Vertically integrated shared learning models in general practice: a qualitative study.

Abstract:

BACKGROUND:The numbers of learners seeking placements in general practice is rapidly increasing as an ageing workforce impacts on General Practitioner availability. The traditional master apprentice model that involves one-to-one teaching is therefore leading to supervision capacity constraints. Vertically integrated (VI) models may provide a solution. Shared learning, in which multiple levels of learners are taught together in the same session, is one such model. This study explored stakeholders' perceptions of shared learning in general practices in northern NSW, Australia. METHODS:A qualitative research method, involving individual semi-structured interviews with GP supervisors, GP registrars, Prevocational General Practice Placements Program trainees, medical students and practice managers situated in nine teaching practices, was used to investigate perceptions of shared learning practices. A thematic analysis was conducted on 33 transcripts by three researchers. RESULTS:Participants perceived many benefits to shared learning including improved collegiality, morale, financial rewards, and better sharing of resources, knowledge and experience. Additional benefits included reduced social and professional isolation, and workload. Perceived risks of shared learning included failure to meet the individual needs of all learners. Shared learning models were considered unsuitable when learners need to: receive remediation, address a specific deficit or immediate learning needs, learn communication or procedural skills, be given personalised feedback or be observed by their supervisor during consultations. Learners' acceptance of shared learning appeared partially dependent on their supervisors' small group teaching and facilitation skills. CONCLUSIONS:Shared learning models may partly address supervision capacity constraints in general practice, and bring multiple benefits to the teaching environment that are lacking in the one-to-one model. However, the risks need to be managed appropriately, to ensure learning needs are met for all levels of learners. Supervisors also need to consider that one-to-one teaching may be more suitable in some instances. Policy makers, medical educators and GP training providers need to ensure that quality learning outcomes are achieved for all levels of learners. A mixture of one-to-one and shared learning would address the benefits and downsides of each model thereby maximising learners' learning outcomes and experiences.

journal_name

BMC Fam Pract

journal_title

BMC family practice

authors

Ahern CM,van de Mortel TF,Silberberg PL,Barling JA,Pit SW

doi

10.1186/1471-2296-14-144

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

144

issn

1471-2296

pii

1471-2296-14-144

journal_volume

14

pub_type

杂志文章
  • Patient and professional attitudes towards research in general practice: the RepR qualitative study.

    abstract:BACKGROUND:Since the 1990s, professional institutions worldwide have emphasised the need to develop research in general practice to improve the health of the population. The recent creation of professorships in general practice in French Universities should foster research in this field. Our aim was to explore the view...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-15-136

    authors: Cadwallader JS,Lebeau JP,Lasserre E,Letrilliart L

    更新日期:2014-07-21 00:00:00

  • Organisational targets of patient safety improvement programs in primary care; an international web-based survey.

    abstract:BACKGROUND:Organisational problems contribute to many errors in healthcare delivery. Our objective was to identify the most important organisational items in primary care which could be targeted by programs to improve patient safety. METHODS:A web-based survey was undertaken in an international panel of 65 experts on ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-14-145

    authors: Wammes JJ,Verstappen W,Gaal S,Wensing M

    更新日期:2013-10-01 00:00:00

  • Knowledge of stroke risk factors among primary care patients with previous stroke or TIA: a questionnaire study.

    abstract:BACKGROUND:Survivers of stroke or transient ischaemic attacks (TIA) are at risk of new vascular events. Our objective was to study primary health care patients with stroke/TIA regarding their knowledge about risk factors for having a new event of stroke/TIA, possible associations between patient characteristics and pat...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-11-47

    authors: Sloma A,Backlund LG,Strender LE,Skånér Y

    更新日期:2010-06-15 00:00:00

  • Towards a more efficient diabetes control in primary care: six-monthly monitoring compared with three-monthly monitoring in type 2 diabetes - The EFFIMODI trial. Design of a randomised controlled patient-preference equivalence trial in primary care.

    abstract:BACKGROUND:Scientific evidence for the frequency of monitoring of type 2 diabetes patients is lacking. If three-monthly control in general practice could be reduced to six-monthly control in some patients, this would on the one hand reduce the use of medical services including involvement of practice nurses, and thus r...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2296-11-35

    authors: Wermeling PR,van den Donk M,Gorter KJ,Ardine de Wit G,van der Graaf Y,Rutten GE

    更新日期:2010-05-11 00:00:00

  • A qualitative study of primary care clinicians' views of treating childhood obesity.

    abstract:BACKGROUND:The prevalence of childhood obesity is rising and the UK Government have stated a commitment to addressing obesity in general. One method has been to include indicators relating to obesity within the GP pay-for-performance Quality and Outcomes Framework (QOF) contract. This study aimed to explore general pra...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-8-50

    authors: Walker O,Strong M,Atchinson R,Saunders J,Abbott J

    更新日期:2007-09-03 00:00:00

  • Effectiveness of an implementation strategy for a breastfeeding guideline in Primary Care: cluster randomised trial.

    abstract:BACKGROUND:The protection and promotion of breastfeeding is considered a priority in Europe where only 22% of infants less than 6 months old are exclusively breastfed. In Spain this percentage reaches 24.8% but in our city it falls to 18.26%. Various studies emphasise that the improvement of these results should be bas...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2296-12-144

    authors: Martín-Iglesias S,del-Cura-González I,Sanz-Cuesta T,Arana-Cañedo Argüelles C,Rumayor-Zarzuelo M,Alvarez-de la Riva M,Lloret-Sáez Bravo AM,Férnandez-Arroyo RM,Aréjula-Torres JL,Aguado-Arroyo Ó,Góngora-Maldonado F,García-Corraliza M

    更新日期:2011-12-30 00:00:00

  • Management of work-related common mental disorders in general practice: a cross-sectional study.

    abstract:BACKGROUND:General practitioners (GPs) often manage individuals with work-related common mental disorders (CMD: depressive disorders, anxiety and alcohol abuse). However, little is known about the ways in which they proceed. The aim of this study is to analyze GPs' management and patterns of referral to other health pr...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01203-z

    authors: Rivière M,Toullic Y,Lerouge P,Blanchon T,Leroyer A,Plancke L,Prazuck T,Melchior M,Younès N

    更新日期:2020-07-02 00:00:00

  • Deprescribing medication in very elderly patients with multimorbidity: the view of Dutch GPs. A qualitative study.

    abstract:BACKGROUND:Elderly patients with multimorbidity who are treated according to guidelines use a large number of drugs. This number of drugs increases the risk of adverse drug events (ADEs). Stopping medication may relieve these effects, and thereby improve the patient's wellbeing. To facilitate management of polypharmacy...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-13-56

    authors: Schuling J,Gebben H,Veehof LJ,Haaijer-Ruskamp FM

    更新日期:2012-07-09 00:00:00

  • Goal setting is insufficiently recognised as an essential part of shared decision-making in the complex care of older patients: a framework analysis.

    abstract:BACKGROUND:Multimorbidity poses a challenge for decision-making processes and requires that more attention is paid to patient goals, preferences and needs; however, goal setting is not yet widely recognised as a core aspect of the shared decision-making (SDM) approach. This study aims to analyse clinician perceptions o...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-019-0966-z

    authors: Vermunt N,Elwyn G,Westert G,Harmsen M,Olde Rikkert M,Meinders M

    更新日期:2019-06-06 00:00:00

  • Does patient's sex influence treatment in primary care? Experiences and expressed knowledge among physicians--a qualitative study.

    abstract:BACKGROUND:Biological and sociocultural differences between men and women may play an important role in medical treatment. Little is known about the awareness of these differences among general practitioners (GPs) and if they consider such differences in their medical practice. The aim of this study was to explore GPs'...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-015-0351-5

    authors: Loikas D,Karlsson L,von Euler M,Hallgren K,Schenck-Gustafsson K,Bastholm Rahmner P

    更新日期:2015-10-13 00:00:00

  • Systematic review of interventions to improve the psychological well-being of general practitioners.

    abstract:BACKGROUND:The health of doctors who work in primary care is threatened by workforce and workload issues. There is a need to find and appraise ways in which to protect their mental health, including how to achieve the broader, positive outcome of well-being. Our primary outcome was to evaluate systematically the resear...

    journal_title:BMC family practice

    pub_type: 杂志文章,评审

    doi:10.1186/s12875-016-0431-1

    authors: Murray M,Murray L,Donnelly M

    更新日期:2016-03-24 00:00:00

  • Development of the Japanese version of the general practice assessment questionnaire: measurement of patient experience and testing of data quality.

    abstract:BACKGROUND:Physicians' interpersonal performance is critical in medical practice, especially primary care practice. The General Practice Assessment Questionnaire (GPAQ) was developed in the United Kingdom to evaluate the quality of primary care from the viewpoint of patients. This questionnaire highlights the evaluatio...

    journal_title:BMC family practice

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s12875-018-0873-8

    authors: Kijima T,Akai K,Matsushita A,Hamano T,Onoda K,Yano S,Nabika T,Ishibashi Y,Kumakura S

    更新日期:2018-11-28 00:00:00

  • Usability and utility of eHealth for physical activity counselling in primary health care: a scoping review.

    abstract:BACKGROUND:Physical activity (PA) counselling is an effective approach to promote PA in primary health care (PHC). Barriers to PA counselling in PHC include time constraints, lack of knowledge and skills of providers, and systemic barriers. Using electronic health (eHealth) has the potential to promote PA. This scoping...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01304-9

    authors: Wattanapisit A,Tuangratananon T,Wattanapisit S

    更新日期:2020-11-06 00:00:00

  • Effect of administrative information on visit rate of frequent attenders in primary health care: ten-year follow-up study.

    abstract:BACKGROUND:Frequent attenders (FAs) use a disproportionately large share of the resources of general practitioners (GPs) working in primary healthcare centres. The aim of this study was to estimate the proportion of FAs among all patients in the primary health care centres of a medium-sized city in Finland, and to exam...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-018-0836-0

    authors: Santalahti AK,Vahlberg TJ,Luutonen SH,Rautava PT

    更新日期:2018-08-28 00:00:00

  • Implementing a fax referral program for quitline smoking cessation services in urban health centers: a qualitative study.

    abstract:BACKGROUND:Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-10-81

    authors: Cantrell J,Shelley D

    更新日期:2009-12-17 00:00:00

  • Developing a facilitation model to promote organisational development in primary care practices.

    abstract:BACKGROUND:The relationship between effective organisation of general practices and health improvement is widely accepted. The Maturity Matrix is an instrument designed to assess organisational development in general practice settings and to stimulate quality improvement. It is undertaken by a practice team with the ai...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-7-38

    authors: Rhydderch M,Edwards A,Marshall M,Elwyn G,Grol R

    更新日期:2006-06-19 00:00:00

  • Retraction Note: Al Kharj diabetic patients' perception about diabetes mellitus using revised-illness perception questionnaire (IPQ-R).

    abstract::The editors have retracted this article [1] because it contains extensive overlap with an article published by the same authors in the Journal of Family & Community Medicine [2] and is therefore redundant. ...

    journal_title:BMC family practice

    pub_type: 杂志文章,撤回出版物

    doi:10.1186/s12875-019-1043-3

    authors: Al-Ghamdi S,Ahmad G,Ali AH,Bahakim N,Alomran S,Alhowikan W,Almutairi S,Basalem T,Aljuaid F

    更新日期:2019-11-05 00:00:00

  • Implementing new care models: learning from the Greater Manchester demonstrator pilot experience.

    abstract:BACKGROUND:Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additi...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-018-0773-y

    authors: Elvey R,Bailey S,Checkland K,McBride A,Parkin S,Rothwell K,Hodgson D

    更新日期:2018-06-19 00:00:00

  • Discussing prognosis with older people with musculoskeletal pain: a cross-sectional study in general practice.

    abstract:BACKGROUND:Prognosis has been described as an important but neglected branch of clinical science. While patients' views have been sought in the context of life-threatening illness, similar research is lacking for patients presenting with common, non-life-threatening musculoskeletal complaints. The aim of this study was...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-10-50

    authors: Mallen CD,Peat G

    更新日期:2009-07-07 00:00:00

  • Episodes of care in a primary care walk-in clinic at a refugee camp in Germany - a retrospective data analysis.

    abstract:BACKGROUND:From 2015 to 2016 Germany faced an influx of 1.16 million asylum seekers. In the state of Hamburg Primary Care walk-in clinics (PCWC) were commissioned at refugee camps because the high number of residents (57,000 individuals) could not be provided with access to regular healthcare services. Our study aims w...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01253-3

    authors: Oltrogge JH,Schäfer I,Schlichting D,Jahnke M,Rakebrandt A,Pruskil S,Wagner HO,Lühmann D,Scherer M

    更新日期:2020-09-21 00:00:00

  • Interpersonal psychotherapy (IPT) for late-life depression in general practice: uptake and satisfaction by patients, therapists and physicians.

    abstract:BACKGROUND:Interpersonal Psychotherapy (IPT) is recommended in most depression treatment guidelines and proved to be a suitable treatment for elderly depressed patients. Despite the favorable results of IPT in research populations, the dissemination to general practice is surprisingly limited. Little is known about upt...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2296-8-52

    authors: van Schaik DJ,van Marwijk HW,Beekman AT,de Haan M,van Dyck R

    更新日期:2007-09-13 00:00:00

  • The accuracy of the MMSE in detecting cognitive impairment when administered by general practitioners: a prospective observational study.

    abstract:BACKGROUND:The Mini-Mental State Examination (MMSE) has contributed to detecting cognitive impairment, yet few studies have evaluated its accuracy when used by general practitioners (GP) in an actual public-health setting. OBJECTIVES:We evaluated the accuracy of MMSE scores obtained by GPs by comparing them to scores ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-9-29

    authors: Pezzotti P,Scalmana S,Mastromattei A,Di Lallo D,Progetto Alzheimer Working Group.

    更新日期:2008-05-13 00:00:00

  • Does patient satisfaction of general practice change over a decade?

    abstract:BACKGROUND:The Patient Participation Program (PPP) was a patient satisfaction survey endorsed by the Royal Australian College of General Practitioners and designed to assist general practitioners in continuous quality improvement (CQI). The survey was been undertaken by 3500 practices and over a million patients betwee...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-10-13

    authors: Allan J,Schattner P,Stocks N,Ramsay E

    更新日期:2009-02-08 00:00:00

  • Validation of Self-Management Screening (SeMaS), a tool to facilitate personalised counselling and support of patients with chronic diseases.

    abstract:BACKGROUND:A rising number of people with chronic conditions is offered interventions to enhance self-management. The responsiveness of individuals to these interventions depends on patient characteristics. We aimed to develop and validate a tool to facilitate personalised counselling and support for self-management in...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-015-0381-z

    authors: Eikelenboom N,Smeele I,Faber M,Jacobs A,Verhulst F,Lacroix J,Wensing M,van Lieshout J

    更新日期:2015-11-11 00:00:00

  • Impact of vital signs screening & clinician prompting on alcohol and tobacco screening and intervention rates: a pre-post intervention comparison.

    abstract:BACKGROUND:Though screening and intervention for alcohol and tobacco misuse are effective, primary care screening and intervention rates remain low. Previous studies have increased intervention rates using vital signs screening for tobacco misuse and clinician prompts for screen-positive patients for both alcohol and t...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-11-18

    authors: Seale JP,Shellenberger S,Velasquez MM,Boltri JM,Okosun I,Guyinn M,Vinson D,Cornelius M,Johnson JA

    更新日期:2010-03-05 00:00:00

  • Factors associated with low patient satisfaction in out-of-hours primary care in Denmark - a population-based cross-sectional study.

    abstract:BACKGROUND:Low patient satisfaction with the quality of out-of-hours primary care (OOH-PC) has been linked with several individual and organizational factors. However, findings have been ambiguous and may not apply to the Danish out-of-hours (OOH) setting in which general practitioners (GPs) perform the initial telepho...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-017-0681-6

    authors: Tranberg M,Vedsted P,Bech BH,Christensen MB,Birkeland S,Moth G

    更新日期:2018-01-11 00:00:00

  • Effectiveness of training general practitioners to improve the implementation of brief stop-smoking advice in German primary care: study protocol of a pragmatic, 2-arm cluster randomised controlled trial (the ABCII trial).

    abstract:BACKGROUND:The German clinical guideline on tobacco addiction recommends that general practitioners (GPs) provide brief stop-smoking advice to their patients according to the "5A" or the much briefer "ABC" method, but its implementation is insufficient. A lack of training is one barrier for GPs to provide such advice. ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-019-0986-8

    authors: Kastaun S,Leve V,Hildebrandt J,Funke C,Becker S,Lubisch D,Viechtbauer W,Reddemann O,Hempel L,McRobbie H,Raupach T,West R,Kotz D

    更新日期:2019-07-27 00:00:00

  • GPs' use of problem solving therapy for depression: a qualitative study of barriers to and enablers of evidence based care.

    abstract:BACKGROUND:Depression is a major health concern, predominantly treated by general practitioners (GPs). Problem solving therapy (PST) is recognised as an effective treatment for depression that is not widely used by GPs. This research aims to explore barriers and enablers that may influence GPs use of this treatment. M...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-8-24

    authors: Pierce D,Gunn J

    更新日期:2007-04-25 00:00:00

  • Establishing chronic condition concordance and discordance with diabetes: a Delphi study.

    abstract:BACKGROUND:The vast majority of patients with diabetes have multiple chronic conditions, increasing complexity of care; however, clinical practice guidelines, interventions, and public reporting metrics do not adequately address the interaction of these multiple conditions. To advance the understanding of diabetes clin...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-015-0253-6

    authors: Magnan EM,Gittelson R,Bartels CM,Johnson HM,Pandhi N,Jacobs EA,Smith MA

    更新日期:2015-03-28 00:00:00

  • The RISAP-study: a complex intervention in risk communication and shared decision-making in general practice.

    abstract:BACKGROUND:General practitioners (GPs) and patients find it difficult to talk about risk of future disease, especially when patients have asymptomatic conditions, and treatment options are unlikely to cause immediate perceptible improvements in well-being. Further studies in risk communication training are needed. AIM...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2296-11-70

    authors: Kirkegaard P,Edwards AG,Hansen B,Hansen MD,Jensen MS,Lauritzen T,Risoer MB,Thomsen JL

    更新日期:2010-09-22 00:00:00