Evaluation of general practice house officer attachments in Counties Manukau: insights and benefits

Abstract

BACKGROUND The Medical Council of New Zealand requires graduating doctors to have community attachments within their first two years of practice by 2020. Counties Manukau Health has developed a programme where house officers (HOs) are attached to a general practice for three months. AIM This study aimed to establish the value of four HO general practice attachments in Counties Manukau and describe how HOs are being used in these practices. METHODS A mixed-methods design was used to evaluate three attachment runs. Two practices provided the number of patients seen by HOs. Fifty-eight patients were surveyed to assess patient perceptions of the HOs. Six HOs, four supervising general practitioners, two PHO senior staff and one practice manager participated in semi-structured interviews. Focus groups were held with nurses, doctors and administrative staff at all four practices. FINDINGS HOs saw 300-600 patients in one practice and 800-1000 in the other during their attachment. Practices developed their own approach to mentoring and teaching HOs. Most patients reported positive perceptions of the HOs. Themes from interviews and focus groups were consistent among participants and included: improved HO confidence, clinical skills and understanding of general practice; extra capacity and improved quality of care and staff satisfaction among practices. CONCLUSION HOs and practices viewed HO attachments in general practice positively. HOs developed clinical skills and understanding of primary health care. Practice teams enjoyed the energy and enthusiasm of the HOs, while providing clinical support to ensure quality patient care.

From the Editor: Forces of nature

“…Le Comte et al report their evaluation of the new House Officer attachments in one region. 2 Although GPs, house officers, and patients all appreciated the educational value of these attachments, there were challenges in dealing with the financial costs to general practices. The funding model for 20 th century house officer training is at odds with the ideals of house officer preparation for 21 st century medical practice and solutions have yet to be found.…”