Transitions in general practice training: quantifying epidemiological variation in trainees' experiences and clinical behaviours.
Change management
Education, Medical, Graduate
Family practice
General practice
In-practice experience
Primary health care
Social theory
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
23 Feb 2022
23 Feb 2022
Historique:
received:
11
06
2021
accepted:
10
02
2022
entrez:
24
2
2022
pubmed:
25
2
2022
medline:
26
2
2022
Statut:
epublish
Résumé
General Practice training in Australia is delivered through the apprenticeship model. General Practice supervisors support trainees transitioning from hospital-based work towards competent independent community-based practice. The timing and manner in which support should be provided is still not well understood. This study aimed to establish the variation in clinical and educational experiences and behaviours, and location, of general practice trainees' consultations by stage of their vocational training. It was hypothesised that change is greater in earlier stages of training. A cross-sectional analysis of data (2010-2018) from the Registrar Clinical Encounters in Training (ReCEnT) study, an ongoing cohort study of Australian GP registrars' in-consultation clinical and educational experience and behaviours. Multinomial logistic regression assessed the association of demographic, educational, and clinical factors in different stages of training. The outcome factor was the training term. Two thousand four hundred sixteen registrars contributed data for 321,414 patient consultations. For several important variables (seeing patients with chronic disease; new patients; seeking in-consultation information or assistance; ordering pathology and imaging; and working in a small or regional practice), odds ratios were considerably greater for comparisons of Term 1 and 3, relative to comparisons of Term 2 and 3. Differences experienced in demographic, clinical and educational factors are significantly more pronounced earlier in registrars' training. This finding has educational and training implications with respect to resource allocation, trainee supervision and curriculum design. Sociocultural learning theory enables an understanding of the impact of transitions on, and how to support, general practice trainees and supervisors.
Sections du résumé
BACKGROUND
BACKGROUND
General Practice training in Australia is delivered through the apprenticeship model. General Practice supervisors support trainees transitioning from hospital-based work towards competent independent community-based practice. The timing and manner in which support should be provided is still not well understood. This study aimed to establish the variation in clinical and educational experiences and behaviours, and location, of general practice trainees' consultations by stage of their vocational training. It was hypothesised that change is greater in earlier stages of training.
METHODS
METHODS
A cross-sectional analysis of data (2010-2018) from the Registrar Clinical Encounters in Training (ReCEnT) study, an ongoing cohort study of Australian GP registrars' in-consultation clinical and educational experience and behaviours. Multinomial logistic regression assessed the association of demographic, educational, and clinical factors in different stages of training. The outcome factor was the training term.
RESULTS
RESULTS
Two thousand four hundred sixteen registrars contributed data for 321,414 patient consultations. For several important variables (seeing patients with chronic disease; new patients; seeking in-consultation information or assistance; ordering pathology and imaging; and working in a small or regional practice), odds ratios were considerably greater for comparisons of Term 1 and 3, relative to comparisons of Term 2 and 3.
CONCLUSION
CONCLUSIONS
Differences experienced in demographic, clinical and educational factors are significantly more pronounced earlier in registrars' training. This finding has educational and training implications with respect to resource allocation, trainee supervision and curriculum design. Sociocultural learning theory enables an understanding of the impact of transitions on, and how to support, general practice trainees and supervisors.
Identifiants
pubmed: 35197039
doi: 10.1186/s12909-022-03178-0
pii: 10.1186/s12909-022-03178-0
pmc: PMC8867826
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
124Informations de copyright
© 2022. The Author(s).
Références
Educ Prim Care. 2015 May;26(3):155-65
pubmed: 26092144
Aust J Prim Health. 2020 Apr;26(2):184-190
pubmed: 32050081
BMC Fam Pract. 2012 Jun 06;13:50
pubmed: 22672139
Med Educ. 2011 Oct;45(10):1006-15
pubmed: 21916940
Med Educ. 2010 May;44(5):449-58
pubmed: 20518984
Fam Pract. 2015 Oct;32(5):525-32
pubmed: 26089297
BMC Fam Pract. 2020 Feb 7;21(1):28
pubmed: 32033540
Med J Aust. 2012 May 21;196(9):594
pubmed: 22621154
Med J Aust. 2011 Jun 6;194(11):S63-4
pubmed: 21644855
BMC Med Educ. 2012 Aug 06;12:67
pubmed: 22866981
Soc Sci Med. 1999 Feb;48(4):547-57
pubmed: 10075179
Fam Pract. 2017 Sep 1;34(5):599-605
pubmed: 28369454
Aust J Rural Health. 2020 Feb;28(1):32-41
pubmed: 31950594
Milbank Q. 2005;83(3):457-502
pubmed: 16202000
Med Educ. 2018 Feb;52(2):192-205
pubmed: 29044683
BMC Med Educ. 2015 Oct 29;15:190
pubmed: 26511843
Med Teach. 2019 Sep;41(9):1065-1072
pubmed: 31215285
Acad Med. 2015 Apr;90(4):525-31
pubmed: 25470308
Med Educ. 2012 Dec;46(12):1161-73
pubmed: 23171258
Med J Aust. 2011 Jun 6;194(11):S59-62
pubmed: 21644854
Med J Aust. 2018 Jul 16;209(2):52-54
pubmed: 29996746
Med Educ. 2011 Jan;45(1):51-9
pubmed: 21155868
BMC Fam Pract. 2020 Jun 27;21(1):123
pubmed: 32593291
J Prim Health Care. 2016 Dec;8(4):283-287
pubmed: 29530151
Perspect Med Educ. 2018 Feb;7(1):8-22
pubmed: 29383578
Postgrad Med. 2021 Jun;133(5):572-580
pubmed: 33843446
Postgrad Med J. 2009 Nov;85(1009):582-9
pubmed: 19892893
Med J Aust. 2018 Jun 18;208(11):471-472
pubmed: 29902400
Educ Prim Care. 2018 Nov;29(6):322-326
pubmed: 30207897
J Appl Psychol. 2003 Oct;88(5):779-94
pubmed: 14516244
Med J Aust. 2017 Jul 17;207(2):70-74
pubmed: 28701127
BMC Med Educ. 2013 Jan 07;13:2
pubmed: 23294479
BMC Med Educ. 2014 Dec 10;14:260
pubmed: 25491229
Med Educ. 2017 Dec;51(12):1277-1288
pubmed: 29124801
Med J Aust. 2011 Jun 6;194(11):S101-4
pubmed: 21644851
BMC Med Educ. 2014 May 02;14:90
pubmed: 24886098