Medical students, early general practice placements and positive supervisor experiences (original) (raw)
Related papers
Rewards, costs and challenges: the general practitioner’s experience of teaching medical students
Medical Education, 2011
CONTEXT Medical student attachments in general practices play an important role in undergraduate medical education internationally. The recruitment by universities of new teaching practices or an increase in the teaching commitment of existing practices will be necessary to address rising medical student numbers. General practitioners (GPs) are likely to weigh the perceived rewards of practice-based teaching against the perceived costs and challenges in deciding whether to accept a student placement and how to teach. These aspects of the 'lived experience' of the GP-teacher have not been adequately investigated. OBJECTIVES This study aims to enhance understanding of the GP clinical teacher experience in order to inform strategies for the recruitment, retention, training and support of teaching general practices. METHODS Sixty GP clinical teachers in Brisbane-based urban teaching general practices were interviewed individually face-to-face by the principal investigator, using a semistructured interview plan. Representativeness was ensured through quota sampling. The interview data were analysed thematically by two of the investigators independently, following member checking of interview transcripts. RESULTS The results demonstrate a number of key interrelated perceived rewards, costs and challenges of teaching, including intellectual stimulation, cognitive fatigue and student characteristics. CONCLUSIONS The findings extend reports in the previous literature by offering a richer description of current GP-teacher experience. Participants identified teaching rewards in a manner largely consistent with previous research, with the exception of enhanced practice morale and teamwork. Findings confirm that reduced productivity and increased time pressures remain key perceived negative impacts of teaching, but also reveal a number of other important costs and challenges. They emphasise the diversity of GP experience and practice cultures, and the need for teaching to enhance both GP and patient perceptions of consultation quality without increasing the load on the GP-teacher. Recruitment and retention strategies should promote the rewards of teaching, and teacher training should respond to the costs and challenges of practice-based teaching, and facilitate the growth of GPs in their role as clinical educators.
BMJ, 1999
Objective To examine the perceived effect of teaching clinical skills and associated teacher training programmes on general practitioners' morale and clinical practice. Design Qualitative semistructured interview study. Setting General practices throughout north London. Subjects 30 general practitioners who taught clinical skills were asked about the effect of teaching and teacher training on their morale, confidence in clinical and teaching skills, and clinical practice. Results The main theme was a positive effect on morale. Within teacher training this was attributed to developing peer and professional support; improved teaching skills; and revision of clinical knowledge and skills. Within teaching this was attributed to a broadening of horizons; contact with enthusiastic students; increased time with patients; improved clinical practice; improved teaching skills; and an improved image of the practice. Problems with teaching were due to external factors such as lack of time and space and anxieties about adequacy of clinical cover while teaching. Conclusions Teaching clinical skills can have a positive effect on the morale of general practitioner teachers as a result of contact with students and peers, as long as logistic and funding issues are adequately dealt with.
MedEdPublish, 2020
Background: General Practice (GP) is the cornerstone of the NHS and has faced workload and workforce issues for many years. Enabling GP trainees to successfully complete their training and become independent practitioners is crucial to addressing these challenges. There is limited previous research exploring the postgraduate training experience specific to General Practice. Aim: To explore GP Trainees' experience of learning opportunities and support available during the three-year vocational training programme in the Southampton GP Education Unit. Design and Setting: 15 semi structured interviews were undertaken December 2016-2018 with participants recruited from four cohorts. Telephone interviews lasting between 30-60 minutes were audio-recorded and transcribed verbatim; and analysed using inductive thematic analysis. Results and Conclusion: Two themes were identified as affecting the training experience: 'Developing clinical competence' and 'Sources of support'. Trainees perceived developing competencies relevant to General Practice was key. Busier hospital rotations with limited time for formal teaching were viewed less favourably. Trainers and peers were the main sources of support. Despite seeking a broad range of participants, interviewing trainees in difficulty was hard to achieve.
BMJ Open, 2016
Objectives: An increase in patients with long-term conditions and complex care needs presents new challenges to healthcare providers around the developed world. In response, more broad-based training programmes have developed to better prepare trainees for the changing landscape of healthcare delivery. This paper focuses on qualitative elements of a longitudinal, mixed-methods evaluation of the postgraduate, post-Foundation Broad-Based Training (BBT) programme in England. It aims to provide a qualitative analysis of trainees' evaluations of whether the programme meets its intentions to develop practitioners adept at managing complex cases, patient focused care, specialty integration and conviction in career choice. We also identify unintended consequences. Setting: 9 focus groups of BBT trainees were held over a 12-month period. Discussions were audiorecorded and subjected to directed content analysis. Data were collected from trainees across all 7 participating regions: East Midlands; West Midlands; Severn; Northern; North Western; Yorkshire and Humber; Kent, Surry and Sussex. Participants: Focus group participants (61 in total) from the first and second cohorts of BBT. Results: Evidence from trainees indicated that the programme was meeting its aims: trainees valued the extra time to decide on their onward career specialty, having a wider experience and developing a more integrated perspective. They thought of themselves as different and perceived that others they worked alongside also saw them as different. Being different meant benefitting from novel training experiences and opportunities for self-development. However, unintended consequences were feelings of isolation, and uncertainty about professional identity. Conclusions: By spanning boundaries between specialties, trainee generalists have the potential to improve experiences and outcomes for patients with complex health needs. However, the sense of isolation will inhibit this potential. We employ the concept of 'belongingness' to identify challenges related to the implementation of generalist training programmes within existing structures of healthcare provision.
BMJ Open, 2022
Objective This study aimed to explore the positive factors related to working in general practice in France, from a student studying medicine, trainee general practitioner (GP) and GP point of view. Setting Primary care, France. Design Nine different qualitative studies involving medical students, trainees and GPs. Participants Sixty-seven medical students, 22 trainees in general practice and 71 GPs. Results The final codebook contained 66 interpretative codes and 8 positive themes. The themes were general practice as a commitment, doctor-patient care and relationships, skills and competencies in general practice, practice organisation and work-life balance, relationship with the professional community, GPs and university, GPs in the social community and private life, relatives and family. Positive feelings about being a GP are similar throughout the different age groups, from young students to older professionals. Discussion and conclusion This study provided a comprehensive picture of the satisfied GP across different ages. This picture describes GPs as patient-centred professionals who need to have the freedom to choose an efficient working environment, organise their practice, have opportunities for professional development and acquire specific competencies. Both younger and older GPs believe in the future of general practice.
Education for primary care, 2020
Background: Despite several studies focusing on the negative aspects of general medicine, the speciality seems attractive for students. Researchers from the European General Practice Research Network created a group to study job satisfaction in general practice. The aim of this eight-country European study was to determine which positive view students have about general practice. Method: Systematic review of the literature from Pubmed, Embase and Cochrane databases. Articles published between 01/01/2000 and 12/31/2018 were searched and analysed by two researchers working blind. The data on satisfaction factors were extracted from the full text article used as verbatims. Then the data were coded with a thematic analysis. Results: 24 articles out of 414 were selected. Satisfaction factors were classified: teaching of general practice, workplace and organisational freedom, quality of life, variety in practice, workload balance and income. The analysis highlighted intellectual stimulation and the relationship built with patients and other professionals. Conclusion: Literature on the appeal of general practice for students revealed many factors of job satisfaction in general practice. It is possible to create a global view of a satisfied GP on the students' opinion. Courses and clerkships in general practice with positive role models are determining factors in career choice.
BMJ, 2005
Objectives To compare patients' enablement and satisfaction after teaching and non-teaching consultations. To explore patients' views about the possible impact that increased community based teaching of student doctors in their practice may have on the delivery of service and their attitudes towards direct involvement with students. Design Observational study using validated survey instruments (patient enablement index-PEI, and consultation satisfaction questionnaire-CSQ) administered after teaching consultations and non-teaching consultations. Ten focus groups (two from each practice), comprising five with patients participating in prearranged teaching sessions and five with patients not participating in these. Setting Five general practices in west Suffolk and southern Norfolk, England, that teach student doctors on the Cambridge graduate medical course. Participants 240 patients attending teaching consultations (response rate 82%, 196 patients) and 409 patients attending non-teaching consultations (response rate 72%, 294 patients) received survey instruments. Ten focus groups with a total of 34 patients participating in prearranged teaching sessions and 20 patients not participating in these. Main outcome measures Scores on the patient enablement index and consultation satisfaction questionnaire, analysed at the level of all patients, allowing for age, sex, general practitioner, and practice, and at the level of the individual general practitioner teacher. Qualitative analysis of focus group data. Results Patients' enablement or satisfaction was not reduced after teaching consultations compared with non-teaching consultations (mean difference in scores on the patient enablement index and consultation satisfaction questionnaire with adjustment for confounders 2.24% and 1.70%, respectively). This held true for analysis by all patients and by general practitioner teacher. Qualitative data showed that patients generally supported the teaching of student doctors in their practice. However, this support was conditional on receiving sufficient information about reasons for doctors' absence, the characteristics of students, and the nature of teaching planned. Many patients viewed their general practice as different from hospital and expected greater control over students' presence during their consultations. Conclusions Patients' enablement and satisfaction are not impaired by students' participation in consultations. Patients generally support the teaching of student doctors in their general practice but expect to be provided with sufficient information and to have a choice about participation, so they can give informed consent. Recognising this when organising general practice based teaching is important.
Medical Journal of Australia, 2007
Objective: To examine pre-registration junior doctors' perceptions of the value of a general practice term in their training program. Design, setting and participants: Semi-structured interviews, in five teaching hospitals in South Australia in 2005, with 20 pre-registration junior doctors (interns) who had completed a general practice term and at least one core term of intern training. Main outcome measure: Comparisons between general practice and teaching hospital core training terms with respect to the domains of junior doctor education. Results: Interns perceived general practice and teaching hospital terms to be complementary in their overall training program. The general practice term provided them with knowledge and skills they would not have acquired in the teaching hospital terms alone. One-on-one consulting, initiating patient management, and the opportunity to practise a range of practical and procedural skills were seen to be of particular value. Conclusions: The general practice and teaching hospital terms both contribute to the training of interns, offering contrasting environments and experiences which enhance interns' professional and personal growth. General practice terms should be considered MJA 2007; 186: 346-349 for inclusion in intern training programs across Australia.