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Effect of a short skills training course on competence and performance in general practice
J J Jansen1, R P Grol, C P Van Der Vleuten
1Department of General Practice University of Maastricht, Maastricht, The Netherlands.
Objectives:
Evaluation of the efficacy of a short course of technical clinical skills to change performance in general practice.
Design:
Subjects were self-selected general practitioners (n=59) who were unaware of the study design. They were assigned to the intervention group (n=31) or control group (n=28) according to their preference for course date. The course covered four different technical clinical skills (shoulder injection technique, PAP-smear, laboratory examination of vaginal discharge, ophthalmoscopic control in diabetes mellitus). Main outcome measures used were pre- and post-training scores on a knowledge test of skills (60 multiple choice items), and pre- and post-training performance of procedures in practice using a log-diary covering 20 days.
Setting:
University of Maastricht, The Netherlands.
Subjects:
Self-selected general practitioners.
Results:
Competence, as measured by the knowledge test of skills, improved significantly as a result of the training and skills test scores were satisfactory after training. A significant effect on performance in practice was found for PAP-smear and shoulder injection technique, whereas no effect could be demonstrated for examination of vaginal discharge and ophthalmoscopic control in diabetes mellitus.
Conclusions:
A good degree of competence is a necessary but not always sufficient condition for a physician to change his performance in practice. While some skills training seems adequate to bring about desired changes, for other skills more complex interventions are probably needed.
