Problems managed by Australian general practice trainees: results from the ReCEnT (Registrar Clinical Encounters in Training) study

Morgan, Simon, Henderson, Kim, Tapley, Amanda, Scott, John, Thomson, Allison, Spike, Neil, McArthur, Lawrie, van Driel, Mieke and Magin, Parker (2014) Problems managed by Australian general practice trainees: results from the ReCEnT (Registrar Clinical Encounters in Training) study. Education for Primary Care, 25 3: 140-148.

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Name Description MIMEType Size Downloads
Author Morgan, Simon
Henderson, Kim
Tapley, Amanda
Scott, John
Thomson, Allison
Spike, Neil
McArthur, Lawrie
van Driel, Mieke
Magin, Parker
Title Problems managed by Australian general practice trainees: results from the ReCEnT (Registrar Clinical Encounters in Training) study
Journal name Education for Primary Care   Check publisher's open access policy
ISSN 1473-9879
1475-990X
Publication date 2014-04-01
Sub-type Article (original research)
Volume 25
Issue 3
Start page 140
End page 148
Total pages 9
Place of publication Milton Keynes, United Kingdom
Publisher Radcliffe Publishing
Language eng
Subject 2739 Public Health, Environmental and Occupational Health
Formatted abstract
Background: Previous studies have found that general practitioner (GP) trainees (registrars) see a different spectrum of clinical problems compared to trainers, including less chronic disease and more acute minor illness. Our aim was to describe the case mix of first-term Australian GP trainees.

Methods: This was a cross-sectional analysis of trainee consultations. Descriptive analyses were used to report patient demographics and the number and type of problems managed.

Results: Two-hundred-and-three trainees provided data on 36 182 consultations and 55 740 problems. Overall, 60.7% of patients seen were female and 56.2% were new to the trainee. Trainees managed a mean of 154.1 problems per 100 encounters. Problems managed most commonly were respiratory (23.9 per 100 encounters), general/unspecified (21.8) and skin (16.4). New problems comprised 51.5% of the total, and 22.4% of problems were chronic diseases.

Conclusion: Trainees gain reasonably broad exposure overall in terms of patient demographics and problems managed. In comparison to established GPs, trainees managed the same mean number of problems, but the nature of problems managed was different, with more new patients, more new problems and less chronic disease. Our findings have significant implications for GP training in Australia.

What is already known in this area
⦁ Broad clinical exposure is a key element of comprehensive training.
⦁ There are particular clinical areas in which GP trainees require satisfactory exposure and training to meet emerging health needs, including complex, chronic disease management.
⦁ There are differences in the clinical exposure of trainees and trainers, with trainees seeing less chronic disease and more acute minor illness.
What this work adds
⦁ This is the first published study on the content and nature of patient encounters with trainees in Australian general practice training.
⦁ Trainees manage almost exactly the same number of problems per encounter as established GPs.
⦁ Trainees see a different patient demographic and different clinical spectrum compared to established GPs, with more new patients, more new problems and less chronic disease.
⦁ Trainees have a relative lack of opportunity for continuity of care with patients.
Suggestions for future work or research
⦁ To explore the associations of continuity of care and chronic disease management.
⦁ To examine changes in individual trainee clinical exposure over the course of training.
⦁ To implement and evaluate models of trainee management of chronic problems.
Keyword General practice training
Medical education
Patient case-mix
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Discipline of General Practice Publications
Official 2015 Collection
School of Medicine Publications
 
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Created: Tue, 20 May 2014, 12:46:54 EST by System User on behalf of Discipline of General Practice