Research and Quality Assurance (June 2019)

By June 12, 2019 June 19th, 2019 Newsletter

Research

2019 EV Research Unit Updates
The EV Research Unit has had a busy and productive first half of the year. As our 2018-19 RACGP Education Research Grant (ERG) projects draw to a close, we are reflecting on what we have learned from our research, and how these learnings can best be used to inform our training program and educational practice. We are also looking forward to preparing several research proposals for the RACGP and ACRRM 2020 ERG rounds that open next month.

Supervisors, medical educators, practice managers, registrars and program staff are central to the research and quality improvement activities undertaken at EV. We greatly appreciate the time and input that each of you contribute to our programs of research. We also encourage you to become involved in future research projects. It is a great way to share your experience with others and provides valuable information to enhance the education, training and support that we provide to GP registrars.

Through our collaborative research with other RTOs and university partners over the past six to twelve months, we have contributed to the development of a Work-Based Assessment (WBA) Framework for GP training and education, have sought to understand the role of feedback in registrars overcoming significant learning challenges and have examined the factors that facilitate progression of registrars to independent practice. We have tracked the journeys of new registrars as they progress through their first GP term and training post; identifying some of the critical challenges and successes in their learning and professional development as a GP. In each of these projects we have been privileged to work with other RTOs around Australia, with EV as the project lead or a collaborative partner. Each experience has been as valuable as the other in terms of building our understanding of the inner workings of registrar development as GPs and the key role of medical educators, supervisors, practice staff and peers in supporting the development of our future GPs.

As we move into the second half of 2019, we will continue to communicate findings of this research within the GP and medical education community. Our focus will also be on developing a program of research to inform and facilitate junior doctors’ transition from hospital to general practice environments. This will commence in July with a six-month scoping project to develop a clearer understanding of what is required for junior doctors to be sufficiently prepared for GP training, and the specific areas in which GPT1/PRRT1 registrars are struggling and/or ill-prepared for practice. This research extends upon findings from EV’s ‘Review of Australian and International Models of GP Training and Education’ (2018) and findings from two of our current ERG projects.

On a final note, we’d like to congratulate our four registrars who are progressing well and enjoying their academic posts at Monash Rural Health, University of Melbourne Department of GP, and Monash University Department of GP. The academic posts are a great opportunity for registrars to gain teaching and research experience within a supportive academic environment. To find out more about these posts, contact Cat Kirby.

Recent Publications
The EV research team have been successful in publishing several papers in local and international journals. This is a great way for us to communicate findings from our research to the broader GP and medical education community. You can click the titles below to access these papers.

Belinda Garth, Cat Kirby and James Brown had their paper ‘Your head can literally be spinning’: a qualitative study of general practice supervisors’ professional identity published in the Australian Journal of General Practice.

James, Cat and colleagues also published a paper in Medical Education: Theory, a lost character? As presented in general practice education research papers.

Julie Willems was a co-editor on the ASCILITE 2018 conference proceedings relating to technology-enhanced learning.

Julie also co-wrote an article with her PhD student on youth recovery following the Gippsland Black Saturday bushfires.

Neil Spike, Cat Kirby and colleagues have also recently published a paper in the British Medical Journal Open Access:New alumni EXperiences of Training and independent Unsupervised Practice (NEXT-UP): protocol for a cross-sectional study of early career general practitioners’.

We’re pleased to have had two other papers recently accepted for publication. The links to these papers will be shared on the EV research webpage when available.

Wearne SM, Brown J, Kirby C, Snadden D. International medical graduates and general practice training: Facilitating the transition from new migrant to local family doctor. Medical Teacher.
Denny B, Brown J, Kirby C, Garth B, Chesters J, Nestel D. “I’m never going to change unless someone tells me I need to”: Fostering feedback dialogue between general practice supervisors and registrars. Australian Journal of Primary Health.

Quality Assurance

End of Training Interviews – An improved system for capturing valuable feedback on our training practices and our program

As a result of a review in 2018, end of training interviews (otherwise known as registrar exit interviews) have undergone significant content and process improvements. This involved consultation with key staff which then led to revised interview questions and a secure online form for interviewers to capture responses. This means that the feedback provided to us by registrars upon completion of their training will inform practice re-accreditation (i.e. gaining feedback on training practices), identify future work plans of registrars’ post-fellowship, and inform program development and improvement. EV values this feedback and respects registrar confidentiality, therefore only aggregate de-identified data will be used. The online form is currently undergoing testing and is anticipated to be up and running towards the end of 2019 (the revised interview questions are currently in use via a Word document; Registrar Support Officers will provide interviewers with a copy of these when setting up interviews). Interviewers will be provided with training/support in the use of the online form.

Evaluating the EV Program
What activities have a demonstrable impact on registrar learning for independent practice?
What is providing meaningful evidence of a registrar’s progression and increasing competence, toward program outcomes?
What factors positively (and negatively) impact on program implementation?
What program elements are having unintended negative outcomes/effects (on registrars, supervisors, EV medical educators and program support staff)?

An EV program evaluation of our progress towards overall program objectives is underway in 2019. This evaluation asks questions such as those listed above and is guided by EV’s strategic priorities in moving toward college led training from 2022. Key informant interviews and an examination of EV’s existing documentation and data will occur over the coming months.

Following recommendations from the Quality Assurance Advisory meeting in February 2019, it was decided that EV will prioritise the evaluation of progress towards overall program objectives. For EV, it is important to consider the efficacy of our current delivery model during this transition period while also utilising the opportunity to inform future direction. Where resourcing allows, activity-specific evaluations may still occur.

Contact Us
Please feel free to get in touch with us if you are interested in obtaining copies of our evaluation or research reports, to discuss a research idea, or to talk about possible research supervision. We’d love to hear from you!

Belinda Garth, Manager Quality Assurance
Catherine Kirby, Research Manager
Julie Willems, Senior Research Fellow and Manager Supervisor CPD
James Brown, Director of Education Quality Improvement