Closer supervision in Australian general practice training: planning major system change

Area of Science:

• Medical Education
• General Practice Training
• Healthcare Management

Background:

• General practice registrar supervision in Australia requires significant system change.
• Current supervision models may not adequately prepare registrars for independent practice.
• Stakeholder involvement is crucial for effective change management in medical training.

Purpose of the Study:

• To explore the views of stakeholders on current and potential supervisory practices for general practice registrars.
• To identify barriers and facilitators for implementing closer supervision models.
• To inform system changes for improved registrar training.

Main Methods:

• Semi-structured interviews with lead medical educators across nine Australian regions.
• Focus groups conducted with general practice supervisors and registrars.
• Conventional content analysis of interview and focus group transcripts to identify inductive themes.

Main Results:

• Registrars can progress to independent practice within 1-3 months under closer supervision.
• Registrars strongly support closer supervision, while supervisors and educators show less support.
• Key barriers include high clinical demand, insufficient payment for supervision, and lack of supervisor skills/motivation.

Conclusions:

• Implementing closer supervision for general practice registrars is feasible if funding and logistical barriers are addressed.
• Addressing identified barriers is essential for successful system change.
• A pilot study is recommended to refine the proposed changes in registrar supervision.