Perceptions of the effectiveness of using patient encounter data as an education and reflection tool in general practice training

Abstract

Introduction Patient encounter tools provide feedback and potentially reflection on general practitioner (GP) registrars’ in-practice learning and may contribute to the formative assessment of clinical competencies. However, little is known about the perceived utility of such tools. Aim To investigate the perceived utility of a patient encounter tool by GP registrars, their supervisors, and medical educators (MEs). Methods General practice registrars, supervisors and MEs from two Australian regional training organisations completed a cross-sectional questionnaire. Registrars rated how Registrar Clinical Encounters in Training (ReCEnT), a patient encounter tool, influenced their reflection on, and change in, clinical practice, learning and training. Supervisors’ and MEs’ perceptions provided contextual information about understanding their registrars’ clinical practice, learning and training needs. Results Questionnaires were completed by 48% of registrars (n = 90), 22% of supervisors (n = 182), and 61% of MEs (n = 62). Most registrars agreed that ReCEnT helped them reflect on their clinical practice (79%), learning needs (69%) and training needs (72%). Many registrars reported changing their clinical practice (54%) and learning approaches (51%). Fewer (37%) agreed that ReCEnT influenced them to change their training plans. Most supervisors (68%) and MEs (82%) agreed ReCEnT reports helped them better understand their registrars’ clinical practice. Similarly, most supervisors (63%) and MEs (68%) agreed ReCEnT reports helped them better understand their registrars’ learning and training needs. Discussion ReCEnT can prompt self-reflection among registrars, leading to changes in clinical practice, learning approaches and training plans. Reaching its potential as an assessment for learning (as opposed to an assessment of learning) requires effective engagement between registrars, their supervisors and MEs.

Exploring how a patient encounter tracking and learning tool is used within general practice training: a qualitative study

“…This study further clarifies the utility of ReCEnT as a PETAL tool, as established in the quantitative arm of the project, 14 and offers greater understanding of the potential of ReCEnT as a tool that not only helps to identify GP registrars' learning needs, but also provides objective data on registrars' clinical exposure. Although ReCEnT feedback reports aid in providing reassurance and promoting self-reflection by registrars on their practice, ReCEnT has greater potential where there is a culture of reflection leading to opportunities for meaningful discussions with supervisors and MEs.…”

“…The study builds on quantitative survey findings regarding perceptions of registrars, MEs, and supervisors about the utility of ReCEnT for reflection on, and change to, registrar learning and clinical practice. 14…”

“…Key informants for focus groups were identified by the two RTOs and directly invited. For interviews, three avenues of invitation were deployed: (1) key informants who could not attend a focus group (eg unsuitable time) were automatically invited; (2) participants who completed a quantitative survey (conducted as part of a larger study) 14 were invited to express interest in an interview; and (3) an email invitation was sent by each RTO to further seek interest in interviews by registrars, supervisors and MEs who met the inclusion criteria but did not respond to the quantitative survey. Among those who expressed an interest (avenues 2 and 3), purposive selection was undertaken to get a broad sample based on demographic variables (eg age, gender, country of primary medical degree, location of practice).…”

“…PETALs offer a systematic approach to determine clinical exposure in general practice, but to our knowledge, published research investigating the utility of PETAL data is limited to our 2023 study. 14 Reviews of older methods, such as logbooks that provide information on patient mix and learning 15 and audits that compare clinical practice to established guidelines, 16 have shown that with feedback, some changes in learning outcomes 15 and in clinical practice 16 can occur. A qualitative study of established GPs found feedback and peer discussion about audits provided motivation for practice change.…”

Doing the ‘bread and butter’ of general practice well in uncertain times

“…6 This issue features three ReCEnT research studies. Klein and colleagues 7 surveyed registrars, supervisors and medical educators regarding the effectiveness of ReCEnT as an educational tool for registrars to enhance reflection and influence change in practice. They found that ReCEnT can prompt self-reflection among registrars, leading to changes in clinical practice, learning approaches and training plans.…”