Education for Primary Care最新文献

{"title":"Essential workers? An institutional ethnographic lens on pandemic GP placements.","authors":"Grainne P Kearney,&nbsp;Helen Reid,&nbsp;Nigel D Hart","doi":"10.1080/14739879.2023.2182715","DOIUrl":"https://doi.org/10.1080/14739879.2023.2182715","url":null,"abstract":"<p><strong>Background: </strong>Clinical placements for medical students in the United Kingdom (UK) came to an abrupt halt in March 2020. The rapidly evolving Covid19 pandemic created specific challenges for educators, balancing safety concerns for patients, students and healthcare staff alongside the imperative to continue to train future clinicians. Organisations such as the Medical Schools Council (MSC) published guidance to help plan return of students to clinical placements. This study aimed to examine how GP education leads made decisions around students returning to clinical placements for the 20/21 academic year.</p><p><strong>Method: </strong>Data collection and analysis was informed by an Institutional Ethnographic approach. Five GP education leads from medical schools throughout the UK were interviewed (over MS TEAMS™). Interviews focused on the work the participants did to plan students' return to clinical placements and how they used texts to inform this work. Analysis focused on the interplay between the interview and textual data.</p><p><strong>Results and discussion: </strong>GP education leads actively used MSC guidance which confirmed students to be 'essential workers', an unquestioned and unquestionable phrase at the time. This permitted students to return to clinical placements by affording the GP education leads authority to ask or persuade GP tutors to accept them. Furthermore, by describing teaching as 'essential work' in its own right in the guidance, this extended what the GP tutors came to expect to do as 'essential workers' themselves.</p><p><strong>Conclusion: </strong>GP education leads activated authoritarian phrases such as 'essential workers' and 'essential work' contained within MSC guidance to direct students' return to clinical placements in GP settings.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 3","pages":"131-137"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10236928","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":"Comparison of the effectiveness of exclusively facilitated clinical teaching as an alternative to traditional practice-based primary care placements.","authors":"Edward G Tyrrell,&nbsp;Richard Knox,&nbsp;Runa Saha,&nbsp;Kathryn Berry,&nbsp;Jaspal S Taggar","doi":"10.1080/14739879.2023.2217795","DOIUrl":"10.1080/14739879.2023.2217795","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19 presented major challenges to undergraduate GP placement capacity and there was an increased reliance on clinical training using facilitated simulation. The authors present a novel comparison of the effectiveness and cost-effectiveness of delivering a one-week primary care course using entirely GP-facilitated clinical teaching outside the GP setting against traditional practice-based GP clinical education.</p><p><strong>Methods: </strong>A one-week GP placement was redeveloped from a traditional teaching model (TT-M) to an exclusively facilitated teaching model (FT-M) delivered outside the GP practice setting, using principles of blended learning, flipped classroom methods, e-learning and simulation. Both teaching models, delivered in different locations during 2022 to pre-clinical students, were evaluated using student feedback surveys for attainment of learning outcomes and course satisfaction.</p><p><strong>Results: </strong>The students reported their consultation skills and clinical knowledge (amalgamated mean score 4.36 for FT-M versus 4.63 for TT-M; <i>P</i> = 0.05), as well as preparation for the clinical phases (mean scores 4.35 for FT-M versus 4.41 for TT-M; <i>P</i> = 0.68), were well developed and similar for both courses. Students reported similar enjoyment across both teaching models (FT-M mean score 4.31 versus 4.41 for TT-M; <i>P</i> = 0.49). The costs for delivering teaching per 4-h session for 100 students were £1,379 and £5,551 for FT-M and TT-M, respectively.</p><p><strong>Conclusion: </strong>Delivery of a one-week primary care attachment to third year medical students using an FT-M was similarly effective and more cost effective than delivering it by a TT-M. FT-M potentially offers an important adjunct to clinical learning and resilience to capacity challenges for GP placements.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 3","pages":"152-160"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10237989","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 benefits of the expansion of the social prescribing student champion scheme into allied health professionals.","authors":"A de Iongh,&nbsp;D Kirtley","doi":"10.1080/14739879.2023.2204307","DOIUrl":"https://doi.org/10.1080/14739879.2023.2204307","url":null,"abstract":"Dear Editor, In 2020, a Twitter debate initiated the inclusion of allied healthcare professionals (AHPs) within the wellestablished Social Prescribing Student Champion Scheme [1]. The scheme gave medical students the opportunity to champion social prescribing (SP) by delivering peer-teaching [2]. Since the scheme was founded in 2017, the importance of SP has grown, with the potential contribution of AHPs further highlighted [3,4]. Therefore, the scheme expanded to include AHPs. Our role as leads for the medical and AHP branches of the scheme was to work together to develop a structure that met our different learning needs while successfully integrating the two branches of the scheme. This required more than a tokenistic insertion of 'and other healthcare professional students' into the scheme text. To truly integrate both ‘branches’ of the scheme, when we all have different professional applications of social prescribing, we needed to recognise what we all had in common as students – the shared purpose of making a positive difference for our patients. Although as students, we spend time developing our own professional identities, it was refreshing to remember ‘we have more in common than divides us’. Students were able to unite over this, and the new AHP champions were welcomed and integrated into the scheme by medical students. It was also helpful to recognise that under the umbrella of one profession, such as medicine, or professional cohort such as AHP, there remains enormous variation in roles and interests – a valuable lesson for future MDT working. As is common within MDT working, organising meetings was difficult, but working through the pandemic normalised virtual platforms and collaborative software. It also helped us to develop insights into the pressures and demands we all have during training, fostering respect for the time and effort spent developing our respective professional skills. One challenge was that our core team was not representative of all fourteen AHPs. However, conversations with respective professional bodies enabled the scheme to gain authenticity which facilitated approaching universities about the scheme, and furthered our MDT learning. The scheme’s structure did not directly incorporate the voluntary sector, which forms the backbone of social prescribing, and this provided a valuable lesson in the wider scope for collaboration beyond organisational boundaries, as is routinely required within clinical practice. Both branches had very different journeys in their inception, so while treating and evaluating the scheme as a whole, we also wanted to recognise the established track record of the medical scheme, and manage expectations of delivery of the AHP scheme in the first year. Therefore, collaboration rather than direct comparison was important. We are able to recognise each others’ relative successes and the cumulative impact of these for the scheme as a whole, which was more than the sum of its parts. Having since","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 3","pages":"176-177"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9861059","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":"Whilst on the topic of letters ….","authors":"Samantha Scallan","doi":"10.1080/14739879.2023.2217155","DOIUrl":"https://doi.org/10.1080/14739879.2023.2217155","url":null,"abstract":"","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 3","pages":"112"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9898177","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":"\"I didn't give it enough respect\" - an evaluation of preparation strategies used by GP trainees for the AKT.","authors":"T Lambton,&nbsp;J Lyon-Maris,&nbsp;S Scallan","doi":"10.1080/14739879.2023.2204557","DOIUrl":"10.1080/14739879.2023.2204557","url":null,"abstract":"<p><p>The Applied Knowledge Test (AKT) is one third of the licensing exam to become a General Practitioner in the United Kingdom. It is a computer-based, machine-marked multiple-choice examination with an overall pass rate of around 70%. Statistics reveal international medical graduates to have lower rates of passing. The aim of this evaluation was to determine the key features of preparation for the exam used by successful candidates. A questionnaire survey was sent to recently successful general practice trainees in Southampton. The results were further informed by a group interview and three in-depth interviews. A series of six areas were identified within the exam preparation that featured as common areas for all candidates. Further analysis showed the parameters around these areas suggesting the ability to maximise the candidates' chances of success. The areas included: preparation; time management; expectations; peer support; change of approach and impact on trainee mental health. A period of at least 10 hours per week for at least three months revision, using four to six resources and using question banks to consolidate learning rather than as a primary tool were found to be the key parameters with successful candidates. When to take the exam should be discussed with the trainer, the difficulty of the exam needs to be acknowledged by candidates, working in study groups can be beneficial and planning of the approach to revision was found to be essential. The impact of failure on trainee mental health must not be underestimated.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 3","pages":"168-174"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9861060","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":"\"I'm almost opioid-a-phobic\": family medicine residents' perceptions of enhancing opioid analgesic and agonist treatment training in a Canadian setting.","authors":"Shawna Narayan,&nbsp;Hana Brath,&nbsp;Danielle Di Marco,&nbsp;Malcolm Maclure,&nbsp;Rita McCracken,&nbsp;Jan Klimas","doi":"10.1080/14739879.2023.2204310","DOIUrl":"https://doi.org/10.1080/14739879.2023.2204310","url":null,"abstract":"<p><strong>Purpose: </strong>As deaths from the illicit drug poisoning crisis continue to rise in Canada, increasing the number of healthcare professionals qualified to effectively prescribe opioids could be beneficial. The willingness of family medicine residents to undertake structured training in prescribing opioids for Opioid Agonist Treatment (OAT) and pain management have not been well described.</p><p><strong>Materials and methods: </strong>Family medicine residents (<i>n</i> = 20) in British Columbia, Canada, were asked about their experience with and willingness to enrol in OAT training. Informed by the Consolidated Framework for Implementation Research, data were analysed thematically using NVivo software.</p><p><strong>Results: </strong>Four themes were identified: (1) challenges to training implementation, (2) feelings and attitudes on prescribing practices, (3) helpful learning spaces and places of substance use training, and (4) recommendations for implementing training. Preparedness, exposure, and supportive learning environments for substance use education increased willingness to pursue OAT accreditation, while ineffective learning experiences, mixed feelings about opioid prescribing, and lack of protected time were the most common reasons for unwillingness.</p><p><strong>Conclusions: </strong>Protected time and a range of clinical experiences appear to facilitate residents' willingness to complete OAT and opioid training. Implementation strategies to enhance the uptake of OAT accreditation in family medicine residency must be prioritised.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 3","pages":"161-167"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914807","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 contextual definition of longitudinal integrated clerkships within the UK and Ireland: A bi-national modified Delphi study.","authors":"Megan El Brown,&nbsp;Victoria Collin,&nbsp;Ravi Parekh,&nbsp;Sonia Kumar","doi":"10.1080/14739879.2023.2204463","DOIUrl":"https://doi.org/10.1080/14739879.2023.2204463","url":null,"abstract":"<p><p>Disagreement exists within the UK and Ireland regarding how Longitudinal Integrated Clerkships should be defined, and the relevance of international definitions. In this modified, online Delphi study, we presented the UK and Ireland experts in Longitudinal Integrated Clerkships with statements drawn from international definitions, published LIC literature, and the research team's experience in this area and asked them to rate their level of agreement with these statements for inclusion in a bi-national consensus definition. We undertook three rounds of the study to try and elicit consensus, making adaptations to statement wording following rounds 1 and 2 to capture participants' qualitative free text-comments, following the third and final round, nine statements were accepted by our panel, and constitute our proposed definition of Longitudinal Integrated Clerkships within the UK and Ireland. This definitional statement corresponds with some international literature but offers important distinctions, which account for the unique context of healthcare (particularly primary care) within the UK and Ireland (for example, the lack of time-based criteria within the definition). This definition should allow UK and Irish researchers to communicate more clearly with one another regarding the benefits of LICs and longitudinal learning and offers cross-national collaborative opportunities in LIC design, delivery and evaluation.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 3","pages":"138-151"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9863167","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":"Developing a career as a GP educationalist: contemporary challenges and workforce solutions.","authors":"Elizabeth Iris Lamb,&nbsp;Hugh Alberti,&nbsp;Douglas G J McKechnie,&nbsp;Sophie Park,&nbsp;Lindsey Pope,&nbsp;Harish Thampy","doi":"10.1080/14739879.2023.2204294","DOIUrl":"https://doi.org/10.1080/14739879.2023.2204294","url":null,"abstract":"<p><p>GP educationalists are crucial in training the future medical workforce and in developing and advancing the field of primary care medical education, yet opportunities in the UK are patchy and varied. In this article, a group of GP educationalists summarise the challenges facing the sustainability of this particular group of clinical academics and outline opportunities available at each career stage, from medical students through to senior GP educationalists. Recommendations to support the growth of this workforce include the development of a nationally recognised framework for GP educationalist careers, collaboration with professional and educational bodies and taking steps to level out opportunities in order to reduce existing inequity.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 3","pages":"113-118"},"PeriodicalIF":1.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914808","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":"Attitudes and experiences of GP registrars towards undergraduate teaching: has anything changed?","authors":"Joanna Leader,&nbsp;Hugh Alberti,&nbsp;Lizzie Dowling","doi":"10.1080/14739879.2023.2179427","DOIUrl":"https://doi.org/10.1080/14739879.2023.2179427","url":null,"abstract":"Developing teaching skills is part of the RCGP curriculum for GP trainees [1], and it is thought that exposing medical students to GP role models can positively affect their career choices [2]. In 2015 Marshall and Alberti conducted a study looking into GP registrars’ experiences of teaching medical students [3]. They found overwhelmingly that trainees were keen to teach medical students but had minimal opportunities available [3]. They also found that more teaching opportunities were available in hospital posts than GP posts [3]. We conducted research to look into whether these disparities still exist. The aims of this project were to determine the current level of involvement in undergraduate medical education of GP registrars in the Northern Deanery and to establish if there has been any change or improvement compared to 2015. Ethics approval was granted from Newcastle University. We initially collected data by sending the same six-question survey that was used in 2015 to ST2 and ST3 GP registrars in the region, as well as GPs who were within 5 years of CCT. Overall, 104 GPs completed the survey; their responses were collated and analysed and compared to the results from 2015. There was a large disparity between the GP registrars’ desire to get involved with teaching, and the reality. Overall, 53% said they expected to have regular involvement with teaching medical students in their future career, but 85% reported having little or no involvement with teaching in their GP posts. Overall, 76% said they would like to have done more teaching. There continues to be a disparity in teaching opportunities between hospital and GP posts. Only 13.6% of trainees reported teaching at least monthly in GP posts, whereas in hospital posts 39% of trainees taught at least monthly. There has been little change since 2015. In GP posts 85% of trainees reported having little or no involvement in teaching (down from 91% in 2015). In hospital posts 62% reported having little or no involvement in teaching (down from 73% in 2015). These results show that in fact the most improvement in teaching opportunities has occurred in hospital posts, although the improvement is still minimal. Overall, there has been little improvement in GP registrars’ involvement in teaching of medical students since 2015, yet there is still a strong desire from them to have more opportunity to do so. Teaching opportunities continue to be significantly more limited in GP posts compared to hospital posts and so this is where any future work on improvements should be focussed. More work to understand why opportunities in GP posts are so limited should also be prioritised. GP practices continue to be stretched, both financially and timewise, so GP registrars could provide a cost-effective solution to delivering undergraduate medical education. Given the benefits to both practices and registrars, we strongly recommend that this area needs to be highlighted as a matter of great importance in future.","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 2","pages":"110"},"PeriodicalIF":1.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9859551","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":"Challenge GP: using gamification to bring the reality and uncertainty of a duty doctor's surgery to early year medical students.","authors":"Linzi Lumsden,&nbsp;Philip Cannon,&nbsp;Val Wass","doi":"10.1080/14739879.2023.2190936","DOIUrl":"https://doi.org/10.1080/14739879.2023.2190936","url":null,"abstract":"<p><p>Exposing medical student cohorts to the lived reality of uncertainty and complexity experienced by GPs is challenging to achieve. We present a novel teaching concept: 'Challenge GP' designed for early years students. Gamification methodology is used to reproduce key elements of the 'duty GP' experience in a classroom setting where working in teams, students play a competitive card game. Cards drawn at random pose scenarios based on practical, logistical, and ethical dilemmas of a duty doctor surgery. Each team discusses whether to score by reporting a decision or play special cards to pass the dilemma onto, or collaborate with, another team. Answers are facilitated and scored by a GP tutor.Student feedback demonstrated highly effective learning for clinical reasoning, risk management and problem-solving. Students were exposed to the uncertainty and complexity of real-life medicine. Gamification, through competitiveness, increased task engagement. Students learned the value of working in teams under time pressure and grew in confidence by sharing knowledge in a safe environment. Students were enabled to think, feel and practise as real-life clinicians. This became a powerful force in contextualising their theory-based knowledge, aided understanding of the GP role and opened their eyes to a possible career in general practice.</p>","PeriodicalId":46436,"journal":{"name":"Education for Primary Care","volume":"34 2","pages":"103-108"},"PeriodicalIF":1.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9863116","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}