Home visits and nursing home visits by early-career GPs: a cross-sectional study

Magin, Parker; Catzikiris, Nigel; Tapley, Amanda; Morgan, Simon; Holliday, Elizabeth G.; Ball, Jean; Henderson, Kim; Elliott, Taryn; Regan, Cathy; Spike, Neil

doi:10.1093/fampra/cmw099

Cited by 13 publications

(23 citation statements)

References 9 publications

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“…Our findings concerning hesitancy due to lack of training and support, and logistical difficulties for part-timers, provide an explanation for the associations noted in data collected 9 months later by Magin et al (2016) which were that factors associated with participation in RACF visiting were experiencing in-practice clinical teaching/supervision, conducting RACF visits during training and working full-time.…”

Section: Discussionmentioning

confidence: 56%

“…This finding was also supported by a later Australian study, which included responses from over 3,000 GPs (Charles, Britt, & Valenti, ). More recently, a cross‐sectional study of 230 early career GPs revealed an even more modest nursing home visit participation rate of 40% (Magin et al., ). Given the expected growth in nursing home patient numbers, this research calls into question the sustainability of the Australian RACF GP workforce.…”

Section: Introductionmentioning

confidence: 99%

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Australian general practitioner attitudes to residential aged care facility visiting

Pearson

Mullan

Ujvary

et al. 2018

Health Soc Care Community

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Demographic trends suggest that the sustainability of the general practitioner (GP) Residential Aged Care Facility (RACF) workforce, worldwide and in Australia, is under threat, compromising the ongoing care of chronically ill RACF residents. It is therefore important to ascertain current GP attitudes towards this work, to better understand and hypothesise means of reversing this trend. To this end, during 2014 the views of 26 GPs and GP Registrars working in rural and regional New South Wales, Australia, were captured during focus group discussions and one-on-one interviews. Analysis of the qualitative date revealed that GP attitudes towards RACF visiting fell into five key themes: pleasure, duty, remuneration and logistics, hesitation, and frustration. The data also revealed that the overriding emotion GPs felt about RACF visitation was frustration with the avoidable delays and inefficiencies associated with the work. Despite the pleasure GPs derived from their work in RACFs and their sense of obligation to be involved, their hesitation and frustration was compounded by the work's perceived poor remuneration. This research suggests that the barriers to GP participation in RACF visiting were managerial rather than attitudinal, and that a strategic focus upon improving administrative and logistical support is needed.

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Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Australian general practitioner attitudes to residential aged care facility visiting

Pearson

Mullan

Ujvary

et al. 2018

Health Soc Care Community

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“…In an earlier analysis in this alumni population, we found that part-time status was associated with markedly reduced provision of nursing home visits and home visits. 9 As we suggested above, continuing engagement of part-time practitioners in supervision is essential. However, limited supervisor experience of and expertise in nursing home visits and home visits of part-time GPs may need to be addressed.…”

Section: Implications For Educational Practice and Future Researchmentioning

confidence: 98%

“…Results regarding provision of nursing home visits and home visits have been published previously. 9 The questionnaire was pilot tested and modified with alumni who did not meet the study inclusion criteria.…”

Section: Questionnairementioning

confidence: 99%

Maintaining capacity for in-practice teaching and supervision of students and general practice trainees: a cross-sectional study of early career general practitioners

Catzikiris¹,

Tapley²,

Morgan³

et al. 2018

Aust. Health Review

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Expanding learner cohorts of medical students and general practitioner (GP) vocational trainees and the impending retirement of the 'baby boomer' GP cohort threaten the teaching and supervisory capacity of the Australian GP workforce. Engaging newly qualified GPs is essential to sustaining this workforce training capacity. The aim of the present study was to establish the prevalence and associations of in-practice clinical teaching and supervision in early career GPs. The present study was a cross-sectional questionnaire-based study of recent (within 5 years) alumni of three of Australia's 17 regional general practice training programs. The outcome factor was whether the alumnus taught or supervised medical students, GP registrars or other learners in their current practice. Logistic regression analysis was used to establish associations of teaching and supervision with independent variables comprising alumnus demographics, current practice characteristics and vocational training experiences. In all, 230 alumni returned questionnaires (response rate 37.4%). Of currently practising alumni, 52.4% (95% confidence interval (CI) 45.6-59.0%) reported current teaching or supervisory activities. Factors significantly (P<0.05) associated with alumni currently undertaking in-practice clinical teaching and supervision were: Australian medical graduation (odds ratio (OR) for international graduates 0.36; 95% CI 0.14-0.92), working in a regional or remote area (OR 2.75; 95% CI 1.24-6.11) and currently undertaking nursing home visits, home visits or after-hours work (OR 2.01; CI 1.02-3.94). Rural-urban and country-of-graduation differences in the engagement of early career GPs in practice-based apprenticeship-like teaching or training should inform strategies to maintain workforce training capacity. Projected changes in the demand for and supply of clinical teaching and supervision within Australian general practice will require greater uptake of teaching and supervision by recently qualified GPs to ensure sustainability of this teaching model. Although interest in and undertaking of teaching roles have been documented for GP or family medicine trainees, studies investigating the engagement in these clinical roles by GPs during their early post-training period are lacking. This paper is the first to document the prevalence of teaching and supervision undertaken by early career GPs as part of their regular clinical practice. We also demonstrate associations of practice rurality, country of medical graduation and undertaking non-practice-based clinical roles with GPs' engagement in teaching and supervisory roles. Establishing current teaching patterns of GPs enables appropriate targeting of new strategies to sustain an effective teaching and supervisory capacity within general practice. The findings of the present study suggest that exploring focused strategies to facilitate and support international medical graduates to engage in teaching during their vocational training, aided by focused supervisor support, may be of particula...

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“…There is, however, concern surrounding training capacity, with indications that there may not be sufficient senior GPs to take on such roles 23. Our previous research (the Readiness of Alumni for Practice Post Registrar Training—RAPPoRT—project), indicates that recent alumni (ex-registrars of GP training organisations) are engaging in teaching and training in the practice setting, and can be a vital part of the training of GP registrars 17 24. Further investigation is warranted.…”

Section: Introductionmentioning

confidence: 99%

New alumni EXperiences of Training and independent Unsupervised Practice (NEXT-UP): protocol for a cross-sectional study of early career general practitioners

et al. 2019

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IntroductionGeneral practice in Australia, as in many countries, faces challenges in the areas of workforce capacity and workforce distribution. General practice vocational training in Australia not only addresses the training of competent independent general practitioners (GPs) but also addresses these workforce issues. This study aims to establish the prevalence and associations of early career (within 2 years of completion of vocational training) GPs’ practice characteristics; and also to establish their perceptions of utility of their training in preparing them for independent practice.Methods and analysisThis will be a cross-sectional questionnaire study. Participants will be former registrars (‘alumni’) of three regional training organisations (RTOs) who achieved general practice Fellowship (qualifying them for independent practice) between January 2016 and July 2018 inclusive. The questionnaire data will be linked to data collected as part of the participants’ educational programme with the RTOs. Outcomes will include alumni rurality of practice; socioeconomic status of practice; retention within their RTO’s geographic footprint; workload; provision of nursing home care, after-hours care and home visits; and involvement in general practice teaching and supervision. Associations of these outcomes will be established with logistic regression. The utility of RTO-provided training versus in-practice training in preparing the early career GP for unsupervised post-Ffellowship practice in particular aspects of practice will be assessed with χ2 tests.Ethics and disseminationEthics approval is by the University of Newcastle Human Research Ethics Committee, approval numbers H-2018-0333 and H-2009-0323. The findings of this study will be widely disseminated via conference presentations and publication in peer-reviewed journals, educational practice translational workshops and the GP Synergy Research subwebsite.

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Home visits and nursing home visits by early-career GPs: a cross-sectional study

Abstract: Our findings of graduates' modest engagement with HVs and NHVs reinforce concerns regarding Australian general practice's capacity to accommodate the needs of an aging population.

Cited by 13 publications

References 9 publications

Australian general practitioner attitudes to residential aged care facility visiting

Australian general practitioner attitudes to residential aged care facility visiting

Maintaining capacity for in-practice teaching and supervision of students and general practice trainees: a cross-sectional study of early career general practitioners

New alumni EXperiences of Training and independent Unsupervised Practice (NEXT-UP): protocol for a cross-sectional study of early career general practitioners

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