Contemporary Educational Interventions for General Practitioners (GPs) in Primary Care Settings in Australia: A Systematic Literature Review

Abstract

Background: The primary purpose of educational interventions is to optimize the clinical management of patients. General practitioners (GPs) play a major role in the detection and management of diseases. This systematic literature review will describe the type and outcomes of educational interventions designed for general practitioners (GPs) in the Australian context. Methods: PubMed, CINHAL, and Scopus databases were systematically searched for studies on educational interventions conducted for GPs in Australia during 1st January 2008 to 11th June 2018. Data collected on the methodology of the interventions, GPs satisfaction regarding the educational intervention, changes in knowledge, confidence, skills and clinical behavior of the GPs. We also assessed whether the acquired clinical competencies had an impact on organizational change and on patient health. Results: Thirteen publications were included in this review. The methods with which educational interventions were developed and implemented varied substantially and rigorous evaluation was generally lacking particularly in detailing the outcomes. The reported GP response rate varied between 2 and 96% across studies, depending upon the method of recruitment, the type of intervention and the study setting (rural vs. urban). The most effective recruitment strategy was a combination of initial contact coupled with a visit to GP practices. Nine of the studies reviewed reported improvement in at least one outcome measure: gaining knowledge, improving skills or change in clinical behavior which was translated into clinical practice. In the 3 pre- and post-intervention analysis studies, 90–100% of the participating GPs reported improvement in their knowledge and attitudes. Conclusion: Education interventions for GPs in Australia had low response (recruitment) and retention (GPs that participated in follow-ups) rates, even when financial benefits or CPD points were used as incentives. Higher GP response rates were achieved through multiple recruitment strategies. Multifaceted interventions were more likely to achieve the primary outcome by improving knowledge, skills or changing practice, but the effect was often modest. Inconsistent results were reported in studies involving the use of multiple contact methods within an intervention and conducting online interventions.

Dementia ECHO: Evaluation of a telementoring programme to increase dementia knowledge and skills in First Nations-led health services

“…Of note is the relatively high attendance of general practitioners (GPs) representing just under one-third of the 94 registered attendees (n = 30). The difficulty in recruiting GPs for professional development training and research participation is reported both here in Australia and overseas, 22,23 which further highlights the success of the Dementia ECHO programme.…”

Clinician Perspectives of Communication with Aboriginal and Torres Strait Islanders Managing Pain: Needs and Preferences

“…Future interventions to improve communication between clinicians and Aboriginal and Torres Strait Islander patients should be patient-centred, observing local cultural principles of communication and evidence-based medicine [15,20]. Among the training preferences, consistent with previous studies, clinicians indicated that an interactive training format with the possibility of post-training feedback and follow-up or mentoring would be the most preferable training format [50,51]. A cross-sectional study exploring the learning preferences of 2500 general practitioners identified that 70% of participants indicated that interactive group discussions were their preferred learning format and that relevance to clinical practice was the main motivation for participation [52].…”

Towards collaborative management of non‐alcoholic fatty liver disease: a ‘real‐world’ pathway for fibrosis risk assessment in primary care

“…Education and guidance to improve PCP awareness and familiarity with the diagnosis and management of liver disease will be essential in future strategies to implement community fibrosis assessment. 30 A key strength of this study was its pragmatic 'realworld' design, which supports the applicability of findings to clinical practice and will facilitate translation of the pathway into 'routine' care. The TCM-NAFLD model fostered strong collaborative working relationships with PCP within the local practice environment, which enabled communication regarding referrals, patient follow up, collection of study data, and opportunities for targeted education and upskilling of PCP.…”

“…Although it is possible that some people with another liver disease or true advanced fibrosis may have been missed due to the lack of formal hepatology assessment, ongoing monitoring in primary care was advised to identify disease progression or false‐negative fibrosis tests. Education and guidance to improve PCP awareness and familiarity with the diagnosis and management of liver disease will be essential in future strategies to implement community fibrosis assessment 30 …”