What are The Learning Needs of London-based GP Trainees in Conducting Telephone Consultations?

Conference: 
SAPC ASM 2018 - London
Talk Code: 
P2.33
Presenter: 
Umar A R Chaudhry
Twitter: 
@n/a
Co-authors: 
Dr Umar A R Chaudhry[1-4], Dr Judith Ibison[2], Professor Tess Harris[1], Dr Imran Rafi[2], Dr Miles Johnston[3], Dr Tim Fawns[4].
Author institutions: 
[1] Population Health Research Institute (PHRI), St George's University of London (SGUL), Cranmer Terrace, SW17 0RE; [2] Institute of Medical and Biomedical Education (IMBE), SGUL; [3] Parliament Hill Medical Centre, 113-117 Highgate Road, London, NW5 1TR; [4] Edinburgh Medical School, The Chancellor's Building, 49 Little France Crescent, Little France, Edinburgh, EH16 4SB.

Problem

Tele-healthcare and telephone consultations are increasingly used in primary care for daily triage, patient reviews and providing clinical information. From a training perspective, telephone consultations are a key component of the postgraduate curriculum; however little is known about the perceptions of General Practice (GP) trainees with respect to telephone consultations. The need to gather this learner voice in pursuing quality improvement for innovative consultation platforms is required to shape best-practice education within our healthcare system. The objectives of the study are: to investigate the knowledge and skills of GP trainees in conducting telephone consultations with patients and their perceptions from a clinical perspective; to evaluate their current experiences and any learning needs; to potentially identify future considerations of GP training based on feedback received.

Approach

This study utilises a mixed-methods approach: explanatory design with follow-up explanations model. Firstly, a cross-sectional electronic quantitative survey of North Central and East London (NCEL) GP trainees will be performed. Subsequently, a qualitative non-categorical approach using semi-structured telephone interviews will allow deeper exploration of themes. GP trainees who are part of 11 vocational training schemes (VTS) within NCEL (approximately 500 trainees) are invited to participate. The content of the survey is informed by research literature and reviewed by a virtual informal focus group consisting of qualified GPs and trainees. From the initial survey analysis, where there is limited or incomplete data, specific questions shall be formulated to form part of the recorded semi-structured telephone interviews, for which 10-20 participants will be recruited. Conversations shall be anonymously transcribed, with thematic analysis being undertaken to capture key subjects and a broader understanding of GP trainees’ perceptions. This study is sponsored by the University of Edinburgh and approved by Health Education England (HEE).

Findings

Following development and ethical review, the on-line survey will be imminently disseminated to trainees, with data capture within three weeks for the survey. The results, data analysis and preliminary conclusions of the on-line questionnaire will be presented, with any initial findings from completed semi-structured interviews.

Consequences

Telephone consultations are becoming increasingly important within primary care. However, little is known about the current learning, feedback and assessment practices in place to promote clinician competence, and whether the learning needs of GP trainees are met. This project will shed light on the curriculum and teaching, and use an evidence-based approach to implement the feedback of learners, thereby promoting best practice. An evaluation of the learning needs will provide a helpful guide to various stakeholders as to whether current training practises are suitable, and how any foreseeable challenges may be overcome. Furthermore, the analysis may help to inform the national debate amongst undergraduate and postgraduate clinical learners regarding their training for the use of technology in healthcare.

Submitted by: 
Umar Chaudhry
Funding acknowledgement: 
This study is being undertaken as part of the MSc in Clinical Education dissertation project, by the University of Edinburgh. Small grant applications are likely to be made to the RCGP (RCGP Scientific Foundation Board) and/or the Association for the Study of Medical Education (ASME) for future funding.