Australian general practice registrars and their experience with postpartum consultations: A cross‐sectional analysis of prevalence and associations

Hill, Sophia; Tapley, Amanda; Driel, Mieke van; Holliday, Elizabeth G.; Ball, Jean; Davey, Andrew; Patsan, Irena; Spike, Neil; FitzGerald, Kristen; Morgan, Simon; Magin, Parker

doi:10.1111/ajo.13034

Cited by 4 publications

(3 citation statements)

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“…Lack of time for primary care consultations is common, even more so for a postpartum consultation which can easily take up to 25 min as reported in an Australian study on local GPs [ 36 ]. In contrast, the average duration of a GP consultation was 9.3 min in a Singapore study [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

A qualitative research study of primary care physicians’ views of telehealth in delivering postnatal care to women

Poon

Tan

2022

BMC Prim. Care

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Background The postpartum period is a critical time for women to optimise their physical and mental health. Primary care physicians (PCP) often manage postpartum women in the community setting after uneventful births. However, women encounter difficulties accessing care before and after their conventional 6-week physical review. Telehealth-based interventional studies have demonstrated their successful applications in several areas of postpartum care but is not widely adopted. The study aimed to explore the PCPs’ views on their acceptability and perceived barriers of telehealth in delivering postpartum care to women in primary care. Methods Twenty-nine PCPs participated in eleven in-depth interviews and four focus group discussions for this qualitative study conducted in Singapore. The purposively sampled PCPs had varied demographic background and medical training. Two investigators independently coded the audited transcripts. Thematic content analysis was performed using the codes to identify issues in the pertaining to the perceived usefulness, ease of use and attitudes towards telehealth in postpartum care as described in the “Telehealth Acceptance Model” framework. Results Most PCPs perceived usefulness and ease of use of video consultation in delivering postpartum care. They recognised telehealth service to complement and support the current face-to-face postpartum care amidst the pandemic. However, training, leadership support, organizational infrastructure, healthcare financial policy and personal demographic profile influence their acceptance of a new care model for postnatal mothers. Conclusion Addressing the barriers and strengthening the facilitators will enhance PCPs’ acceptance and utilisation of the proposed hybrid (telehealth and in-person) postnatal care model for mothers.

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Section: Discussionmentioning

confidence: 99%

A qualitative research study of primary care physicians’ views of telehealth in delivering postnatal care to women

Poon

Tan

2022

BMC Prim. Care

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“…In an Australian cohort study of GP trainees, antenatal care comprised 1.1% of trainee problems and diagnoses and post-partum care comprised 0.2% of diagnosis issues. 19,20 We suggest revision of the educational content of the modules to provide updated knowledge that reflects current research evidence. We also suggest provision of protocols, guidelines, summarised key points, and recent educational resources for management of conditions.…”

Section: Discussionmentioning

confidence: 99%

Relevance of Otago University postgraduate programmes in women’s health to general practice: a case study

Kanagasabai

Filoche

Ekeroma

et al. 2021

J. Prim. Health Care

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INTRODUCTIONThere are important changes in the health care needs of women presenting to general practice in New Zealand, which prompted an evaluation of postgraduate training needs of general practitioners (GPs) who care for women in the community.AIMTo evaluate the perceived relevance of the curriculum of Otago University postgraduate programmes in women’s health to GPs’ work profile to identify any need for curricular change. This study was also performed to investigate the need for refresher courses or a Master’s degree in obstetrics, gynaecology and women’s health.METHODSIn total, 426 GPs and GP trainees who had completed the postgraduate Certificate and Diploma programmes in women’s health were invited to complete an online survey. The survey consisted of multiple-choice questions with five-point Likert scale ratings to rate the relevance of papers to general practice, and options for free-text comments.RESULTSThere were 86 responses (20.2% response rate) and we analysed 73 (17.1%). Curriculum modules related to gynaecological care were rated as more relevant than obstetric and newborn care. GPs suggested more training in contraception and management of infertility, abnormal uterine bleeding and pelvic pain including procedural skills such as insertion of long-acting reversible contraceptives, implants and intrauterine devices. An interest in a refresher course was indicated by 76.6% of GPs.DISCUSSIONGPs recognised the need for enhanced training in women’s gynaecological care. Revision of the postgraduate women’s health curriculum and development of new refresher courses will enable GPs, trainees and prospective GPs to improve their care for women in the community.

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“…Exploratory analyses allow us to establish associations of a wide range of registrar clinical exposures-for example, patient demographics (older patients [40], Aboriginal and Torres Strait Islander patients) [42] and problems/ diagnoses (for example, atopic dermatitis [43], post-natal care [44], vertigo [45]); and registrar actions (prescribing [46], deprescribing [47], delayed prescribing [48], test-ordering [49], referral [50], and preventive activities [51]). We can also examine the associations of structural aspects of the training experience.…”

Section: Exploratory Analysesmentioning

confidence: 99%

The Registrar Clinical Encounters in Training (ReCEnT) cohort study: updated protocol

et al. 2022

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Background During vocational general practice training, the content of each trainee’s (in Australia, registrars’) in-consultation clinical experience is expected to entail a breadth of conditions that exemplify general practice, enabling registrars to gain competency in managing common clinical conditions and common clinical scenarios. Prior to the Registrar Clinical Encounters in Training (ReCEnT) project there was little research into the content of registrars’ consultations despite its importance to quality of training. ReCEnT aims to document the consultation-based clinical and educational experiences of individual Australian registrars. Methods ReCEnT is an inception cohort study. It is comprised of closely interrelated research and educational components. Registrars are recruited by participating general practice regional training organisations. They provide demographic information about themselves, their skills, and their previous training. In each of three 6-month long general practice training terms they provide data about the practice where they work and collect data from 60 consecutive patient encounters using an online portal. Analysis of data uses standard techniques including linear and logistic regression modelling. The ReCEnT project has approval from the University of Newcastle Human Research Ethics Committee, Reference H-2009–0323. Discussion Strengths of the study are the granular detail of clinical practice relating to patient demographics, presenting problems/diagnoses, medication decisions, investigations requested, referrals made, procedures undertaken, follow-up arranged, learning goals generated, and in-consultation help sought; the linking of the above variables to the presenting problems/diagnoses to which they pertain; and a very high response rate. The study is limited by not having information regarding severity of illness, medical history of the patient, full medication regimens, or patient compliance to clinical decisions made at the consultation. Data is analysed using standard techniques to answer research questions that can be categorised as: mapping analyses of clinical exposure; exploratory analyses of associations of clinical exposure; mapping and exploratory analyses of educational actions; mapping and exploratory analyses of other outcomes; longitudinal ‘within-registrar’ analyses; longitudinal ‘within-program’ analyses; testing efficacy of educational interventions; and analyses of ReCEnT data together with data from other sources. The study enables identification of training needs and translation of subsequent evidence-based educational innovations into specialist training of general practitioners.

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Australian general practice registrars and their experience with postpartum consultations: A cross‐sectional analysis of prevalence and associations

Cited by 4 publications

References 10 publications

A qualitative research study of primary care physicians’ views of telehealth in delivering postnatal care to women

A qualitative research study of primary care physicians’ views of telehealth in delivering postnatal care to women

Relevance of Otago University postgraduate programmes in women’s health to general practice: a case study

The Registrar Clinical Encounters in Training (ReCEnT) cohort study: updated protocol

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