Education Posters 551 – 557
551 “Engaging primary care”: Health Education England genomics education programme strategy for delivering genomics education within primary care
Developments in genomics within cancer diagnosis and treatment, familial cancer, prescribing, rare diseases, infectious diseases and complex disease all have the potential to impact on primary care. The transformational Department of Health-funded 100,000 Genomics Project has accelerated the pace of scientific discovery within genomic medicine, aspiring to integrate genomics into routine clinical care.
An increasing number of patients will be able to access genomic testing through research programmes, routine clinical care, or direct-to-consumer testing from commercial companies. They and their relatives will turn to primary care practitioners (PCPs) including GPs for discussion and advice of these results; for example a patient with results of a commercial genomic screen, or whose family member carries a pathogenic variant associated with cancer, or a mother wishing to discuss a neonatal screening test.
PCPs will need to be equipped with the knowledge, skills and resources to communicate sequenced genomic information, understand the implications and institute appropriate management. Health Education England’s (HEE) Genomics Education Programme has outlined its strategy “Engaging Primary care”, launching an educational needs assessment specific to genomics.
This poster summarises the 3 components of the educatioal needs assessment: a Delphi-style survey to identify core genomic clinical activities and competencies required, an audit to identify existing educational resources, and a questionnaire survey to investigate how PCPs access information regarding genomics within the consultation (“just-in-time” resources). It will also provide some preliminary findings.
This information will be crucial to future development of resources and curricula, and in ensuring every PCP is equipped as genomics increasingly impacts on routine clinical care.
552 Increasing exposure to general practice as an undergraduate is associated with an increased preference for general practice as a career
Aims/objectives To establish whether there is a link between the quantity of undergraduate primary care teaching and the intention of foundation doctors to pursue a career in GP.
Content of presentation To further explore the implications this data may have on undergraduate curricula and the type of general practice exposure they provide i.e. authentic and non-authentic teaching.
Relevance/Impact It has been demonstrated that the quantity of exposure to GP teaching at medical school is associated with future GP career choice. The GMC have mandated that universities recognise the importance of educating in GP, in a bid to increase the uptake to the training scheme. In the current recruitment crisis this data is relevant and could help encourage universities to reevaluate their curriculum to encompass more GP teaching.
Outcomes A significant association was demonstrated between the quantity of authentic GP teaching per medical school and the percentage of their F2 (Foundation doctors year 2) graduates who selected GP training in both 2014 (r=0.41, p=0.027) and 2015 (r=0.3, p=0.044).
Discussion We have clearly demonstrated, for the first time in the United Kingdom, a significant association between the quantity of clinical undergraduate GP teaching and career choice of GP. This association, previously presumed but not demonstrated, has significant implications for medical schools and Health Education England. This study suggests that an increased percentage of medical school funding should be directed towards general practice placements in order to ensure that HEE meets its obligations to the Government.
553 Vodcasts to support educational supervisors in using the ePortfolio
Background GP trainees maintain an ePortfolio online over the duration of the training programme to record evidence from workplace-based assessment (WPBA) in order to demonstrate their developing competence. Educational Supervisors (ESs) are required to validate this evidence. There is no formal, hands-on teaching for supervisors on how to use this eportfolio, instead there is a 45 page manual. We felt that more user-friendly support was needed for supervisors aimed at showing them how to use the ePortfolio.
Summary of work A suite of video tutorials (‘vodcasts’) were created. They are 3-6 minutes long and concern accessing the eportfolio and performing the various supervisor management and validation tasks. The vodcasts use a live supervisor’s account and all are recorded in real time. They were uploaded to YouTube and advertised on the GPEU twitter feed. They are tagged with keywords, and so can be accessed at anytime. Users can also search for specific tutorials without having to watch long clips for particular segments.
Summary of results Early informal feedback from users has been positive, and a more formal evaluation is underway.
Discussion The use of video tutorials gives supervisors a more interactive source of information on how to use the eportfolio; users can work at their own pace, pause and rewind as needed and they can follow the steps in completing a task on screen in real time.
Conclusions /Take-home messages This vodcast pilot will broaden the educational support tools for supervisors, and if positively received may be rolled out more widely.
554 Does CSA preparation develop ongoing skills for a future in general practice and what areas do trainees and newly qualified GPs feel are missing?
Background: Many GP trainees have heard the phrase “we will teach you to pass your Clinical Skills Assessment (CSA) and then we will teach you what you need to be a GP”. As a GP education fellow involved in the teaching of GP trainees, I am interested in the impact of preparing for the CSA on the final year of GP training. The aim of my enquiry is to look at perceptions of how the CSA shapes GP training, particularly in the last year, and once qualified, whether GPs feel that their CSA preparation developed their consultation skills which are now used on an on-going basis.
Method: Current GP ST3 trainees and newly qualified GPs were interviewed using a semi-structured interview schedule. The interviews were transcribed and the transcripts that were analysed for themes and relationships to existing literature.
Results: Clear themes emerged including reflections around the absence of the opportunity to deal with multiple problems in the CSA, the benefits of developing skills in time-keeping and establishing ideas, concerns and expectations and the need to ensure the training program is not only CSA dominated, particularly as trainees may take the exam at various points over a year.
Conclusions: For trainees, the importance of completing exams and assessments can direct the final year of GP training and shape their learning activities. It is important that the teaching program remains focused on a broad set of skills and that areas which are not covered in the formal assessments are addressed.
555 Clinical Debrief: An innovative GP-led model preparing undergraduate medical students for practice
Aim To explore how patient participation groups (PPGs) can best assist practice improvement in vulnerable practices.
Content An initial evaluation of how best to support practices in special measures gathered minimal data on the role of PPGs. This study extends the understanding of this key topic through semi-structured interviews with purposively selected individuals and focus groups of patients, practice staff, GPs, RCGP practice support advisers and others. The focus of the discussions was the role of PPGs in practices placed in special measures.
Relevance In December 2015 NHS England announced a £10m programme to offer support to vulnerable practices. Ultimately, patients benefit when practices make improvements and climb out of ‘special measures’. The identification of PPG best practice in challenging circumstances should benefit other practices facing difficulties.
Outcomes Whilst some practices entering special measures had a PPG, others did not. Each of these situations brings its own challenges. Setting up new, effective PPGs takes time whilst the role of existing PPGs may need to change. Overly supportive PPGs may contribute to a practice’s denial of difficulties and strong PPGs may resist changes important to the practice’s future. Effective support and challenge depends upon an honest and informed relationship with the practice. An information leaflet offering suggestions to PPGs supporting vulnerable practices is being written to supplement the more generic advice already available to PPGs.
Discussion PPGs may take on a variety of often ill-defined roles, whether or not a practice is struggling. If substantial improvements are needed it is particularly important to agree the role of the PPG, especially the balance of support versus challenge the PPG will provide.
556 Near-peer facilitation: an under-utilised resource in GP education
Aims The GMC and RCGP curriculums highlight the importance of teaching, training and mentoring of junior doctors (1). Bulte et al identify a near-peer tutor as ‘a trainee one or more years senior to another trainee on the same level of medical education training’ (2). Near-peer teaching has not been widely used in GP training programmes (3). The aims of the study were to assess the acceptability and perceived usefulness of ST3 GP trainees facilitating small groups of ST2 GP trainees.
Method Two ST3 GP trainees led small group discussions for ST2 GP trainees over a 3-month period. The sessions were structured by the ST3s to include preparation for registrar year, examinations, e-portfolio and out-of-hours. Questionnaires were used to assess the acceptability and usefulness of the sessions. Programme Directors observed the sessions and gave feedback.
Outcomes 100% of ST2s agreed or strongly agreed that the near-peer teaching sessions were a useful experience and that the ST3’s recent insight was beneficial. Qualitative analysis showed that the sessions were particularly valued by the ST2s: “Definitely feel it is important we all get a chance to have this.”
Discussion Near-peer teaching is ‘win-win’ for GP training programmes, GP ST3 teachers and GP ST2 recipients. It is a cost-effective way of reinforcing education for training. We propose that near-peer teaching is an underutilised resource in GP training programmes and could be employed locally and nationally.
557 The impact of gender and age on medical students’ perception of General Practice as a career
The link between gender and age and General Practice as a career is an interesting one. Past studies have shown that General Practice tends to be favoured by females and those of an older age, due to factors such as more flexibility in working hours and a possible better work-life balance for a family. Research is currently being carried out to investigate medical students’ attitudes towards General Practice as a career, and whether gender and age affects this.
This research follows on from data collected last year about medical students’ attitudes General Practice, and the results will eventually be compared and contrasted. A qualitative and quantitative online questionnaire was created using SurveyMonkey and sent out to medical students in all years of their studies. Questions asked include those about factors affecting the student’s career choice; their past experiences with General Practice placements; and enquiries about age and gender.
Results will be analysed in September 2016 using statistical analysis and qualitative data analysis, before conclusions are drawn based on statistical significance and data trends. These results may be used to target medical students and recruit their interest in General Practice early on, or to change General Practice placements so that students have a more beneficial and enjoyable time.