Teaching and Learning Core Values in General Practice/Family Medicine: A Narrative Review

Abstract

General Practice/Family Medicine (GP/FM) is a key discipline within primary health care and so by extension for the whole health care system. An essential condition for effective GP/FM care is a work force that is highly qualified. As society is changing rapidly, a revision of the GP/FM definition is ongoing, in addition to a recent movement of identifying related core values. In this paper, we want to give an overview on how these new paths and perspectives are currently reflected in GP/FM teaching and training. We selected four core values that fit in with possible future visions: person-centered care, continuity of care, cooperation in care, and community-oriented care. By a narrative review, we observed that GP/FM education toward core values is often built around overarching topics. Teaching and learning take place in specific contexts, most of all through placements within communities, primary care settings, or hospital wards. Mixed teaching- and training methods are used combining knowledge, skills, and attitude. Furthermore, collaboration with other health professionals and peers is stressed, in addition to the importance of role models, a holistic focus and the involvement of patients. Since these core values are important within GP/FM and rather few studies on the educational aspects and learning tools were found we advocate encouraging each other more to share good practices, certainly the innovative ones specifically related to GP/FM.

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“…Continuity of care is essential for patient health and quality of life [16]. Prior literature indicates that enhanced continuity of care can improve patient mortality rates and physician and patient satisfaction levels [17]. The identified gap in outpatient management experience among medical residents underscores the necessity for a more structured and consistent outpatient training approach [16,18].…”

General practice undergraduate and vocational training: ambulatory teaching and trainers’ curriculum and remuneration – a cross-sectional study among 30 member countries of WONCA Europe

“…With this experience, GP trainees can obtain the essential core values, knowledge, skills and attitude to become a general practitioner. This can be strengthened even more by allowing trainees and trainers to inspire each other and thus to share innovative educational methods [ 15 ]. Integration of GP education and training generally has a positive impact on all levels of learners [ 16 ].…”

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“…2 , 70 Fundamental to the values and provision of primary care, generalism involves the ability to manage undifferentiated illness and a wide range of conditions, to see the person as a whole in the context of their family and wider environment, to take on responsibility for continuity of care, and to coordinate care within and between health and social care institutions. 71 , 72 Conceived as such, the elevation of generalism aligns with the increasing emphasis in medical training on cultural and more recently structural competency. 73 , 74 Greater emphasis on generalism in medical training is also a necessary condition for actualising syndemic care.…”

“…It also entails the capacitation of multi-or trans-disciplinary teams to provide preventative and curative care at community level. 71,72 South Africa, already ahead of the curve, has trained ward-based outreach teams of physicians, nurses, and community health workers, 75 strengthened generalist training within the HIV platform through programmes such as SWITCH (Strengthening the Workforce to Improve Treatment and Care of HIV) and sought to align care roles and responsibilities through its Integrated Chronic Disease Management programme. 76 In high-income settings, there has been some pushback against attempts to move towards greater generalism in medicine for reducing specialist opportunities.…”