What are the perceived learning needs of Australian general practice registrars for quality prescribing?

Abstract

BackgroundLittle is known about the perceived learning needs of Australian general practice (GP) registrars in relation to the quality use of medicines (QUM) or the difficulties experienced when learning to prescribe. This study aimed to address this gap.MethodsGP registrars' perceived learning needs were investigated through an online national survey, interviews and focus groups. Medical educators' perceptions were canvassed in semi-structured interviews in order to gain a broader perspective of the registrars' needs. Qualitative data analysis was informed by a systematic framework method involving a number of stages. Survey data were analysed descriptively.ResultsThe two most commonly attended QUM educational activities took place in the workplace and through regional training providers. Outside of these structured educational activities, registrars learned to prescribe mainly through social and situated means. Difficulties encountered by GP registrars included the transition from hospital prescribing to prescribing in the GP context, judging how well they were prescribing and identifying appropriate and efficient sources of information at the point of care.ConclusionsGP registrars learn to prescribe primarily and opportunistically in the workplace. Despite many resources being expended on the provision of guidelines, decision-support systems and training, GP registrars expressed difficulties related to QUM. Ways of easing the transition into GP and of managing the information 'overload' related to medicines (and prescribing) in an evidence-guided, efficient and timely manner are needed. GP registrars should be provided with explicit feedback about the process and outcomes of prescribing decisions, including the use of audits, in order to improve their ability to judge their own prescribing.

Preparation for general practice vocational training: time for a rethink

“…Registrars work in a community of practice, but the observation and role modelling from experts, and the graded increase in work complexity according to proven skills — hallmarks of an industrial apprenticeship 14 — rarely occur. GP registrars describe the transition from hospital as scary and isolating 15 . Anecdotally, supervisors report that new GP registrars are more anxious, have reduced repertoires of the illness scripts needed in general practice, and have fewer skills in making decisions and managing multimorbidity.…”

“…GP registrars describe the transition from hospital as scary and isolating. 15 Anecdotally, supervisors report that new GP registrars are more anxious, have reduced repertoires of the illness scripts needed in general practice, and have fewer skills in making decisions and managing multimorbidity.…”

Necessidades De Treinamento: Uma Proposta De Avaliação Estratégica No Contexto De Empresas Juniores Brasileiras

“…• necessidades de treinamento • O objetivo de uma ANT é identificar necessidades de treinamento expressas por lacunas de competências que impedem a caracterização de um desempenho no trabalho como excelente nos mais diversos contextos de atuação (Carlisle, Bhanugopan, & Fish, 2011;Trudeau, Ainscough, Trant, Starker, & Cousineau, 2010;Ajjawi, Thistlethwaite, Aslani, & Cooling, 2010;Akhtar-Danesh et al, 2010;Ateudjieu et al, 2010;Cofré et al, 2010).…”

The competent prescriber: 12 core competencies for safe prescribing

“…24 Registrars have expressed difficulty in judging the quality of their own prescribing. 11 The 12 core prescribing competencies and their accompanying criteria and assessments could serve as a formative tool for giving explicit feedback about the process and outcome of prescribing decisions. The competencies can also be used as a summative tool.…”