General Practice Education Research Articles

Educational training requirements for general practice/family medicine specialty training: recommendations for trainees, trainers and training institutions

ABSTRACTHigh-quality training is a prerequisite to teaching future general practitioners. To inspire and guide all countries to implement General Practice (GP) specialist education and training and bring it to the highest standards, we aimed, within the European context, to produce a collaborative document entitled ‘Educational Requirements for GP Specialty Training’. Through an iterative process existing documents from the European Academy of Teachers in GP and Family Medicine (EURACT) and the World Organization of Family Medicine Doctors (WONCA) were collated. Other reports, grey literature about specialty GP training and requirements for trainees, trainers and training institutions were included. State-of-the-art GP specialty training ‘core’ competences, characteristics and essential features of GP are described. General principles and specified tools for training and assessment are summarised. Recommendations on the duration and place(s) of training and selection of trainees are provided. Trainers should be accredited teachers and quality training institutions are essential. New insights, existing gaps and issues for debate have highlighted areas for further research. This document was produced in the specific context of Europe but its general principles are relevant to GP training in all countries.

How can General Practice be incorporated longitudinally in medical studies? Students' views on the development of a new rural health program.

Aim: Participation of medical students in the conceptual development of targeted and attractive teaching content for rural areas.Method: A questionnaire was developed to gather information on students' views of their current medical studies, career interests, and what requirements should be met by an optional rural health program in general practice. By means of an online survey in summer 2015, all medical students from the fourth preclinical semester onwards (n=2,150) at Goethe University Frankfurt were surveyed on one occasion. Statistical analysis was mainly descriptive. Personal attitudes towards a career as a family practitioner were examined for statistical significance. Further information was gathered on whether a measurable correlation exists between personal background and desired work location. Results: Of the 2,150 students that were contacted, 617 participated in the survey (response rate=28.7%). The results covered a wide range of ideas and recommendations and were representative both of medical students with a positive attitude toward general practice, as well as those that were rather critical of teaching in general practice. The students expected the planned health program to be of strong practical relevance and to acquaint them with the administrative and economic aspects of running a practice.Conclusions: By including the target group in the development process, it was possible to tailor the health program to meet the needs of future participants more precisely. Student participation can also be expected to result in greater acceptance of the program. The results on teaching content may also provide other medical faculties with orientation when developing comparable programs.

Tobacco and electronic cigarette products: awareness, cessation attitudes, and behaviours among general practitioners.

Little is known around how general practitioners (GP) approach tobacco products beyond traditional cigarettes.AimTo examine GP perceptions of tobacco and electronic cigarette (EC) products, and their attitudes and behaviours towards product cessation. A 13-item self-completed anonymous questionnaire measured awareness of waterpipe tobacco smoking (WTS) and smokeless tobacco (ST). Cessation advice provision, referral to cessation services, and the harm perception of these products were asked using five-point Likert scales that were dichotomised on analysis. Correlates of cessation advice were analysed using regression models.FindingsWe analysed 312 responses, of whom 63% were aware of WTS and between 5-32% were aware of ST products. WTS and ST were considered less harmful than cigarettes by 82 and 68% of GPs, respectively. WTS, ST, and EC users were less advised (P<0.001) and referred (P<0.001) to cessation services compared to cigarette users. Ethnic minority and senior GPs were more likely to provide cessation advice for WTS and ST users compared to younger white GPs. GPs who were recent tobacco users were less likely to give cessation advice to cigarette users (adjusted odds ratios 0.17, 95% confidence interval 0.03-0.99, P<0.049).Conclusions (implications for practice and research)GPs had lower harm perception, gave less cessation advice, and made less referrals for WTS and ST users compared to cigarettes. Our findings highlight the need for targeted tobacco education in general practice. More research is needed to explore GP perceptions in depth as well as patient perspectives.

When I say … exposure.

‘Exposure’ is increasingly being used for teaching and placements in general practice. This word has overwhelmingly negative connotations, is rarely used for other disciplines and we think should be avoided.

Inside general practice ethics: guidelines 'and' 'of' or 'for' good clinical practice.

The RCGP conference, like other annual healthcare conferences offers a protected space for reflection on ethical aspects of practice. This paper presents a summary and discussion of a fringe session led by the RCGP Committee On Medical Ethics at the 2017 RCGP annual conference in Liverpool. Well thought-out rules offer a potential solution to the burden of responsibility for making every single decision from first principles. But guidelines can be difficult to follow, too numerous to know, may conflict with each-other and may not be appropriate in all circumstances. Delegates at this meeting discussed barriers to good guideline development and implementation, perceptions of medicolegal risk in non-adherence, aspects of benefit, harm and justice in guideline use and ethical guidelines. Delegates found it easier in the meeting to critique clinical rather than ethical guidelines. There was broad agreement that understanding how to practice in relation to guidelines represented a learning need in general practice education.

The Intention of General Education in Taiwan’s Universities: To Cultivate the Holistic Person

The cultivation of the holistic person has always been a topic of concern for general education in Taiwan’s universities. Hopefully students can attain a more perfect human nature. So the question is how to practice general education to cultivate the holistic person. This is the focus of this article. After reading and analyzing related studies, the strategies for cultivating the holistic person we identified are as follows: (1) concern about students’ knowledge integration and moral manifestation, (2) cultivation of students’ human nature, (3) concern with students’ life experiences, and (4) general education is as important as professional education. Hopefully the discussion in this article will provide some ideas to help Taiwan's current general education practices, and allow us to realize the ideal of general education, i.e., the cultivation of the holistic person.

Gathering, strategizing, motivating and celebrating: the team huddle in a teaching general practice

Objectives: To understand how implementing a daily team huddle affected the function of a complex interprofessional team including learners.Design: A qualitative descriptive study using semi-structured interviews in focus groups.Setting: An academic general practice teaching practice.Participants: All members of one interprofessional team, including nurses, general practitioners, junior doctors, and support staff.Method: Focus group interviews using semi-structured guidance were transcribed and the results analysed using qualitative content analysis.Main findings: Four interrelated themes were identified: communication and knowledge sharing; efficiency of care; relationship and team building; and shared responsibility for team function. The implementation of the daily team huddle was seen by participants to enhance the collaboration within the team and to contribute to work life enjoyment. Participants perceived that problems were anticipated and solved quickly. Clinical updates and information about patients benefited the team including learners. Junior doctors quickly understood the scope of practice of other team members, but some felt reluctant to offer clinical opinions.Conclusion: The implementation of a daily team huddle was viewed as worthwhile by this large interprofessional general practice team. The delivery of patient care was more efficient, knowledge was readily distributed, and problem solving was shared across the team, including junior doctors.

Twenty Years of General Education in China: Progress, Problems, and Solutions

General education is a subject with rich contents and that is highly contested in the field of higher education studies. It has been highly praised for its core concepts such as broad educational targets, liberating educational objectives, and balanced educational content. Looking back at the course of general education in China over the past 20 years we can find “top-down” cultural quality education (文化素质教育) and “bottom-up” general education (通识教育) have formed two stages with clear “characteristics,” with the first decade being mainly cultural quality education, and the most recent decade having had general education gradually enter the mainstream and reveal native qualityistics. This change has led the practice of general education to turn from being government led to university autonomy, and also reflects the increasing depth of Chinese exploration into general education. China’s practice of general education still faces problems with integrating major-based professional education and general education, and must adopt suitable solutions.

Integration and Cross-Border: Design of General Education Based on Multiple Fusion

General education is the development appeal of humanistic education. At the basic education stage, the general teaching fits with the physical and mental development and cognitive rules of learners at a young age. Therefore, the application and practice of general education in developed countries is relatively universal. The teaching of general education in our country started late, but the proposition that needs to be developed in the current basic education reform is urgent. At present, the development of general education is still dominated by the cultivation of general teachers. There is still a lack of integrated and complete design from mechanism to landing for general education, which is particularly lacking in the design and development of general education and curriculum. The future development trend of general teaching is characterized by informatization, interdisciplinarity, and diversity. Therefore, the integration of disciplines and practice, the integration of learners and disciplines, the teaching content and information, the technology and teaching evaluation are necessary for the integration of teaching and curriculum design.

Современные педагогические технологии как инструмент моделирования профессиональной деятельности в учебном процессе педагогического колледжа

In article the urgency of development of modern educational technologies by teachers of pedagogical colleges is justifi ed. Relevance is considered as part of the philosophy of education, and in the context of legislative changes enshrined in the law “On education in the Russian Federation” and the FSES at all levels. We considered two aspects of this process: educational technology used in teaching, and support of college students in the selection of complex educational technologies to replenish professional tools for future teachers. The factors which prevent not only the process of implementation of pedagogical technologies in educational process of pedagogical colleges, but also in the practice of General education are considered. The measures to facilitate the organization of such a process are off ered and criteria that can be used both for the selection of the most eff ective for teaching in a teacher training college, and for the creation by future teachers of their own complex of pedagogical technologies are given.

Physical examination in undergraduate medical education in the field of general practice \u2013 a scoping review

BackgroundPhysical examination (PE) is an essential clinical skill and a central part of a physician’s daily activity. Teaching of PE has been integrated into medical school by many clinical disciplines with respective specific examination procedures. For instance, PE teaching in general practice may include a full-body examination approach. Studies show that PE-skills of medical students often need enhancement. The aim of this article was to scope the literature regarding the teaching and research of PE within general practice during undergraduate medical education. We evaluated a wide breadth of literature relating to the content, study design, country of research institution and year of publication.MethodsLiterature search in Medline along the PRISMA-P protocol was performed by search syntax (“physical examination” AND “medical education” AND “undergraduate” AND general practice) considering Medline MeSH (Medical Subject Heading)-Terms and Medline search term tree structure. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. Full texts were analyzed by publication year, country of origin, study design and content (by categorizing articles along their main topic according to qualitative content analysis of Mayring).ResultsOne-hundred seven articles were included. The annual number of publications ranged from 4 to 14 and had a slightly rising trend since 2000. Nearly half of the publications originated from the United States (n = 54), 33 from Canada and the United Kingdom. Overall, intervention studies represented the largest group (n = 60, including uncontrolled and controlled studies, randomized and non-randomized), followed by cross-sectional studies (n = 29). The 117 studies could be assigned to five categories “teaching methods (n = 53)”, “teaching quality (n = 33)”, “performance evaluation and examination formats (n=19)”, “students’ views (n = 8)” and “patients’ and standardized patients’ views (n=4)”.ConclusionsThe present work shows a wide spectrum of teaching and research activities and a certain level of evidence for the effectiveness of individual teaching methods. It can be used as orientation and impulse generator for the further development of medical education in the field of PE.

Insights on Developing General Practice Education in China.

Insights on Developing General Practice Education in China.

Twelve tips for the recruitment and retention of general practitioners as teachers of medical students

Background: Primary care physicians have become a fundamental aspect of teaching in modern medical school curricula worldwide with a significant proportion of undergraduate teaching taking place in primary care. There are calls for this to increase with more patient care occurring in the community but teaching capacity in primary care is a potential challenge. Medical schools, therefore, need strategies to be able to increase their primary care physician teaching workforce.Methodology: We asked all Heads of General Practice Teaching in UK medical schools to share their three top tips for recruiting and retaining GPs to teach undergraduate students. The majority (two-thirds) of medical schools responded and we have summarized the answers into the following twelve tips.Results: Although the twelve tips are varied and comprehensive, including broad topics such as finances and training, one clear theme running through the majority of tips is good communication and relationships between education teams and GPs.Conclusions: The solutions to recruiting and retaining GPs to teach undergraduate medical students are clearly multifactorial and complex. We hope that by presenting suggestions from UK GP heads of teaching as these twelve tips provides some helpful, thought-provoking ideas and inspiration for both the UK and internationally.

GP recruitment and medical education: part of the solution?

The current crisis in recruitment to general practice in the U.K. is likely, in part, to be caused by students’ and recent graduates’ negative perceptions of this career choice, perceptions which may have their roots in their experiences of general practice teaching and the effect of the ‘hidden curriculum’ in medical schools. There is some evidence that the expansion of the contribution of general practice in medical school curricula has stalled, and may even be shrinking, and of the diminishing visibility of general practice departments. Coupled with negative media and professional perceptions of general practice, the profession faces significant challenges in re-invigorating and re-inventing itself as an attractive career choice for students and recent graduates. General practice teachers and researchers in medical schools have significant opportunities to influence and improve many of these difficulties.

Strengthening general practice/family medicine in Europe\u2014advice from professionals from 30 European countries

BackgroundSubstantial variations are still to be found in the strength of general practice/family medicine (GP/FM) across Europe regarding governance, workforce competence and performance, as well as academic development and position. Governments are encouraged by the WHO to secure high quality primary health care to their population, a necessity for reaching the goal “Health for all”. The present study aimed at investigating the opinions of council members of the European Academy of Teachers in General Practice (EURACT) on necessary actions to strengthen the position of GP/FM in their country.MethodsThe study used a mixed methods exploratory sequential design. EURACT representatives from 32 European countries first participated in brain-storming on how to strengthen GP/FM in Europe. Later, representatives from 37 countries were asked to individually score the relevance of the proposed actions for their country on a 9-point Likert scale. They were also asked to evaluate the status of GP/FM in their country on four dimensions.ResultsRespondents from 30 European countries returned complete questionnaires. To build and secure GP/FM as an academic discipline comprising teaching and research was seen as essential, regardless the present status of GP/FM in the respective country. To build GP/FM as a specialty on the same level as other specialties was seen as important in countries where GP/FM held a strong or medium strong position. The importance of common learning objectives and a defined bibliography were stated by respondents from countries where GP/FM presently has a weak position.ConclusionsIn order to strengthen GP/FM throughout Europe, EURACT and other professional organizations must establish common goals and share expertise between countries. To influence decision makers through information on cost-effectiveness of a GP/FM-based health care system is also important.

Redefining Learning: Kolb's Theory of Learning Styles with Gardner's Multiple Intelligences

This study attempts to bridge David Kolb’s theory of Learning Styles Howard with Gardner’s Theory of Multiple Intelligences to overcome criticisms to both. The necessity to sequentially achieve Kolb's four learning stages (concrete experience, reflective observation, abstract conceptualization, and active experimentation) and their respective preferred combinations are discussed as an onset. Succeeding that is an analysis of Gardner's Theory of Multiple Intelligences which claims intelligence to be one of eight types of independent arenas of competence, all independent of each other (linguistic. analytical, musical, bodily, interpersonal and intrapersonal, spatial and naturalist). Both theories suffer from certain drawbacks. For instance, Kolb’s theory has sufficient empirical support but lacks scientific backing while Gardner's theory is bereft of empirical support but founded on clinical research on central nervous system. Utilizing a combination of both theories the study examines possibilities to improve quality of education, training and pedagogical advice. The purpose of this study is to examine both theories in detail so as to isolate unique concepts both scientifically accurate and empirically compelling with the intent to formulate a compound theory through active use of pragmatism and quality control. The paper further presents a real life model to overcome impediments faced by the two theories and proposes revisions in learning techniques to facilitate absorption of knowledge and synthetization of information in general educational practice at both amateur and professional level. Keywords: education, learning styles, learning theory, multiple ıntelligences, pedagogical.

Constructing a Prototype: Realizing a Scholarship of Practice in General Education

This chapter will construct a prototype of a scholarship of practice through specific application to general education. The chapter includes specific illustrations and potential challenges for such an endeavor.

Strengthen the training of general practitioner to promote the construction of Healthy China

Department of General Medicine in Zhongshan Hospital, Fudan University was founded in 1994, which was the only unit established in a tertiary hospital in the country at that time, engaged in clinical practice, teaching and research of general practice. Zhongshan Hospital won the second prize of National Teaching Achievement in 2014 for Exploration and innovation of training system of general practitioners in China , which contributed to development of standardized training system of general practitioners suitable to China's national conditions. This article summarizes the experience in training general physician, development of disciplines and enhancing influence of Zhongshan Hospital over years, hopefully it will be of reference value for medical educators. Key words: General physician; Training

Association of osteoarthritis risk factors with knee and hip pain in a population-based sample of 2424 30–59 year olds in Denmark: a cross-sectional analysis.

The TOF pilot study was funded by a grant from the Region of Southern Denmark: 11/13244, and grants from The Committee of Quality and Education in General Practice, The Region of Southern Denmark: J.nr 15/10562 and 14/43732. Joyce van Tunen was funded by the European Union Seventh Framework Programme (FP7-PEOPLE-2013-ITN;KNEEMO) under grant agreement no. 607510. The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

Strategically Mediated Reflective Practice Framework In Terms of Task, Meaningful Learning, and Interaction

It is widely accepted that reflective teaching in its purely cognitive and introspective sense cannot be responsive to the dilemmas and the problems with which teachers encounter during their teaching practice. Thus, the present study believes that the very tentative solution to this problem is introducing teacher education in general and reflective practice in particular from a sociocultural perspective where any sort of knowledge is dialogically constructed as a result of interaction among individuals. Although the shift in paradigm, i.e. moving from a cognitive position to a more situated and social epistemology in teacher education, has already been acknowledged and addressed by scholars such as Johnson (2006, 2009), Johnson and Golombek (2003), Golombek (2011), Freeman (2004), and Hawkins (2004), the current literature on teacher education reveals of no direct or serious attempt as a framework in which such a view has been put into practice in teacher education. As a result, the present study proposed a tentative framework under the rubric of ‘Strategically Mediated Reflective Practice’ (henceforth SMRP) framework that treats reflective practice largely as an interactive process rather than an individualistic and demonstrates how reflective practice is strategically mediated with the help of more knowledgeable others and new insights emerge resulting from dialogical thinking, highlighting the Vygotskian notion of Concept development. More importantly, examining the SMRP framework with four participants, the present study evidently reports the affirmative and constructive outcome of this framework on the utilitarian ground language teaching.