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In-consultation information and advice-seeking by Australian GP trainees from GP trainers - a cross-sectional
Simon Morgan1, Susan Wearne2, Amanda Tapley3
1General Practitioner and Medical Educator, General Practice Training Valley to Coast, PO Box 573, HRMC, NSW 2310, Australia. simon.morgan@gptvtc.com.au.
Introduction:
The apprenticeship model of general practice (GP) training is based on appropriate supervision. A central component of supervision - in-consultation information-seeking of GP trainees from their trainer - has not been documented. We aimed to establish the prevalence, characteristics and associations (trainee, practice, patient and consultation) of this information-seeking.
Methods:
Australian trainees recorded demographic, clinical and educational details of 60 consecutive consultations in each GP term of their training, including the rate and nature of information-seeking.
Results:
Six-hundred and forty-five trainees contributed data for 1426 trainee-rounds, 84 723 consultations and 131 583 problems. Information was sought from the trainer for 9130 (6.9% (95% CI 6.8-7.1)) of all problems encountered (and in 7833 (9.2% (95% CI 9.0-9.4)) of consultations): 11.7% (95% CI 11.0- 12.4) were for diagnosis, 53.1% (95% CI 52.1-54.2) for management and 35.2% (95% CI 34.2-36.2) for both diagnosis and management. Assistance was sought most commonly for skin problems (20.0%) and musculoskeletal problems (12.6%). Significant adjusted associations of information-seeking included patient age; male patient gender; earlier training term; trainee being younger and female; trainee's training organisation; longer consultation; and trainee generation of learning goals.
Discussion:
Our findings have implications for trainer workload and professional development, patient care and trainee education and training.
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