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BackgroundThe training of family physicians is a relatively new phenomenon in the district health services of South Africa. There are concerns about the quality of clinical training and the low pass rate in the national examination.AimTo assess the effect of a five-day course to train clinical trainers in family medicine on the participants’ subsequent capability in the workplace.SettingFamily physician clinical trainers from training programmes mainly in South Africa, but also from Ghana, Uganda, Kenya, Malawi and Botswana.MethodsA before-and-after study using self-reported change at 6 weeks (N = 18) and a 360-degree evaluation of clinical trainers by trainees after 3 months (N = 33). Quantitative data were analysed using the Statistical Package for Social Sciences, and qualitative data were analysed thematically.ResultsSignificant change (p < 0.05) was found at 6 weeks in terms of ensuring safe and effective patient care through training, establishing and maintaining an environment for learning, teaching and facilitating learning, enhancing learning through assessment, and supporting and monitoring educational progress. Family physicians reported that they were better at giving feedback, more aware of different learning styles, more facilitative and less authoritarian in their educational approach, more reflective and critical of their educational capabilities and more aware of principles in assessment. Despite this, the trainees did not report any noticeable change in the trainers’ capability after 3 months.ConclusionThe results support a short-term improvement in the capability of clinical trainers following the course. This change needs to be supported by ongoing formative assessment and supportive visits, which are reported on elsewhere.

Family physicians are expected to build the capacity of the primary care team and to provide clinical training to students, but often lack the educational expertise and a supportive learning environment. This article aims to outline the competencies needed to fulfil these expectations and to assist with professional development in this area. The organisational environment has a profound effect on the success of learning and issues such as adequate infrastructure, optimal staff numbers and mix, appropriate patient mix, quality of care, supportive management and organisational culture are all important. Within this organisational culture learning is often dependent on an effective clinical trainer. Clinical trainers impact learning through role modelling, facilitation of learning and providing up to date information. They need educational competencies to embed brief and effective training into clinical practice, to provide effective feedback and to engage with small group teaching and assessment. The family physician can lead the entire team and practice through developing themselves as a clinical trainer, creating supportive relationships and transforming policies and processes to support innovation and learning.

The tool enabled course participants to show evidence of their behaviour change, enabled their colleagues to report on the impact on their own teaching practices, and enabled registrars to voice their opinions of their trainer's supervision skills. A post-course formative evaluation visit has the potential to catalyse the impact of the training course. It will be necessary to train the family physicians who conduct these visits.