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From novice to proficient general practitioner: a critical incident study
M G Sim1, M Kamien, M R Diamond
1University of Western Australia, Australia.
Australian Family Physician
|September 1, 1996
Summary
Doctors in the Royal Australian College of General Practitioners (RACGP) Training Program showed improved confidence and reduced anxiety with experience. While many skills advanced, challenges persisted in specific medical areas and patient management.
Area of Science:
- Medical Education
- General Practice Training
- Qualitative Research
Background:
- Assessing the impact of advancing experience on general practitioners (GPs) in vocational training is crucial for medical education.
- The Royal Australian College of General Practitioners (RACGP) Training Program aims to equip doctors with essential skills for comprehensive patient care.
- Understanding the evolving performance and perceptions of trainees is key to refining training methodologies.
Purpose of the Study:
- To evaluate changes in performance and perceptions of doctors during the RACGP Training Program as their general practice experience increases.
- To identify specific areas of skill development and persistent challenges faced by GP trainees.
- To assess the effectiveness of the RACGP Training Program in fostering competence and confidence.
Main Methods:
- A qualitative comparative analysis using the Critical Incident Technique was employed.
- Interviews were conducted with 18 Western Australian doctors at two distinct stages of their RACGP training (6 months and advanced/mentor terms).
- The study involved analyzing critical incidents reported by doctors to gauge changes in their professional practice and self-perception.
Main Results:
- Doctors reported an increase in the number of critical incidents from the initial to the later interview (4.4 to 5.0).
- Significant improvements were observed in patient relationships, interprofessional collaboration, specific clinical skills (paediatrics, orthopaedics), and managing complex conditions.
- Areas of ongoing difficulty included gynaecology, pharmacotherapy, dermatology, managing challenging patients, and dealing with diagnostic uncertainty and guilt.
Conclusions:
- Advancing experience within the RACGP Training Program fosters competence, confidence, and reduced performance anxiety among doctors.
- The training program was perceived as beneficial by most participants in developing professional proficiencies.
- The Critical Incident Technique proved to be an effective tool for learning and assessment within vocational medical training.