Education Posters 565 – 571
565 Digital Communities of Practice in GP Training
Aim Trainees working in practices can feel isolated frrom their peers and may only have the opportunity to share their learning experiences with others at training events and away days. Many groups have started to use social media to connect with one another outside of these meetings, highlighting the need for a more pervasive connection with their peers.
Development In Mid Wessex we attempted to facilitate this connection between our ST3s by creating a private online community which they could all contribute to, hosted by the FourteenFish website which many qualified GPs in Wessex use for their learning diary and appraisal tools. ST3s were able to email in their teaching presentations, learning resources and comments and to generate and contribute to discussions. The ST3 Programme Directors and patch administrators were also able to contribute to the content. At the end of the academic year the group was surveyed to assess their opinions of the innovation.
Outcome Trainees found it useful to be able to share and access teaching presentations and learning resources online, and felt that it contributed to their experience within the trainee community. Discussion topics were varied and included administrative, educational and clinical questions for their peers. Weblinks to relevant learning resources were also shared.
Impact The success of the ST3 online community at connecting trainees working in separate clinial settings has prompted the development of two further digital communities of practice within Mid Wessex; for the Programme Directors and Trainer groups, with the hope that the presence of an online forum for connecting with peers will help support them and reduce the feeling of isolation in their personal educational practice also.
567 Global Health Capability framework: What it offers to General Practice
General Practice is a challenging speciality, continually adapting to the interconnected world we are living in today. To support and empower GPs with the knowledge and skills they need to practice effectively in this global community a global health capability framework was developed, published and is open access.
Examples in Practice
Migration: 2015 saw 59 million forcibly displaced people, and this is increasing. Under a diversity, ethics and human rights theme, Global health education develops competence in addressing health needs and rights of refugees.
Unhealthy bodyweight: Globally, obesity prevalence is likely to be at least 18% by 2025, however malnutrition also remains a major problem. Global health competence requires understanding environmental, social and economic determinants of health, which is crucial to addressing complex issues.
Air pollution and climate change: Air pollution kills 40,000 people yearly in the UK. Understanding the global burden of disease requires recognition that health threats are not confined by borders.
Smoking: Factors affecting smoking rates include policy, marketing and global trade. Competencies in global health governance will enable General Practitioners to understand the wider issues that contribute to effective international tobacco control.
Austerity: At a time when austerity and privatisation threaten the NHS, Global Health competencies related to health systems and human resources enable international comparison and learning from other health systems.
Global health capability framework can empower General Practitioners to address effectively contemporary and future health challenges.
568 Giving something back: Introducing GP Trainees to Teaching in Local Schools
Background context Widening access to medicine and positively promoting general practice as a career presented an opportunity for GP trainees to become involved with schools in the locality. This project had the following aims: to inspire a younger generation, especially those from areas of social deprivation where GP may not be an obvious career to enable trainees to give something back to the local community to allow GPs and teachers to gain a deeper understanding of each other’s roles and the challenges they face.
Summary of work We identified several primary and secondary schools in the local area, which were interested in inviting GP trainees talk to their pupils. These opportunities were then offered to GPST1-3s. They then arranged a session with the schools which reflected the needs/interests of the pupils, broadly encompassing promoting GP as a career, healthy living and introducing pupils to the role of a GP.
Summary of results Early feedback shows the sessions were quite varied in content according to the schools needs and that they were positively received by the all: trainees found the session uplifting, and innovative, whilst schools found the idea exciting and interesting. The scheme had, however, an unintended consequence in revealing need from the schools’ perspective of more support for pupils’ mental and social health. The project was not able to address this need, but has highlighted the gap between health and education for the future.
Conclusion The project demonstrated the need for closer interaction between schools and primary care. The poster will further discuss the findings, their impact and future proposals.
569 ‘Out of hours’: experiences of GP trainees and their trainers
Background Developing competence ‘Out of Hours’ (OOHs) remains an essential component of nMRCGP with distinct challenges from the ‘in hours’ setting. Many GP trainers no longer do OOHs work and cannot personally supervise their trainees. Anecdotal evidence suggested that trainees were experiencing difficulties achieving effective OOHs learning, so we undertook some research to understand this further and identify how trainers felt about supporting them.
Summary of work We invited all our newly qualified GPs to complete a survey about their OOHs learning and emailed their trainers for their perspective.
Summary of results 13 of our newly qualified GPs contributed to the online survey (30% response rate). They identified learning needs through discussions with their OOHs clinical supervisors and personal reflection. They found their OOHs experience valuable but limited by the variety of sessions available: most of their sessions were home visits and their confidence was greatest here. They had least experience and confidence doing telephone triage. 18 GP trainers responded via email; only two of these still did OOHs work. They felt confident supporting their registrars develop OOHs competences, citing previous experience or aspects of ‘In hours’ work that they felt posed similar challenges. Four trainers expressed concern that lack of current experience in OOHs limited the support they could offer.
Conclusions Evidence is emerging that our trainees struggle to achieve experience and confidence across the full range of OOHs settings (car, triage, clinics). Lost continuity in clinical supervision requires them to take a more structured and proactive approach to their learning if it is to be comprehensive and remain effective.
570 ‘Out of Hours’ workshop for GP ST3s
Background Feedback from GP ST3s has suggested several issues that compromised their learning in the ‘out of hours’ (OOHs) setting. Many felt their induction was unhelpful, clinical supervision appeared variable and unstructured, and more preparation would have been beneficial. Few of their GP trainers did OOHs work and they struggled to achieve continuity in clinical supervision. We hoped a workshop might equip our trainees with the confidence and knowledge to drive their own OOHs learning more effectively and address the needs identified.
Summary of work A workshop ran on a Saturday morning 2 months into OOHs training so that trainees would already have some experience. All our final year GP trainees were invited and 12 attended (~33%). We used a mixture of directed small group work (challenging scenarios), presentation to the wider group (effective use of clinical supervisors, available resources) and open discussion.
We asked the participants to evaluate the workshop by completing a short questionnaire.Summary of resultsThe participants rated the workshop highly. They felt it had helped them to plan and direct their OOHs training more effectively and found the small group discussion of challenging OOH scenarios particularly helpful (they would have liked more time devoted to this).
They also appreciated learning about resources for advice and guidance outside normal working hours and felt better equipped to use the existing framework of clinical supervision.
Conclusions The workshop seems to have motivated trainees to engage more pro-actively with their OOHs training rather than simply ‘complete the hours’. This year we will extend it to include other training patches and offer a greater focus on small group discussion of OOHs scenarios.
571 What is taught in UK medical schools on domestic violence and abuse?
Domestic violence and abuse (DVA) is a leading contributor to physical and mental ill-health of women. It is increasingly recognised that doctors have an important role in identifying and referring domestic violence; recent NICE guidance recommends we should be training future doctors in DVA as part of the undergraduate curriculum.
This study aimed to describe current UK medical education on domestic violence and abuse (DVA); including exploration of what is delivered, how it is delivered, views of its adequacy and any barriers to its delivery. All UK medical schools (n=34) were invited to particpate in an online survey consisting of 18 questions. 25 out of 34 medical schools participated in the survey (74%).
All responders reported that they felt there should be formal teaching on DVA in the medical curriculum. Reasons given for this included that it’s common, important, has a profound impact on health and students request it. 21 respondents reported that there was some formal teaching at their medical school, 19 of which was mandatory. The majority (11), reported that provision was 0-2 hours.
Most commonly, content was delivered in year 4 (n=9), followed by year 5 (n=7). DVA teaching was sited in a range of different modules, by a range of differnet methods and delivered by a range of different providers. 75% of responders reported that they felt provision at their medical school was inadequate or not enough. Barriers identified included time constraints, failure to perceive it as a medical problem and the assumption that it will be covered elsewhere.
This is an important, as yet untouched, area of research that will, in conjunction with Public Health England, inform curriculum development nationally.