Examining positive views from students, trainees and GPs about general practice: a generational problem? A set of qualitative studies in France

Floch, Bernard Le; Bastiaens, Hilde; Reste, Jean-Yves Le; Nabbe, Patrice; Montier, Tristan; Peremans, Lieve

doi:10.1136/bmjopen-2021-048857

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…[ 22 ]. International studies have demonstrated that completing general practice block internships, for example, significantly influences the later choice of profession or the readiness to take up non-hospital work [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

How can primary care be secured in the long term? – a qualitative study from the perspective of general practitioners in Germany

Wangler

Jansky

2023

European Journal of General Practice

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Background Securing primary care is an important issue for health policy. Given a threatened shortage of GPs in Germany, there are discussions about what actions to take to guarantee primary care. Objectives The aim was to obtain opinions of German GPs towards (a) the status quo and development of primary care, (b) favoured actions to secure it and (c) assessment of the actions taken. Methods In 2021 and 2022, 96 semi-structured interviews (criterion sampling) amongst GPs were conducted in all German federal states (41 face-to-face, 32 by telephone, 23 via telecommunication application). The data was analysed according to qualitative content analysis. Additionally, a short questionnaire recorded the problem of GP shortage. Results Many interviewees fear a veritable shortage of GPs in the future. They identify structural problems linked to the health care system. The interviewees suggested creating a primary care physician system or upgrading the GP position. They proposed greater support of interests about general practice in education and training, a restructuring of curricula and admissions criteria in higher medical education and reforming GP training. Building up multi-professional outpatient care centres and strengthening task shifting are valuable. The interviewees have observed progress in ensuring primary care but see a need for further action. Conclusion The study has shown that GPs, from their perspective and experience, make specific suggestions to ensure primary care in the long term. Consequently, it is advisable to consider their points of view when planning, implementing and adjusting steps to strengthen primary care.

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Section: Discussionmentioning

confidence: 99%

How can primary care be secured in the long term? – a qualitative study from the perspective of general practitioners in Germany

Wangler

Jansky

2023

European Journal of General Practice

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“…Our findings also included or touched on factors similar to those identified by studies on satisfaction of trainees and GPs in primary care in the European context. These themes include GPs as people, the practitioner-patient relationship, workplace autonomy, work-life balance including private life, relatives, and family [ 56 , 57 ]; commitment to general practice, skills and competencies for general practice [ 57 ]; balance between workload and income, professional challenges or responsibilities such as teaching [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Ontario family physicians’ perspectives about their scope of practice: what is it, what drives it and how does it change?

et al. 2022

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Background There is little evidence to show what scope of practice (SOP) means from the point of view of family physicians, how family physicians think about their SOP as it changes over time, or what factors shape and influence their SOP. Understanding family physician perspectives on SOP and the factors that influence it can aid our understanding of how it can constrain and enable physicians’ agency and autonomy in professional practice. Methods Using qualitative description and incorporating constructivist grounded theory data collection and analysis techniques, four focus groups were conducted involving twenty-four Ontario-based family physicians from different contexts, at different career stages, and with different practice experiences. Results Participants’ SOP was highly dynamic, changing throughout their careers due to factors both within and beyond their control. Their sense of their own SOP was the product of a continuous cycle of personal and professional transitions, exposures, and experiences throughout their careers. These family physicians sought regular and sustained mentorship, support, and engagement for their SOP throughout their careers. This was particularly the case during professional transitions and for drivers of their SOP for which they felt unprepared early in their careers, such as through the first years of independent practice, and when functioning as owner-operators of medical practices. Four descriptive themes were identified focusing on the nature of their current practice, their professional preparedness and supports, practice management dynamics, and ‘doctors are people, too’. Conclusions The SOP of the family physicians in this study was dynamic and unique to each individual, it emerged from interactions between their personal and professional lives and identities, and it was embedded in their lived experiences. SOP was also to some extent imposed and externally driven. This study advances understanding by exploring the ‘why’ and ‘how’ of SOP rather than focusing solely on what it is.

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General practice trainee, supervisor and educator perspectives on the transitions in postgraduate training: a scoping review

Tran,

Rhee,

et al. 2024

Fam Med Com Health

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Transitions are a period and a process, through which there is a longitudinal adaptation in response to changing circumstances in clinical practice and responsibilities. While the experience of the transition in medical student learning and in hospital-based specialty training programmes are well described and researched, the experience of the transition in community-based postgraduate general practitioner (GP) training has not been described comprehensively.ObjectiveWe aimed to identify, and categorise, the formative experiences of transitions in GP training and their impacts on personal and professional development.DesignWe adopted Levacet al’s scoping review methodology. Of 1543 retrieved records, 76 were selected for data extraction. Based on a combined model of the socioecological and multiple and multi-dimensional theories of transitions, data relating to the experiences of transitions were organised into contextual themes: being physical, psychosocial, organisational culture and chronological.Eligibility criteriaEmpirical studies focused on general practice trainees or training, that discussed the transitions experienced in general practice training and that were published in English were included.Information sourcesPubMed, MEDLINE and Web of Science databases were searched in January 2024 with no date limits for empirical studies on the transition experiences of GP into, and through, training.ResultsOur findings describe context-dependent formative experiences which advance, or impede, learning and development. Time is a significant modulator of the factors contributing to more negative experiences, with some initially adverse experiences becoming more positive. Identification of the inflection point that represents a shift from initially adverse to more positive experiences of transitions may help moderate expectations for learning and performance at different stages of training.ConclusionChallenges in training can either advance development and contribute positively to professional identity formation and clinical competency, or detract from learning and potentially contribute to burnout and attrition from training programmes. These findings will assist future research in identifying predictive factors of positive and adverse experiences of transitions and may strengthen existing and nascent GP training programmes. The findings are transferable to other community-based specialty training programmes.

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Examining positive views from students, trainees and GPs about general practice: a generational problem? A set of qualitative studies in France

Cited by 3 publications

References 19 publications

How can primary care be secured in the long term? – a qualitative study from the perspective of general practitioners in Germany

How can primary care be secured in the long term? – a qualitative study from the perspective of general practitioners in Germany

Ontario family physicians’ perspectives about their scope of practice: what is it, what drives it and how does it change?

General practice trainee, supervisor and educator perspectives on the transitions in postgraduate training: a scoping review

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