school.","authors":"Catherine Morgan, Rebecca Baron, Liam Jenkins, Jeremy Brown","doi":"10.1080/14739879.2024.2374467","DOIUrl":"https://doi.org/10.1080/14739879.2024.2374467","url":null,"abstract":"<p><strong>Background and aims: </strong>In the Northwest of England, a national allocation of funding to minimise the effects of differential attainment has been used to support experienced GP educators to act as Differential Attainment Champions (DAC) since October 2021. An evaluation of the role's impact was undertaken.</p><p><strong>Methods: </strong>The evaluation was designed to gather the views and experiences of DACs and their trainees via online semi-structured interviews during the first 12 months following establishment of the intervention programme.</p><p><strong>Results: </strong>Thematic framework analysis identified three main themes: DACs' adaptive approach to support trainees; barriers to fulfilling the DAC role; and the positive impact of the DAC role on training. The following aspects of the DAC role worked well: the freedom to tailor support to the individual needs of the trainees; the targeted and proactive support early on in GP core training; the support of trainees in a wide range of areas including e-portfolio advice, examination preparation, and personal help. Trainees valued one-to-one support when needed. Reported improvements included: improved examination outcomes; portfolio engagement recognised in some cases by Annual Review of Competence Progression (ARCP) panels.</p><p><strong>Conclusions: </strong>The individualised and adaptive approach works well but it does mean it is difficult to quantify how many trainees can be supported by one DAC and their workload needs to be monitored.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749243","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":"Implementing a community rotation to the internship training in Kenya: barriers and enablers.","authors":"Peter Kioko, Fleur De Meijer, Adelaide Lusambili, Catherine Gathu","doi":"10.1080/14739879.2024.2370537","DOIUrl":"https://doi.org/10.1080/14739879.2024.2370537","url":null,"abstract":"<p><p>Community placements among trainee doctors have proven beneficial in understanding community problems, the role of primary care in health, and increasing the likelihood of pursuing a primary care career, albeit with some challenges. In 2020, Kenya started community rotations as part of the mandatory internship programme. This study aimed to describe the experiences among medical interns and their educational supervisors during the rotation from which insights on how to improve the community rotation may be drawn. A qualitative analysis of 13 in-depth interviews carried out among medical interns and their supervisors was undertaken in the first year of the implementation of the community rotation. Factors that enabled a successful rotation were an increased awareness amongst interns about patient health in the context of the community, presence of existing primary care structures, and the use of technology for patient follow-up during the COVID-19 pandemic. Conversely, challenges experienced by participants included insufficient communication prior to implementing the community health rotation, limited community health exposure among medical graduates before the internship, and fear of contracting or spreading COVID-19. The study identified opportunities to improve the community rotation through stakeholder engagement, timely government communication, and strengthening undergraduate medical training in community health competencies.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581211","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":"Should physician-assisted suicide (PAS) be legalised in the UK? An innovative workshop exploring medical students' perspectives.","authors":"Habiba Abbasi, Bethan Gillespie, Mohamad Samhat, Katherine White, David Jeffrey","doi":"10.1080/14739879.2024.2364874","DOIUrl":"https://doi.org/10.1080/14739879.2024.2364874","url":null,"abstract":"<p><p>This workshop aimed to investigate students' perspectives on physician-assisted suicide (PAS) and its potential legalisation. A two-pronged strategy was used - a goldfish bowl roleplay simulation and a facilitated group discussion. The roleplay enabled students to engage with practical and emotional challenges related to responding to a PAS request, while the discussion encouraged open dialogue on the ethical complexities of legalising PAS. Students showed nuanced changes in perspectives on PAS by actively participating in roleplay and discussions, demonstrating the potential for these approaches to promote deeper understanding.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459809","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":"Mentoring to address differential attainment of international medical graduates in GP training.","authors":"Tina Huang, Annabel Shepherd, Monica Milne","doi":"10.1080/14739879.2024.2355933","DOIUrl":"10.1080/14739879.2024.2355933","url":null,"abstract":"<p><strong>Introduction: </strong>International Medical Graduates (IMGs) form an important and valued part of the United Kingdom's (UK) medical workforce but many experience difficult transitions into the National Health Service workforce. Mentoring could support IMGs as they transition into their role as General Practice (GP) trainees but there is a lack of evidence about whether mentoring is an effective intervention for this group.</p><p><strong>Aim: </strong>To evaluate the effectiveness of the NHS Education for Scotland (NES) GP mentoring programme from the perspective of mentors and mentees.</p><p><strong>Method: </strong>Twelve medical educators (the mentors) provided mentoring to 19 IMG GP trainees (the mentees) who were within their first six months of entering GP training in Scotland. Each mentee received four 60-minute mentoring sessions via video conferencing.</p><p><strong>Results: </strong>Mentoring provided tailored support to assist IMG GP trainees' holistic transition into UK General Practice. Mentees appreciated talking to a non-supervisor, receiving non-judgemental support and protected time with a supportive listener to overcome challenges. This had a positive impact, even for those who did not anticipate the need for such support. Mentors supported diverse needs and tailored meetings, experiencing a distinct shift from previous supervisor roles. Their diverse experience enhanced their role and they developed new skills.</p><p><strong>Conclusion: </strong>Mentoring could provide significant support to IMG GP trainees but comes with certain challenges. Future research should evaluate the long-term impact of the NES GP IMG mentoring programme.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200859","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}