Background COVID-19 has changed General Practice (GP) education as well as GP clinical activities. These changes have had an impact on the well-being of medical trainees and the role of GP plays in the society. We have therefore aimed to investigate the impact that COVID-19 has had on GP trainees and trainers in four domains: education, workload, practice organization and the role of GP in society. Design: a cross-sectional study design was used. Methods The Interuniversity Centre for the Education of General Practitioners sent an online survey with close-ended and open-ended questions to all GP trainees and trainers in Flanders, active in the period March – September 2020. Descriptive statistics were performed to analyze the quantitative data and thematic analysis for the qualitative data. Results 216 (response 25%) GP trainees and 311 (response 26%) trainers participated. GP trainees (63%, N = 136) and trainers (76%, N = 236) reported new learning opportunities since the COVID-19 pandemic. The introduction of telehealth consulting and changing guidelines required new communication and organizational skills. Most of the GP trainees (75%, n = 162) and trainers (71%, n = 221) experienced more stress at work and an overload of administrative work. The unfamiliarity with a new infectious disease and the fact that COVID-19 care compromised general GP clinical activities, created insecurity among GP trainers and trainees. Moreover, GP trainees felt that general GP activities were insufficiently covered during the COVID-19 pandemic for their training in GP. GP trainers and trainees experienced mutual support, and secondary support came from other direct colleagues. Measures such as reducing the writing of medical certificates and financial support for administrative and (para) medical support can help to reprioritize the core of GP care. COVID-19 has enhanced the use of digital learning over peer-to-peer learning and lectures. However, GP trainees and trainers preferred blended learning educational activities. Conclusions COVID-19 has created learning opportunities such as telehealth consulting and a flexible organization structure. To ensure quality GP education during the pandemic and beyond, regular GP care should remain the core activity of GP trainees and trainers and a balance between all different learning methods should be found.
Towards a better framing of primary care general practice: the contribution of the ‘practice assistant in primary care’ and the ‘nurse in general practice’ One of the most important observations during the COVID-19 pandemic was that general practitioners (GPs) often lack professional support, mainly within 3 domains: reception function, administrative tasks and performing simple interventions such as taking samples for COVID-19 tests. GPs are asking to be relieved of improper tasks and to be able to focus on the core tasks for which they have been trained. Since 2007, many actors advocated the training of a ‘practice assistant in primary care’. Practice assistants support the GP and other primary care providers with the fulfilment of the reception function and the performance of IT and administrative tasks. Under the supervision of the responsible primary care provider, they can assume some frequently performed, protocolized technical-supportive medical tasks. In this way, GPs can carry out individual consultations, counseling and other interventions more efficiently and focus on their core tasks. In addition, for more than 5 years there have been a number of courses in Flanders to train nurses to become professionals in a primary care practice: the ‘nurses in the GP practice’. These nurses autonomously support GPs in treating, guiding and caring for patients in primary care. This program also responds proactively to the changing healthcare landscape. The practice assistant and the nurse practitioner have complementary roles to strengthen the GPs in primary care.
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