Abstracts are displayed in order of program and excluding Symposium Abstracts.
Concurrent Sessions 3B –3F
PAUSE. RELAX. THINK DEEPLY. SPEAK THE TRUTH. SUSTAINING QUALITIES IN GP EDUCATION.
Dr Hilton Koppe
North Coast GP Training
Life in general practice is busy. Life in medical education is busy too. Some doctors get tired and disillusioned, and leave their practice. Some educators get tired and disillusioned and leave the field. What can be done to help prevent this from occurring?
This skill-based experiential workshop, which is an extension of a NCGPT innovative communication skills workshop, will guide participants through five steps to assist them with strategies designed to sustain them in their working role as clinicians and educators.
Pause: To take a moment to notice what is going on right now.
Relax: To let go of tension, or to accept what can’t be changed.
Listen deeply: To listen effectively, with every cell in the body.
Think creatively: To be curious about what has been observed, and what might follow.
Speak the truth: To offer words based on deep listening and creative thinking, rather than what first comes to the mind.
Participants can expect to leave the workshop refreshed and rejuvenated, and armed with reproducible skills for use in their roles as both clinicians and educators. These skills have the potential to change the way they practice medicine and facilitate learning.
It is an opportunity not to be missed.
ADF REGISTRARS – ARE WE ANY FURTHER AHEAD?
Dr Reginald Michael Crampton
Went West
This workshop is a follow-on from the successful ADF Registrar workshop at GPET
2008. In a workshop format, participants from various RTPs will outline progress made in the past 12 months in addressing barriers faced by ADF Registrars in their region. As GPET encourages each RTP to develop local solutions to assist ADF registrars’ progress, the main focus of this workshop will be to share, compare and contrast local solutions with a view to further facilitating the smooth passage of ADF Registrars through the AGPT.
This workshop will involve brief presentations from each participating RTP and then a facilitated discussion to workshop the ideas and solutions presented. Specifically, the workshop will aim to identify, share and further develop:
local solutions implemented by RTPs to enhance the ADF registrars’ journey;
national solutions implemented by groups of RTPs working collaboratively to address issues arising from ADF registrars movement from one RTP to another;
solutions developed by GPET, the ADF, ACCRM and / or the RACGP tofacilitate ADF registrars completing their general practice training and their ADF duties in a co-ordinated and optimal timeframe.
CAN MUSIC BE USED IN MEDICAL EDUCATION? AN EXPERIMENTAL WORKSHOP.
Dr Tim Senior
WentWest Limited
Many doctors are keen musicians and music lovers. The evolving field of medical humanities has largely concentrated on the use of literature in medical education. This workshop will draw on the experience of participants to try to answer the question “What uses might music have in teaching?”
We will explore what literature there is in this area and participants will contribute ideas and discussion. There will be experimental activities to explore the potential uses of music with registrars and students, covering areas as diverse as setting a mood, cross-cultural awareness, listening skills and emotional literacy. Other opportunities raised by the participants will also be explored.
The workshop will be interactive and fun and participants will have the opportunity to play recorded (or even live!) music of their choice. They will discuss how they might use music and what the barriers to its use might be in practice.
At the end of this workshop, participants will have some ideas to try out in their own teaching, and have formed a network of educators interested in this area to further ideas in the future.
CULTURAL COMPETENCY TRAINING FOR SUPERVISORS OF IMGS
Dr Hung The Nguyen 1, Ms Judith Miralles 2
1 NTGPE, 2 Judith Miralles and Associates
The purpose of IMG supervision is to monitor and support the IMG throughout the introductoryperiod of working within the Australian healthcare setting. The supervision period introduces and sets in place a culture of continuous learning and professional development, which are fundamental to medical practice in the Australian healthcare system.
Performance review and feedback are integral to supervision. Feedback should describe the strengths of the IMG, areas that need development, and strategies that the IMG might employ to improve performance.
Inherent in the relationship is the cross-cultural interaction and associated cross-cultural misunderstanding when giving feedback.
This workshop will introduce participants to a model of cultural competence training. After completing this workshop the participants will know their own cultural preferences and tendencies in order to 1) recognize behaviors in IMGs that indicate a preference for a cultural dimension and 2) provide effective feedback to IMGs after taking culturally preferred behaviors into consideration.
The workshop will be interactive and discussions will feature cases of IMGs being supervised in general practice.
THE PHILOSOPHICAL BASIS OF GENERAL PRACTICE - YOU MUST BE JOKING!
Associate Professor Lyn Clearihan 1
1 Victorian Metropolitan Alliance, 2 Monash University
The purpose of this workshop is to explore the relationship between the way we teach, and use, the clinical method and the philosophical basis that underpins it. This is designed to encourage participants to consider some of the philosophical principles underpinning the current clinical method and how they influence what we do with patients, and what we teach to registrars. This approach is to encourage participants to search for more meaning in what they do clincially and how they go sharing this process with registrars.
The workshop will use a case history approach to explore the ongoing importance of phronesis in the way we gather information and utilize it in our clinical decision making. This will provide an opportunity to reflect on why we do what we do in a very interactive format. In exploring these concepts it is hoped that the value of philosophical reflection and the importance of understanding where some of our thinking has originated from will provide a stronger platform for future choices.
It is anticipated that through this workshop participants will gain greater insights into their own approach to their teaching and practice and that, in turn, both registrars and patients will benefit.
Paper Presentation Session 3G
TO BE A GP OR NOT TO BE.....THAT IS JUST ONE OF MANY QUESTIONS
Ms Kate Froggatt
GP Synergy
What started out as an intention to determine the effectiveness of General Practice marketing activity for pre-vocational doctors turned into valuable research findings revealing the key drivers and stages in the career decision making process of possibly our most important target segment.
This presentation will discuss the findings of two sets of quantitative research – the first from a questionnaire distributed to 345 junior doctors, completed by 229 (generating a response rate of 66%) and the second, results of a questionnaire completed by 163 GP training applicants during the 2009 RTP interview selection process.
Key findings discussed will include identifying when applicants first became interested in General practice and made their decision to select General Practice as career, drivers for and against considering General Practice, the major motivators underlying RTP choie, what marketing communications pre-vocational doctors accessed to help them make their career decision as well as identification of the effectiveness of our most popular marketing activity, hospital General Practice promotional sessions.
OPERATING IN A PARALLEL UNIVERSE - SURVIVING OUTSIDE THE AGPTP
Dr Patrick Giddings
Remote Vocational Training Scheme
The Remote Vocational Training Scheme model of vocational training by distance ed. and remote supervision has been delivered for more than 8 years. RVTS Ltd as a training provider however, is in just its 3rd year of operation.
Though RVTS Ltd is an ”RTP - like” structure it carries out many of the roles of GPET itself but on a “micro” scale.
The program now has 45 registrars training in locations across the nation, with expanded numbers planned for the future.
This paper discusses the opportunities and challenges facing a small vocational training program independent to the AGPTP.
GENERAL PRACTICE TRAINING IN AUSTRALIA AND IRELAND – TOWARDS A NEW ‘PEIL NA RIALACHA IDIRNÁISIUNTA’?
Dr Simon Morgan
GP Training Valley To Coast
Background The Australian General Practice Training (AGPT) Program aims to provide doctors with the competencies to undertake unsupervised general practice and/or rural and remote medicine, with a particular emphasis on meeting their individual community’s health needs.
Similarly, in the Republic of Ireland, specialist training for general practice aims ‘to produce doctors who will be able to provide personal and continuing care to individuals and families in the community’. Both programs are based on the apprenticeship model of learning, and are administered by regional training providers.
In 2006-7, the author spent 18 months working as an Assistant Program Director (equivalent to Medical Educator) with the Donegal Specialist Training Program(me) in General Practice, in the north-west of Ireland.
Objectives To compare and contrast educational and organisational (and social!) aspects of general practice training in Australia with the Republic of Ireland, using both the author’s personal experience and the literature
To have some craic!
Discussion General practice training in Australia shares a number of features with the Irish system, including regionalisation of training, the role of the College(s), clinical exposure though the apprenticeship model and structured educational release activities. Conversely, there are a number of distinct differences between the two models – these include competition for available training places, selection processes, flexibility of training, curriculum content, formative and summative assessment processes, and supervisor development. Consideration of the Irish system, and other international models of vocational training, will benefit general practice training in Australia.
WHAT FACTORS INFLUENCE GP SUPERVISORS’ WILLINGNESS TO HOST A PREVOCATIONAL DOCTOR IN THEIR PRACTICES?
Ms Belinda Allan 1, AProf Jennifer Thomson 1, Dr Katrina Anderson 1,2, Prof Marjan Kljakovic 1
1 Australian National University Medical School, 2 Coast City Country Training
INTRODUCTION With the influx of medical graduates into the workforce and the current general practitioner shortage, new clinical prevocational postgraduate training rotations within general practice need to be expanded. This paper explores some of the general practice characteristics that influence general practice supervisors’ willingness to host a prevocational doctor
METHOD All general practice supervisors (GPS) of registrars and medical students in Australian Capital Territory (ACT) and South Eastern New South Wales (SENSW) were surveyed (n=167). GPS interest in hosting junior doctor rotations was assessed. The general practice features of rurality, size and infrastructure of these GPS’s practices were analysed using cross-tabulation analysis and Pearson’s Chi-squared testing, to determine their influence on GPS interest in hosting rotations.
RESULTS Results showed that factors such as rurality and infrastructure did not independently influence GPS willingness to host junior doctor rotations significantly. Practice size however may be important.
DISCUSSION Designing recruitment and increasing incentives for GP teachers for Prevocational General Practice Placement Program (PGPPP) should have little focus on general practice features of rurality or infrastructure as major contributors. Practice size may be a significant influence and should be further investigated along with supervisor characteristics and opinions on financial remuneration and time constraints.
WHAT MODELS OF TEACHING ARE SUSTAINABLE IN COMMUNITY GENERAL PRACTICE? RESULTS FROM AOGP'S COST-BENEFIT STUDY
Dr Caroline Laurence 1,2, Ms Linda Black 1
1 Adelaide To Outback GP Training Program, 2 Discipline of General Practice, University of Adelaide
With the increase in medical students and graduates over the next 5 years, there will be increasing pressure on institutions providing medical education. While some of this increase may be accommodated within teaching hospitals, a significant proportion is likely to be accommodated within general practice (GP) in the community. GP has shown that it can successfully teach medical students, junior doctors and registrars, making it an attractive option.
This paper will present the results of one aspect of a study undertaken by Adelaide to Outback GP Training Program into the capacity and sustainability of teaching in community GP. Utilising the cost-benefit models of teaching across the training continuum developed in the earlier part of the study, we will identify the cost- benefits of various models of teaching already existing in GP training. At the same time, we will also present the cost-benefits of new and innovative ways of teaching in community general practice.
These teaching models have then been used to project the future requirements in terms of practices and GP trainers required to meet the increased number of medical students, junior doctors and GP registrars that will occur in the next five year. The results of this projection, utilising one or a mix of models will be presented for South Australia.
These results can be used to inform the provision of appropriate support strategies for teaching in GP in the future.
ARE PATIENTS WILLING PARTICIPANTS IN THE NEW WAVE OF COMMUNITY-BASED MEDICAL EDUCATION IN REGIONAL AND RURAL AUSTRALIA?
Professor Nicky (JN) Hudson 1, Dr Kathryn Weston 1, Professor Elizabeth Farmer 1, Dr Rowena Ivers, Dr Russell Peterson 1
1 Graduate School Of Medicine, University of Wollongong, 2 Illawarra Division of General Practitioners, Wollongong
Background Community-based medical education is escalating to meet the increase demand for quality clinical education in expanded settings1. While community-based medical education presents an exciting challenge for general practice1,2 patient participation is vital to the sustainability of this endeavour. What are patients’ views on being used as an educational resource, and are they being under-or over-used? A report from urban general practice sites investigating patients’ acceptance of senior medical student involvement revealed that patients were a willing but underused resource3. This study aimed to investigate whether these findings could be generalised to regional and rural general practices that had recently embraced junior medical student teaching.
Method All patients attending 8 rural and 11 regional general practices over 18 teaching sessions provided consent for student involvement, and to complete a self-administered pre and post-consultation survey. The survey gathered data on their perceptions, expectations and acceptance of medical student involvement in consultations.
Results Ninety nine % of patients (N=118) who consented to medical student involvement completed surveys before their consultation, with 83% (N=100) completing post-consultation surveys. Of these, 62% (N=62) reported no prior experience of medical student involvement. Patients were overwhelmingly positive about their doctor and practice being involved in student teaching now and in the future, and felt they themselves played an important role. Desire to help the student was the major reason for agreeing to student involvement (87%), with personal issues (41%), privacy concerns (19%) and student inexperience (17%) potentially leading to refusal. Pre-consultation, patients expressed reluctance to allow students to conduct aspects, or all of the consultation, independently. However post-consultation, they reported they would have accepted more than actually took place in the teaching session. Despite the fact that the regional/rural students had relatively less clinical experience than their urban counterparts3, the former were involved in patient consultations to a higher degree, and the regional/rural patients expected, and would have accepted higher levels of involvement than actually occurred.
Discussion Patients in regional and rural settings with relatively little prior experience of medical student involvement are willing partners in junior medical student skill development. Our study extends the findings from urban general practice3, namely patients potentially are underutilised partners in community-based medical training. The support of patients from regional and rural settings should facilitate the expansion of primary care-based medical education in these areas of workforce need.
