Mind the gaps: preparedness of new general practitioner fellows for independent practice
GPTQ Investigators: Dr Erin Waters, Dr Marie-Louise Dick, Dr Gillian Eastgate, Dr Peter Coxeter, Project Research Officer (TBA)
Collaborators: A/Prof Katherine Wallis (University of Queensland), Dr Hayley Thomas (University of Queensland), Dr Anna Mullins (RACGP QLD New Fellows Committee)
Funding: RACGP Education Research Grant 2021
The aim of this study is to identify the gaps in training and preparedness for practice for RACGP New Fellows, as perceived by New Fellows and GP supervisors.
The study will use a sequential mixed methods exploratory design. Phase I of the study, focus groups of new fellows and GP supervisors will be conducted to explore the perceived strengths of and gaps in training. Themes identified from focus groups, together with domains from the Australian General Practice Training (AGPT) curriculum and literature search findings, will inform the development of an online survey (Phase II). This quantitative phase will reflect themes identified by a much broader national sample of new fellows themselves (self-perceived gaps) and by GP supervisors (possible ‘blind spots’ or ‘unknown unknowns’ of new fellows). Inclusion of domains from the AGPT curriculum will ensure appropriate breadth of the survey, minimising the risk of missing important additional findings.
The study findings will have implications for Australian vocational general practice training and/or continuing professional development.
Exploring GP medical educator and trainee perceptions of benefits, challenges and enablers to on-line and face to face teaching and learning in vocational GP training
GPTQ Investigators: Dr Ruchika Luhach, Dr Marie-Louise Dick, Dr Michael Hurley, Dr Peter Coxeter, Project Research Officer (TBA)
Collaborators: A/Prof Jane Smith (Bond University), A/Prof Peta-Ann Teague (James Cook University General Practice Training), A/Prof Lawrie McArthur (James Cook University General Practice Training)
Funding: RACGP Education Research Grant 2021
The aim of this project is to explore the experiences of Medical Educators (MEs) and General Practice (GP) trainees with online (OLL) and face-to-face (FTF) teaching and learning in the rapidly changing GP vocational training environment.
The study will use qualitative methods to support an in-depth exploration of the experiences of both MEs and GP trainees, adopting a realist perspective seeking to understand what works best for who, when, and in what context in terms of teaching and learning in GP training. In Phase I of the study, focus groups will be conducted with participating MEs and GP trainees to identify the benefits, challenges and enablers around OLL and FTF delivery. Phase 1 findings will inform the development of interview topics to be explored in more detail using in-depth interviews with individual participants (Phase II).
Findings from this study will support the development of effective and appropriate blended educational modalities delivered by Regional Training Organisations.
Global Assessment Tools in (medical) Education (GATE)
GPTQ investigators: Dr Graham Emblen, Dr Rebecca Stewart, Ms Joanne Fisher, Dr Scott Preston, A/Prof Marie-Louise Dick.
Collaborators: A/Prof Jane Smith (Bond University), Dr Gerard Ingham (Murray City Country Coast GP Training).
Funding: RACGP Education Research Grant 2017-2017 program.
The aim of this study was to explore and define the factors which influence Global Assessments by experienced GPs and Medical Educators during GP training, and gain an understanding of the behaviour of assessors.
A modified Delphi technique was used to define and explore factors influencing Global Assessment (GA) which has the utility of improving the validity and reliability of assessment in medical education. The study also found that GA is useful and trusted by assessors for assessing both non-clinical and clinical domains, the latter traditionally being reviewed in high-stakes assessments. By defining the rate of development of competencies over the training continuum, educators and supervisors should be able to better assess the progress of their GP Registrars so that assistance and interventions can be introduced as early as possible during training.
Medical student participation in GP registrar workshops
GPTQ investigators: Dr Scott Preston, Michelle Sheldrake, A/Prof Marie-Louise Dick.
Collaborators: A/Prof Nancy Sturman (University of Queensland), Dr David King (University of Queensland), Dr Remo Ostini (University of Queensland Rural Clinical School).
Funding: None dedicated.
This aim of this study was to assess the formal invitation and voluntary participation of third year medical students undertaking their GP rotation with the University of Queensland in GPTQ registrar workshops. We hypothesised that participation in these workshops may be an effective component of future GP recruitment strategies. The study also investigated the educational benefits for the medical students. The advantages and disadvantages of this pilot for the registrars and medical educators were also assessed.
Registrar-initiated oversight, support and advice (ROSA): help-seeking in general practice training.
GPTQ investigators: Dr Graham Emblen, Dr Scott Preston, Dr Rebecca Lock, Michelle Sheldrake, Dr Peter Coxeter
Collaborators: A/Prof Nancy Sturman (University of Queensland), Dr James Brown (EV GP training), Dr Tim Clement (Murray City Country Coast GP Training).
Funding: RACGP Education Research Grant 2018-2019
The aim of this study was to better understand registrar help-seeking, particularly in-consultation and delayed help-seeking from GP supervisors, in order to inform training in initiating, facilitating and responding to help-seeking.
Multiple qualitative methods were utilised in this innovative study. Experienced GPTQ External Clinical Teaching (ECT) visitors were given additional research training and then conducted observations of registrar consulting sessions during ECT visits, semi-structured interviews with both registrars and supervisors following the ECT visit, follow-up phone calls to registrars one week after the visit, and ECT visitor reflections.
The findings of this study highlight the value of the ECT visit in general practice training, and the potential for training of both registrars and supervisors to improve the effectiveness of both in-consultation and deferred help-seeking and help provision.
A training intervention has been developed and is currently being evaluated in a follow-up study (see COSA ; Current projects)
Medical Educators: Where do they come from? Exploring the barriers and enablers to becoming a medical educator.
GPTQ investigators: Dr Rebecca Stewart, Dr Graham Emblen, Dr Scott Preston, Michelle Sheldrake, Dr Peter Coxeter.
Collaborators: Dr Ben Mitchell (University of Queensland), Dr Lina Zbaidi (Northern Territory General Practice Education), Dr Vanessa Moran (GP Synergy), Dr Lisa Fraser (General Practice Medical Education Inc.).
Funding: RACGP Education Research Grant 2018-2019
The aim of this study was to explore the barriers and enablers for Medical Education career recruitment and retention, and to define opportunities to improve career pathways for Medical Educators.
We used an exploratory sequential mixed-methods design. The initial phase involved focus groups with GP Supervisors, Medical Educators and External Clinical Teaching visitors recruited via GPTQ, GP Synergy, NTGPT, GPME and the RACGP Medical Education Network. Following the focus groups, results from data analysis were used to inform the development of a survey delivered to a larger participant sample. Key informant interviews were then undertaken with experienced educators to determine how the barriers and enablers may be modifiable at an organisational level.
The findings inform our understanding of the levers that may influence early recruitment and then retention of medical educators into this workforce and the roles they my undertake.
Recruiting and retaining general practitioners in rural practice: systematic review and meta‐analysis of rural pipeline effects
GPTQ investigators: Ms Jessica Ogden, Dr Scott Preston, Dr Peter Coxeter
Collaborators: A/Prof Riitta Partanen (University of Queensland Rural clinical School), Dr Remo Ostini (University of Queensland Rural Clinical School)
Funding: None dedicated
The aim of this study was to synthesise quantitative data on the effects of rural background and experience in rural areas during medical training on the likelihood of general practitioners practising and remaining in rural areas.
We conducted a systematic review and meta‐analysis of the effects of rural pipeline factors (rural background; rural clinical and education experience during undergraduate and postgraduate/vocational training) on likelihood of later general practice in rural areas.
We searched electronic database records (MEDLINE (Ovid), EMBASE, Informit Health Collection, and ERIC electronic database) published to September 2018, bibliographies of retrieved articles, and grey literature.
These findings could inform government‐led initiatives to support an adequate rural GP workforce.
Multi-source feedback: Performance and reflectivity in Practice Experience Program participants
GPTQ Investigators: Dr Rebecca Stewart, Dr Caitlin Vayro, Dr Ben Mitchell, Dr Jan Hanson, Dr Dale Hanson, Dr Mike Hurley, Dr Jaime Hurley, Dr Peter Coxeter
Collaborators: A/Prof Michael Greco (Client Focused Evaluation Program), Prof Ajit Narayanan (Auckland University of Technology), Dr Kristen Fitzgerald (General Practice Training Tasmania), Dr Pat Giddings (Remote Vocational Training Scheme), Dr Neil Spike (EV GP Training)
Funding: RACGP Education Research Grant 2020
Multisource feedback (MSF) has been included as a requirement for the RACGP Practice Experience Program (PEP). However, there is currently no evidence of the utility of MSF within the PEP, nor is there an understanding of how reflection on the MSF process might impact upon its value as an education and assessment activity.
The aim of this study is to ascertain if the MSF results of PEP participants is comparable to that of AGPT Registrars and the broader population of General Practitioners, as well as compare the self-reflective ability of PEP participants during MSF to perceived reflective capacity during MSF feedback.
The findings of this study will inform a better understanding the utility of MSF in those more likely to have career and assessment difficulties, enabling Medical Educators to provide enhanced support.
A realist evaluation of an innovative supervisor training intervention with the aim of achieving safe and efficient consultation-based oversight, support and advice (COSA) which enhances registrar learning
GPTQ Investigators: Dr Elizabeth Fitzmaurice, A/Prof Marie-Louise Dick, Dr John Buckley, Michelle Sheldrake
Collaborators: Dr Nancy Sturman (University of Queensland), Dr Lina Zbaidi (Northern Territory General Practice Education), Dr Gerard Ingham (Murray City Country Coast GP Training)
Funding: RACGP Education Research Grant 2020
The aim of this study is to pilot and evaluate an evidence-based supervisor training intervention which aims to achieve safe, effective and efficient in-consultation supervision, which also enhances registrar learning.
The intervention consists of a 3-hour supervisor workshop (or a 90-minute online workshop) and a Supervisor Toolkit. The Supervisor Toolkit includes five tools: a new model for in-consultation supervision; two “Flags for Help-seeking” checklists; and two tools for Reflection and Feedback on in-consultation help-seeking and supervision.
The evaluation uses a realist evaluation lens, and is collecting data via surveys, interview and focus group data, from supervisors, registrars and workshop facilitators.
Sturman, N., Fitzmaurice, L., Lee, C., Sheldrake, M. and Ingham, G., 2021. Flags for seeking help: making supervisor expectations of general practice trainee help-seeking explicit. Education for Primary Care, 32(2), pp.109-117.
Sturman, N., Fitzmaurice, L., Ingham, G., Lee, C. and Sheldrake, M., 2021. Getting good help: a guide for reflection, debriefing and feedback conversations about in-consultation supervision. Education for Primary Care, 32(2), pp.118-122.
Sturman, N., Fitzmaurice, L., Lee, C., Sheldrake, M. and Ingham, G., 2021. Good help: a model for providing in-consultation supervision of general practice trainees. Education for Primary Care, 32(2), pp.104-108.
Note: RACGP members can access these publications via the John Murtagh library.
Safe learning environments for rural GP trainees: understanding the relationship between emotions, psychological safety and feedback
GPTQ Investigators: Dr Marie-Louise Dick, Michell Sheldrake
GPTQ Medical Educator / Research trainee: Dr Matt French
Collaborators: Dr Christy Noble (University of Queensland), A/Prof Rola Ajjawi (Deakin University), A/Prof Margaret Bearman (Deakin University), Dr Kay Brumpton (Griffith University, Queensland Rural Medical Education), Megan O’Shannessy (Queensland Rural Medical Education)
Funding: ACRRM Education Research Grant 2020
Feedback forms a significant source of learning for GP registrars. However, emotions and the strength of the educational alliance influences how feedback information is framed by the trainee and whether it is used or not. This means that supervisor investment in feedback may not be productive without a psychologically safe environment; instead registrars may seek to avoid it.
The aim of this study is to investigate how emotions and psychological safety influence GP trainees’ (i.e. rural registrars) engagement with feedback processes and learning.
Findings from this research will provide important insights regarding the role of supervisors, registrars and medical educators in effectively attending to emotions, and supporting and maintaining psychologically safe learning environments to generate productive education alliances for improved feedback outcomes.