Development Of General Practice Research Articles

What next for behaviour change professional development in general practice? Insights from an environmental scan and workshops.

A key role of general practice professionals (that is, GPs, and general practice nurses [GPNs]) is to support patients to change behaviours. Traditional approaches to assisting patients with, and learning about, behaviour change have modest outcomes. To explore behaviour change with GPs and GPNs and the availability of related professional development (PD) opportunities. Multi-methods study comprising an environmental scan survey of behaviour change tools and PD opportunities, and online workshops with Australian GPs and GPNs. Survey data were analysed using qualitative content analysis, informing the design of the workshops. Workshop data included observation, note-taking, and collaborative reflection, which were analysed thematically and synthesised with survey data. The survey had 18 complete responses. For the two virtual workshops, workshop 1 had 16 participants and workshop 2 had eight participants. There was diversity in awareness of existing behaviour change tools and resources. Preferences for future tools and PD opportunities related to specific aspects of its design, content, activities, and delivery. The following three themes developed from the workshop data: recognising the importance of relationships; recognising the importance of continuity; and keeping context in mind. In the absence of tools and resources, GPs and GPNs discussed behaviour change as something that occurs best through a patient-centred alliance that is continuing, respectful, grounded in trust and an understanding of their patient, and prioritises patient autonomy. Future general practice behaviour change PD should support clinicians to 'assist' patients and recognise the social and contextual influences on behaviour.

Development of General Practice in Communities From the Perspective of Supply and Demand

Objective To put forward suggestions for improving the scheme of general practice for functional communities from the perspective of supply and demand,guide the efficient use of the resources of general practice by the communities,and incorporate the general practice of communities into hierarchical diagnosis and treatment management. Methods In July 2021,stratified random sampling was employed to conduct the questionnaire surveys of the young and middle-aged (demand side) and the general practitioners (supply side),respectively.SPSS 20.0 was used for data analysis. Results The two sides had the same cognition about the main reasons for not signing a contract with a family doctor,which were the lack of knowledge about general practitioners and the lack of face-to-face communication opportunities.They had the same response about the form of services,with high acceptance of medical services via WeChat,outpatient consultation,and the internet.There were differences in service content between the two sides.The top three demands of the young and middle-aged were appointment registration and referral in superior hospitals,medication guidance,and massage,acupuncture,and moxibustion.The top service self-rated by general practitioners was personalized guidance and report interpretation of physical examination,and the bottom was massage,acupuncture,and moxibustion. Conclusions The general practice varies between the demand and supply sides.General practitioners should be encouraged to enter and learn functional communities and provide personalized services,thus improving the general medical service in functional communities.

Consultation skills development in general practice: findings from a qualitative study of newly recruited and more experienced clinical pharmacists during the COVID-19 pandemic

ObjectiveThe new structured medication review (SMR) service was introduced into the National Health Service in England during the COVID-19 pandemic, following a major expansion of clinical pharmacists within new formations...

Correction to: Sustainable development in general practice

Correction to: Sustainable development in general practice

Sustainable development in general practice.

As health care accounts for 4-5% of global carbon emissions, many health organisations have called for implementing sustainable development actions in health care. However, sustainable development measures in general practice are rarely implemented by physicians. The aim of this study was to explore the practices of general practitioners (GPs) in terms of sustainable development to identify which actions are appropriate and achievable. A qualitative study was conducted in 12 French GPs using face-to-face or telephone interviews, transcribed verbatim and analysed through a global inductive analysis with constant comparison. Semi-structured interviews were focussed on waste management, relationships between health professionals, sustainable development, and GPs' activity. The mean age of the GPs was 42.8 years and they mainly worked in an urban environment. The interviews highlighted 4 themes. It appeared that a balance needs to be found between the environmental impact and the constraints related to medical care. To be able to think about integrating sustainable development into health care, GPs should make a personal commitment to change their routine. In practice, consumption should be reassessed, prescriptions and prevention reconsidered. These actions could be applied to the GPs' environment as role models for their patients, business leaders, and members of the healthcare system. GPs felt concerned by sustainable development and were already involved in its implementation in their practice. Tools are available to help GPs to continue to implement their actions described in this article, but their impact remains to be investigated.

Medical Personnel and Their Professional Level is the Main Component of Family Medicine

The paper focuses on new approaches to the development of family medicine in Ukraine. There has been made a brief historical overview of stages of family medicine development. The main component of the successful development of general practice–family medicine is stated to be human resources: personnel availability, personnel staffing, professional level. The medical education, including continuing professional development, plays an important role in the professional development of family physicians. The modern educational technologies are widely used in Shupyk NMAPE. The paper describes one-day scientific workshops in the format of the off-site training and videoconferences that are conducted under the methodical direction of the Academy.

The Oxford Royal College of General Practitioners Clinical Informatics Digital Hub: Protocol to Develop Extended COVID-19 Surveillance and Trial Platforms.

BackgroundRoutinely recorded primary care data have been used for many years by sentinel networks for surveillance. More recently, real world data have been used for a wider range of research projects to support rapid, inexpensive clinical trials. Because the partial national lockdown in the United Kingdom due to the coronavirus disease (COVID-19) pandemic has resulted in decreasing community disease incidence, much larger numbers of general practices are needed to deliver effective COVID-19 surveillance and contribute to in-pandemic clinical trials.ObjectiveThe aim of this protocol is to describe the rapid design and development of the Oxford Royal College of General Practitioners Clinical Informatics Digital Hub (ORCHID) and its first two platforms. The Surveillance Platform will provide extended primary care surveillance, while the Trials Platform is a streamlined clinical trials platform that will be integrated into routine primary care practice.MethodsWe will apply the FAIR (Findable, Accessible, Interoperable, and Reusable) metadata principles to a new, integrated digital health hub that will extract routinely collected general practice electronic health data for use in clinical trials and provide enhanced communicable disease surveillance. The hub will be findable through membership in Health Data Research UK and European metadata repositories. Accessibility through an online application system will provide access to study-ready data sets or developed custom data sets. Interoperability will be facilitated by fixed linkage to other key sources such as Hospital Episodes Statistics and the Office of National Statistics using pseudonymized data. All semantic descriptors (ie, ontologies) and code used for analysis will be made available to accelerate analyses. We will also make data available using common data models, starting with the US Food and Drug Administration Sentinel and Observational Medical Outcomes Partnership approaches, to facilitate international studies. The Surveillance Platform will provide access to data for health protection and promotion work as authorized through agreements between Oxford, the Royal College of General Practitioners, and Public Health England. All studies using the Trials Platform will go through appropriate ethical and other regulatory approval processes.ResultsThe hub will be a bottom-up, professionally led network that will provide benefits for member practices, our health service, and the population served. Data will only be used for SQUIRE (surveillance, quality improvement, research, and education) purposes. We have already received positive responses from practices, and the number of practices in the network has doubled to over 1150 since February 2020. COVID-19 surveillance has resulted in tripling of the number of virology sites to 293 (target 300), which has aided the collection of the largest ever weekly total of surveillance swabs in the United Kingdom as well as over 3000 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology samples. Practices are recruiting to the PRINCIPLE (Platform Randomised trial of INterventions against COVID-19 In older PeopLE) trial, and these participants will be followed up through ORCHID. These initial outputs demonstrate the feasibility of ORCHID to provide an extended national digital health hub.ConclusionsORCHID will provide equitable and innovative use of big data through a professionally led national primary care network and the application of FAIR principles. The secure data hub will host routinely collected general practice data linked to other key health care repositories for clinical trials and support enhanced in situ surveillance without always requiring large volume data extracts. ORCHID will support rapid data extraction, analysis, and dissemination with the aim of improving future research and development in general practice to positively impact patient care.International Registered Report Identifier (IRRID)DERR1-10.2196/19773

Progress in the development of general practice / family medicine in the city of Saint Petersburg (Russian Federation)

In previous years, indeed in some respects preceding the establishment of the Russian Federation, consideration had been given to the establishment of new approaches to general medical practice in Russia. Particular attention centred upon the establishment of Family Medicine and the preparation of doctors as Family Practitioners to advance this initiative. A number of pilot studies were initiated, including in the city of Saint Petersburg. These were intended to provide real-world opportunities to test and develop new and more effective approaches to primary health care that would more efficiently integrate with secondary care. The authors were involved in the initial pilot studies in the mid to late 1990s and subsequent follow-up projects to further advance the initiatives in the early years of the 21st century (20022010). This brief paper reports on a review of progress made in respect of the above initiatives. It is not at this time a comprehensive evaluation of the healthcare systems as they now operate. The authors nevertheless present some indications of satisfactory progress across a range of practices, some insights into challenges that have arisen, and some suggestions that might be helpful in the current rounds of strategic planning for health.

Reviewing the development of general practice in celebrating the 70th China National Day

Reviewing the development of general practice in celebrating the 70th China National Day

Nursing student perspectives on a quality learning environment in general practice

General practice continues to increase in use as a placement area for nursing students in England. Introducing new general practice placements requires intensive preparation to ensure there is a quality learning environment and the placement is successful. A qualitative study used interviews and focus groups to understand nine nursing students’ perspectives of factors that affected their clinical learning experiences in general practice placements. Students identified factors aiding their learning that were congruent with the characteristics of a good clinical learning environment proposed by the Willis Commission (2012). These included nurse mentorship qualities, interdisciplinary practices, opportunities to share learning, being given a new focus and motivation for learning. The findings suggest GP placements can provide a high-quality learning environment, the factors identified enabling the development of analytical decision-making and professional autonomy, which students regarded as being important components of their successful learning in practice. Further investment and support to increase mentor development in general practice will ensure a wider exposure and positive experience in this clinical practice area for nursing students. This may lead to fewer difficulties in recruiting practice nurses in future.

Personnel training is the key for development of general practice

Personnel training is the key for development of general practice

Distribution and equity trends for general practitioners in China from 2012 to 2015

Objective This study aimed to identify the distribution and equity trends for general practitioners (GPs) in China from 2012 to 2015 and to provide evidence to guide the discipline’s development of general practice and for policy-making. Methods On the basis of data from the National Health Statistics yearbooks, the distribution and equity trends for GPs from 2012 to 2015 were analyzed with the Lorenz curve and Gini coefficient as indictors of health equity. Results From 2012 to 2015 the number of GPs increased at rates ranging from 9.3% to 32.5%, while the number of registered GPs increased at rates ranging from 32.6% to 37.2%. In 2015 the average number of GPs was 1.38 per 10,000 people (among the 31 provinces the highest rate was 3.90 per 10,000 people in Zhejiang and the lowest rate was 0.50 per 10,000 people in Xizang) and 1.98 per 100 km2 (among 31 provinces the highest rate was 89.23 per 100 km2 in Shanghai and the lowest rate was 0.01 per 100 km2 in Xizang). From 2012 to 2015 the Gini coefficients weighted by population were 0.31, 0.29, 0.26, and 0.25 respectively, while the Gini coefficients weighted by geographical area were 0.74, 0.72, 0.72, and 0.72 respectively. Conclusion The number of GPs increased rapidly in China; however, the proportion of registered GPs was unsatisfactory, and there were inequities among the different provinces. The government should launch integrated strategies to encourage GP trainees to become registered GPs and optimize the distribution and equity of GPs.

Development of general practice must start from the understanding of the general practice

Development of general practice must start from the understanding of the general practice

The new era of postgraduate certified general practice training in Japan

This paper describes the background to, and the recent evolution of general practice as a recognised medical specialism in Japan (2015), and the evolution of a system of training to support this development. We, the general practitioners (GPs) in Japan have not been recognised as one body of medical specialists and have been training in our own way. A new certified training system will commence in 2018, authorised by a new third organisation, the Japanese Medical Specialty Board. An effective educational system has been developed for medical graduates that have a career intention in general practice that is distinct from other basic medical fields, but collaborates with them. A challenge exists to provide clarity to the Japanese population about what the specialty of general practice is, and what professionals in general practice can do for them. Japan currently has approximately 500 certified GPs and it is unclear at present what numbers will eventually be required. This paper reviews some of the challenges facing the development of general practice from the perspective of the Japan Primary Care Association.

Advancing general practice nursing in Australia: roles and responsibilities of primary healthcare organisations.

Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce. Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territories Results Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies. Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices. What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses' skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally. What does this paper add? This study delineates organisational support roles for PHCOs in strengthening nurses' roles and career development in Australian general practice. What are the implications for practitioners? Effective implementation of appropriate responsibilities by PHCOs can assist development of the primary care nursing workforce.

Het aiothotraject, 15 jaar na de start

Den Engelsen C, Knottnerus BJ, Dinant GJ. Het aiothotraject, 15 jaar na de start. Huisarts Wet 2014;57(5):226–30. Sinds 1998 is het mogelijk om de huisartsopleiding te combineren met promotieonderzoek als ‘arts in opleiding tot huisarts en onderzoeker’ (aiotho). Ons doel was in kaart te brengen hoe het aantal aiotho’s zich heeft ontwikkeld en hoeveel zij bijdragen aan de wetenschappelijke ontwikkeling van de huisartsgeneeskunde. In de database van het landelijk aiothonetwerk bepaalden wij het totaal aantal aiothotrajecten tussen 1 januari 1998 en 1 juli 2012. In PubMed inventariseerden wij voor die periode het aantal huisartsgeneeskundig relevante publicaties waarin aiotho’s een aandeel hadden, en op basis van NHG-gegevens gingen wij na hoeveel aiotho’s deelnamen aan NHG-richtlijnwerkgroepen. De huidige werkzaamheden van oud-aiotho’s brachten wij in kaart met behulp van een vragenlijst. Op 1 juli 2012 bevatte de database 81 aiotho’s en 34 oud-aiotho’s, naast 16 ex-aiotho’s die het onderzoek of de opleiding voortijdig beeindigd hadden. Van de oud-aiotho’s waren er 33 (96%) werkzaam als huisarts en 13 (39%) als onderzoeker. Van de ex-aiotho’s die voortijdig met hun onderzoek gestopt waren, was het merendeel werkzaam als huisarts, geen enkele als onderzoeker. Zowel het aantal gestarte als het aantal met succes afgeronde aiothotrajecten toonde een globaal stijgende lijn, tot respectievelijk 11 en 7 in 2011. Dat gold ook voor het aantal huisartsgeneeskundig relevante onderzoeksartikelen in PubMed met een aiotho als (co)auteur: 80 in de eerste helft van 2012. Aiotho’s hadden zitting in de richtlijnwerkgroepen van 13 (15%) NHG-richtlijnen die op 1 juli 2012 gepubliceerd waren, en van 6 (38% ) richtlijnen die op dat moment in herziening waren. Aiotho’s leveren een groeiende bijdrage aan de wetenschappelijke ontwikkeling van de huisartsgeneeskunde in Nederland. Om uitval uit het promotietraject te verminderen zou meer aandacht kunnen uitgaan naar een goede onderzoeksopzet, een reele planning en goede begeleiding.

OP0137-PC Number of Painful Regions and their Distribution Predicts Outcome of Pain in the General Population

BackgroundPain reported by a mannequin or predefined figure with body regions is important in evaluation of pain impact and development in general practice. Such reports are also of importance in...

Desenvolvimento e formação profissional em medicina geral e de família na Alemanha

Objective: This article aims to analyze the professional and faculty development of general practice and family medicine (GP/FM) in Germany and discuss its facing challenges. Methods: It is a case study identifying characteristics and potential intervention tools, describing training and qualification requirements in family medicine in Germany. Results: The traditional caring role of GP in Germany has a long history, but GP has no gatekeeper function, which weakens its position in the system. In the past decades, GP has undergone several transformations; it is no longer a practice based on the traditional “Hausarzt” style. It has become a medical specialty of primary care with more modern foundations; it requires five years of practical training in internal medicine, paediatrics, surgery and general medicine, and it is governed by the Physician Chambers. In undergraduate education, courses in General Practice are mandatory. In recent years, the new curriculum requirements have led to an intense process of academic development with the creation of General Practice departments in 20 of the 36 public medical schools in the country. Conclusions: The process of professionalization and faculty development in GP/FM as well as the expansion of undergraduate training in the specialty aim to enhance the appeal of GP/FM to young doctors. This development strengthens academic research on GP/FM, which contributes to enhancing the institutional basis of GP/FM as a science, allowing bolder interaction and collaboration with other branches of medicine and real appreciation of this subject (GP/FM).

Educational expectations of GP trainers. A EURACT needs analysis

Introduction: In this background paper, we discuss the educational needs of family medicine teachers and trainers in the light of a EURACT (European Academy of Teachers in General Practice) project aimed at the development of a European framework for the professional development of general practice (GP) educators. Background: There is evidence that the ideal GP educator would benefit from systematic training in teaching skills. Although international literature indicates that such skills training should be in supervision, feedback, assessment and educational management, it is not clear if these needs vary between trainers who teach general practice in different settings and environments. Needs assessment: Recently EURACT, in collaboration with partners from five EU countries and Turkey, set up a project aimed at the development of a comprehensive ‘training the trainers’ programme. The project included a baseline survey of perceived educational needs and wants among both novice and expert European GP educators. The survey demonstrated that the educational needs of GP educators did not vary much in the content areas in which training was required throughout Europe but did vary in the level and depth of knowledge needed; this depended on their experience and level of expertise as teachers. Implications: Based on the information gathered and experience gained from previous EURACT courses, a Leonardo da Vinci project has developed and launched a comprehensive programme with courses at three levels of participant expertise, to address the personal learning needs of GP educators.

GP training curriculum refreshed

The Royal College of General Practitioners has updated its GP training curriculum to make it easier to use, following feedback from trainers and trainees. The new look curriculum—which reflects the latest developments in general practice, GP training needs, and patient expectations—will …