Education Posters 572 – 577
572 Evaluation of GP trainees’ Out Of Programme Experience (OOPE) – facilitated by Health Education England
Objectives The RCGP recognises that working overseas can provide benefits for both personal and professional development. We wanted to ensure that GP trainees had access to such opportunities and after initial contact with providers in high and low income countries, two facilitated OOPEs have been established in New Zealand and South Africa.
Content of presentation Challenges of setting up overseas OOPE placements for GP trainees. Evaluation through pre- and post-placement questionnaires of GP trainees’ perspectives, with GP trainers completing separate post-placement questionnaires. Lessons learnt and changes made as a result of feedback
Relevance and impact Enhancing both the offer for doctors considering GP training and providing additional benefits to existing trainees and future patients through skills development are key elements of a wider strategy to recruit and develop the GP workforce in the region.
Outcomes Five GP trainees went to New Zealand and one to South Africa in 2014–15. They reported developing knowledge and skills around leadership, decision making, managing uncertainty, relationship building and confidence. Practical issues regarding the structure of their placements were a significant negative factor for some. Benefits reported by GP trainers include an appreciation by trainees of different healthcare systems, self-awareness and accelerated professional maturity.
Discussion As both a pull for prospective GP trainees and as a tool for skills development for existing GP trainees, overseas OOPEs offer a potential opportunity to help recruit and develop the GP workforce.
573 Issues relating to use of a Wiki index in primary care
A wiki index is a collaborative resource signposting to all information used by one professional group. The aim has been to explore the issues in developing a practical wiki index in one practice and then regionally. This poster defines the term wiki index, outlines how it has been applied so far and describes the issues that arose when planning a regional version.
Every GP and healthcare worker has to recall key information which comes from multiple sources, including internet searches. They may rely on memory alone, loose papers, files, note books, desktop word files, or on line records. This is a waste of duplicated resources, which could be more effectively streamlined and shared as one collaborative index.
It is a wiki because all users in that professional grouping can contribute. It is an index because it signposts the original source with a brief summary of key information linked to a single use keyword. A wiki index has been applied in one practice for 12 years and is known as LLAMA (Local Linked Advice Management and Addresses ©2004). Issues overcome for a national version include the user interface, readability, speed of recall, information reliability, age of information, multiple entries, keyword choice, rogue user, sufficient participation and information governance.
GPs find the existing resource and concept of a wiki index useful, but there is difficulty establishing a truly user led independent index under the indemnity, corporate image and governance of an NHS organisation.
574 Exploring the educational value of an ITP in integrated community care
Background ITPs (Integrated or Innovative Training Programmes) have been recognised as a distinct type of training post for general practice and previous research has found them to provide an enhanced training experience. This poster will describe and evaluate a ‘new generation’ ITP post which was piloted in the New Forest.
Summary of Work The post comprised a mix of 2 days a week in GP and 3 days in community posts. The posts were evaluated using a focus group of trainees and trainers (in July), and the evaluation was conducted by two current GP trainees.
Summary of Results Participating trainees and trainers reported that the post was helpful in developing skills and competencies in practice related to community care. The poster will outline the findings of the evaluation and future steps for developing these posts.
Conclusions/Take home messages ICCs mark a welcome return of ITPs to GP training and can offer a positive experience to trainees in developing their care knowledge and skills.
575 ‘Doctor, I’ve had my operation when can I drive again?’ Driving after surgery a legal perspective
Aims: A return to driving is often a question asked by patients’ post-surgical intervention and after they have gone home and so ask their GP. No definitive guidance exists from the Royal College as to when a patient should return back to driving following procedures. We aim to investigate the current recommendation as to when a patient can go safely back to driving following surgery.
Methods: A telephone survey was conducted of five large national UK car insurers to discuss their recommendation regarding their policy with regards to driving post operatively. The DVLA , BMA, MDU, website were reviewed and each institute was contacted regarding the advice for driving after surgery and the legal stand point.
Results: None of the insurance companies had any stipulations in place regarding return to driving after surgery. They did state that if the patient was to be involved in an accident during the time frame given then this would invalidate their insurance policy. The DVLA had no information on their website for surgery and following further discussion, stated that the opinion of a clinician should be sort. The BMA provided no legal advice and referred the issue to the Medical Defence Union who again stated that this was for the doctor to make a judgement call.
Conclusions: No rules are currently present regarding a return to driving following surgery. It appears to be the clinician’s decision as to when a patient can return to driving. We would recommend that patients following surgery are able to make an emergency stop however this should be done in the hospital setting and not by the GP.
576 An eLearning programme for continued professional development of general practitioners
An eLearning programme for continued professional development of general practitioners
Objective: Develop a web-based eLearning programme for general practitioners (GPs) to support Continuing Professional Development (CPD) relating to prescribing and therapeutics.
Content of presentation: The PRACtICE study found that 1 in 20 prescription items contained either a prescribing or monitoring error, affecting 1 in 8 patients. In an analysis of severity, 1 in 550 contained a severe error. We felt there was a need for directed CPD for GPs, which focussed on prescribing and therapeutics.
Relevance/Impact Guidance relating to prescribing and therapeutics frequently changes, as new evidence emerges and new medicines are authorised for UK use. Indicators are now routinely employed in practice to guide prescribing quality and form part of local incentive schemes for GPs. It is important for GPs to revalidate their learning relating to prescribing and therapeutics.
Outcomes We identified 13 topics in therapeutic areas with high prescribing volume and/or high risk medicines in general practice (Table 1). We invited specialist healthcare professionals to author content according to defined learning outcomes. The modules are currently being designed for online use.
Discussion The eLearning programme will initially be disseminated to GPs in a region of England. We will evaluate their reaction to the programme, gain feedback and make necessary adjustments. In the long-term, we aim for this programme of work to be available nationally.
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577 ‘I’m a GP’: Inspiring students with the variety and challenges of General Practice
Aim General Practice is facing a shortage of clinicians and measures need to be put in place to address this. A GP recruitment activity was arranged as part of the annual medical school careers fair, in order to improve student interest and challenge misconceptions.
Method We recruited a broad range of GPs from across the British Isles with a variety of specialist interests from journalism, academia, clinical specialities and politics. We asked students about their impressions of General Practice both before and after speaking with our GPs and collated the information. We also took brief videos of our GPs showcasing their careers to use as a promotional video.
Outcome Before speaking with our GPs, students generally perceived General Practice as boring, lacking challenge and not busy. This supported previous findings in the literature. They were already aware of the better work-life balance in comparison to hospital medicine. After talking with the GPs, students reported being motivated by the challenges and variety that General Practice could offer, with an overall improved impression of General practice as a career choice.
Discussion This brief study reinforced medical student misconceptions about General Practice, and showed how a brief intervention can positively impact on their initial impressions. We plan to utilise the video and involve students in devising a series of activities to further breakdown misconceptions and focus on the variety and challenge provided by a career in General Practice.