‘What have they learnt? A mixed-methods study assessing for changes in knowledge, skills and attitudes as a result of an Out-Of-Program-Experience (OOPE) in global health during UK General Practice training’
Problem
GP Global health fellowships, a four year GP training programme incorporating a 12 month ‘Out Of Programme Experience’ (OOPE) within an international health setting are increasingly available in England and Wales. A previous survey of qualified UK GPs who have undertaken international work has shown a range of benefits, including leadership competencies in self-awareness, working with others, setting direction, managing and improving services. The global health fellowship programme has not yet been evaluated, including its influence on GP career trajectory and Global Health involvement, both in the UK and/or overseas. We undertook a mixed-methods exploration to understand the impact of a global health OOPE on practicing UK GPs.
Approach
We approached UK-trained GPs who have completed an OOPE in another country and/or a global health fellowship between 2009 and 2015 to undertake an online survey and follow-up interview. Recruitment was via email and social media, distributed via current and past global health fellowship leads within GP training deaneries and global health interest groups. Participants received a link to participate in a telephone interview on completion of the survey. Survey questions included participant demographics and details of the OOPE experience. Questions assessing for change in knowledge, skills, and/or attitudes (mapped to the Academy of Royal Medical Colleges [ARMC] ‘Global Health Capabilities for UK Health Professionals’) were included in the survey and follow-up interviews. All interviews employed a semi-structured approach. Survey data has been analysed using descriptive statistics in STATA. Interview transcripts have been entered into NVIVO, analysed thematically and cross-checked by two research active GPs. This study received university ethical approval.
Findings
23 GPs completed the survey. 20 (87%) participants were female, and all aged between 26-45. 20 (87%) participants had trained in London, and all are currently working as GPs. 19 (86.4%) had extended clinical/professional roles. A minority of participants had undertaken global-health related work within the UK (5 [21.7%]) or internationally (3[13%]), however 16 (69.9%) stated they wanted to in the future. Participants reported their global health OOPE had improved their knowledge and skills in all ARMC capability domains.Analysis of the GP interview transcripts (n=9) is ongoing. Provisional emergent themes include ‘Skill development through novel exposures’ and ‘Improved confidence within the diverse challenges of general practice’. The majority of interview participants (66%) had some ongoing involvement in global health, with the remainder keen to explore opportunities in the future.
Consequences
GP Global Health Fellowships may support development of pre-existing and novel clinical, governance, quality improvement and leadership skills, in addition to improving training confidence and resilience within a UK General Practice setting. Global health fellows show a desire to continue involvement in global health-related work within the UK and overseas after training, supporting the cross-cultural outlook of primary care services.