BACKGROUND: In studies exploring the patient mixes of general practitioner (GP) trainees, gaps were repeatedly found, as there were disparities between the patient mixes of GP trainers and trainees. This reduces the opportunities of trainees to acquire enough competence. AIMS: To investigate whether steering the patient mix can be effectuated by instructing medical receptionist, trainer and trainee, and to study the effects of this intervention on trainee's self-efficacy (SE) and knowledge. METHOD: Randomized Controlled Trial (RCT). After a six-month basic registration period, 73 trainees were randomized. Patients with skin conditions and psychosocial conditions were actively assigned to trainees in the intervention group (n=35) during two successive periods of three months. The patient mix was measured by extracting data from electronic patient records. Learning outcomes were measured by SE questionnaires and by a knowledge test. RESULTS: No increase was found in patient volume and diversity of the steered conditions in the intervention group as compared to the control group. However, the percentual increase of exposure to skin conditions was greater in the intervention group. No difference in skin SE and psychiatric knowledge was found. The increase of psychosocial SE was greater in the intervention group. In a regression analysis, patient volume was a significant predictor of both skin and psychosocial SE. CONCLUSIONS: Despite the difficulty in implementing steering in daily practice, tailoring the patient mix to the individual learning needs of trainees could be considered.
RCT Entities:
BACKGROUND: In studies exploring the patient mixes of general practitioner (GP) trainees, gaps were repeatedly found, as there were disparities between the patient mixes of GP trainers and trainees. This reduces the opportunities of trainees to acquire enough competence. AIMS: To investigate whether steering the patient mix can be effectuated by instructing medical receptionist, trainer and trainee, and to study the effects of this intervention on trainee's self-efficacy (SE) and knowledge. METHOD: Randomized Controlled Trial (RCT). After a six-month basic registration period, 73 trainees were randomized. Patients with skin conditions and psychosocial conditions were actively assigned to trainees in the intervention group (n=35) during two successive periods of three months. The patient mix was measured by extracting data from electronic patient records. Learning outcomes were measured by SE questionnaires and by a knowledge test. RESULTS: No increase was found in patient volume and diversity of the steered conditions in the intervention group as compared to the control group. However, the percentual increase of exposure to skin conditions was greater in the intervention group. No difference in skin SE and psychiatric knowledge was found. The increase of psychosocial SE was greater in the intervention group. In a regression analysis, patient volume was a significant predictor of both skin and psychosocial SE. CONCLUSIONS: Despite the difficulty in implementing steering in daily practice, tailoring the patient mix to the individual learning needs of trainees could be considered.
Authors: Kimberly A Mc Cord; Hannah Ewald; Aviv Ladanie; Matthias Briel; Benjamin Speich; Heiner C Bucher; Lars G Hemkens Journal: CMAJ Open Date: 2019-02-03
Authors: Sarah de Bever; Suzanne C van Rhijn; Nynke van Dijk; Anneke Kramer; Mechteld R M Visser Journal: BMJ Open Date: 2019-12-15 Impact factor: 2.692
Authors: Parker Magin; Simon Morgan; Kim Henderson; Amanda Tapley; Patrick McElduff; James Pearlman; Susan Goode; Neil Spike; Caroline Laurence; John Scott; Allison Thomson; Mieke van Driel Journal: BMC Med Educ Date: 2014-12-10 Impact factor: 2.463