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

Abstract

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.

Temporal patterns of antibiotic prescribing for sore throat, otitis media, and sinusitis: a longitudinal study of general practitioner registrars

“…Detailed methods for this project have been published previously. 20 Briefly, details of 60 consecutive consultations are recorded, in each training term, including the problems/diagnoses dealt with and any prescribing performed (explicitly linked to individual problems/diagnoses). Details are recorded at the time of consultation to reduce recall bias.…”

Saxon Epidemiological Study in General Practice-6 (SESAM-6): protocol of a cross-sectional study

“…27 Another Australian study (ReCEnT) focuses on encounters of medical residents and patients. 28 The SESAM-6 study enables an international comparison of GP activity between Germany and other countries and allows global trends to be identified.…”

“…The NatMedCa Survey describes the primary healthcare in New Zealand,26 and another study examined the RFE managed by GP in China 27. Another Australian study (ReCEnT) focuses on encounters of medical residents and patients 28. The SESAM-6 study enables an international comparison of GP activity between Germany and other countries and allows global trends to be identified.…”

Doing the ‘bread and butter’ of general practice well in uncertain times

“…In Australia, the Registrars' Clinical Encounters in Training (ReCEnT) study, an inception cohort study, has been collecting consultation-based clinical and educational experience of GP registrars since 2010. 6 This issue features three ReCEnT research studies. Klein and colleagues 7 surveyed registrars, supervisors and medical educators regarding the effectiveness of ReCEnT as an educational tool for registrars to enhance reflection and influence change in practice.…”