Teaching and mentoring

'Good Samaritan' course for GP trainees

An online questionnaire sent to all GP trainees on the Dorset Vocational Training Scheme found that 70% had responded as a Good Samaritan, for instance, on a plane or at a road traffic collision. 51% reported no previous training in Good Samaritan acts and 70% wanted more training.

A 1-day course was delivered to 45 final-year GP trainees, using outdoor simulation-based workshops (e.g., falls from a bridge; cervical spine assessment; hypo/hyperthermia on the beach; a casualty with painful leg at a road traffic collision). Ethical and legal considerations of the Good Samaritan role were also considered, alongside leadership skills, team-working, effective communication and handover of care. Feedback was overwhelmingly positive.

WiseGP actions:

• Run a simulated 'Good Samaritan’ teaching session for GP trainees within your PCN. Good Samaritan acts often focus on physical health problems- how about testing their response to someone in acute distress, confused or suicidal?

  
  

• Have a practice training session to test and develop your team’s skills in responding to a simulated emergency at the practice. Challenge their whole-person centred approach by adding everyday complexity to simulations (e.g., hypoxic patient with pneumonia, who refuses an acute admission as they need to return home to care for their wife with dementia).

Read more about this work informing this GEM here:

https://bjgp.org/content/65/633/e270

Ensure variety, continuity and opportunities to learn about the business

GPs value exposure to work in other settings (A&E/ prison doctor) or an opportunity to learn about extended practice roles in research and teaching. They value the ability to maintain continuity with their patients. They also value opportunities to learn about the business side of general practice.

WiseGP actions:

• Provide GP trainees the opportunity to shadow GPs working in other settings within your PCN or to speak to GPs with extended roles they may be interested in. You could also suggest they explore our WiseGP Stories on the website.

• Ensure GP registrars can book follow-up appointments with patients they have seen to facilitate continuity.

• Invite GP registrars to practice business meetings, give them the opportunity to shadow the practice manager or give them the chance to take on a role for meeting QOF targets.

Read more about this research here:

bjgp.org

Background General practice is becoming increasingly complex due to an ageing population with multiple morbidities and the shift of services from secondary to primary care, yet GP training remains largely the same. Extended training is now recommended, initially proposed as a fourth GP specialty trainee year, but more recently as a broad-based 4-year specialty training programme. Aim To explore the views of newly-qualified GPs about their training and preparedness for specific aspects of the GP’s role. Design and setting Qualitative study with newly-qualified GPs who qualified with Severn Deanery between 2007 and 2010. Method Semi-structured interviews with 18 GPs between November 2011 and April 2012. Results Gaining experience in a variety of primary care environments widens insight into patient populations as well as helping GPs develop adaptability and confidence, although this is not routinely part of GP training. However, alongside variety, having continuity with patients in practice remains important. Opportunities to be involved in the management of a practice or to take on substantial leadership roles also vary widely and this may limit preparedness and development of generalist skills. Conclusion Extended training could help prepare GPs for the current challenges of general practice. It could ensure all trainees are exposed to a greater variety of primary care settings including those outside GP practice, as well as experience of business, finance, and leadership roles. Collectively, these changes have the potential to produce GPs with both generalist and enhanced skills, who are better prepared to work collaboratively across the organisational boundaries between primary, secondary, and community care.

Supporting GP trainees with specific learning difficulties

Substantial numbers of clinicians have specific learning difficulties (SpLDs) and failure to accommodate their needs can disadvantage them academically. A study aimed to investigate how SpLDs affected the performance of GP registrars during their specialty training.

Candidates with SpLD performed significantly less well on the CSA (particularly on interpersonal skills and clinical management skills), but not the AKT or RCA. They were more likely to have difficulties with WPBA.

WiseGP Actions:

• Do you know what tailored support is available for GP trainees with SpLDs in your area for training and assessment? If not, approach with your local TPDs for advice.

Read more here:

https://onlinelibrary.wiley.com/doi/10.1111/medu.15008