Evaluation of general practice house officer attachments in Counties Manukau: insights and benefits
Lyndsay Le Comte 1 , Brooke Hayward 1 , David Hughes 1 , Luis Villa 1 , Dominic Madell 11 Ko Awatea, Counties Manukau Health, New Zealand
Correspondence to: Brooke Hayward, Ko Awatea Research Office, Level 1 Esmé Green Building, Middlemore Hospital, 100 Hospital Road, Otahuhu, Private Bag 93311, Auckland 1640, New Zealand. Email: Brooke.Hayward@middlemore.co.nz
Journal of Primary Health Care 8(4) 288-294 https://doi.org/10.1071/HC16001
Published: 21 December 2016
Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
BACKGROUND: The Medical Council of New Zealand requires graduating doctors to have community attachments within their first two years of practice by 2020. Counties Manukau Health has developed a programme where house officers (HOs) are attached to a general practice for three months.
AIM: This study aimed to establish the value of four HO general practice attachments in Counties Manukau and describe how HOs are being used in these practices.
METHODS: A mixed-methods design was used to evaluate three attachment runs. Two practices provided the number of patients seen by HOs. Fifty-eight patients were surveyed to assess patient perceptions of the HOs. Six HOs, four supervising general practitioners, two PHO senior staff and one practice manager participated in semi-structured interviews. Focus groups were held with nurses, doctors and administrative staff at all four practices.
FINDINGS: HOs saw 300–600 patients in one practice and 800–1000 in the other during their attachment. Practices developed their own approach to mentoring and teaching HOs. Most patients reported positive perceptions of the HOs. Themes from interviews and focus groups were consistent among participants and included: improved HO confidence, clinical skills and understanding of general practice; extra capacity and improved quality of care and staff satisfaction among practices.
CONCLUSION: HOs and practices viewed HO attachments in general practice positively. HOs developed clinical skills and understanding of primary health care. Practice teams enjoyed the energy and enthusiasm of the HOs, while providing clinical support to ensure quality patient care.
KEYWORDS: Physicians; primary care; hospital; general practice; evaluation research; teaching
References
[1] The Royal New Zealand College of General Practitioners. 2015 Workforce Survey. December 2015.[2] Brett T. New medical graduates: Can general practice help with training? Aust Fam Physician 2008; 37 363–6.
[3] Martin AA, Laurence CO, Black LE, Mugford BV. General practice placements for pre-registration junior doctors: adding value to intern education and training. Med J Aust 2007; 186 349–69.
[4] Sheehan D, Thwaites J, Byrnes I. General practice rotations for post graduate year 1 and 2 house officers—how feasible? N Z Med J 2007; 120 U2770
[5] Anderson K, Haesler E, Stubbs A, Molinari K. Comparing general practice and hospital rotations. Clin Teach 2015; 12 8–13.
| Comparing general practice and hospital rotations.Crossref | GoogleScholarGoogle Scholar |
[6] Greenhalgh T, Humphrey C, Hughes J, et al. How do you modernize a health service? A realist evaluation of whole-scale transformation in London. Milbank Q 2009; 87 391–416.
| How do you modernize a health service? A realist evaluation of whole-scale transformation in London.Crossref | GoogleScholarGoogle Scholar |
[7] Curry N, Harris M, Gunn M, et al. Integrated care pilot in north-west London: a mixed methods evaluation. Int J Integr Care 2013; 13
| Integrated care pilot in north-west London: a mixed methods evaluation.Crossref | GoogleScholarGoogle Scholar |
[8] Best A, Greenhalgh T, Lewis S, et al. Large-System transformation in health care: A realist review. Milbank Q 2012; 90 421–56.
| Large-System transformation in health care: A realist review.Crossref | GoogleScholarGoogle Scholar |
[9] Hsieh HF Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005; 15 1277–88.
| Shannon SE. Three approaches to qualitative content analysis.Crossref | GoogleScholarGoogle Scholar |
[10] Sturman N, Re’go P, Dick ML. Rewards costs and challenges: the general practitioners experience of teaching medical students. Med Ed 2011: 45.
[11] Williams C, Cantillon P, Cochrane M. Pre-registration house officers in general practice: the views of GP trainers. Fam. Prac 2001; 18 619–21.
| Pre-registration house officers in general practice: the views of GP trainers.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MnptFKnsA%3D%3D&md5=b26e711da2ce071aab730791083a5e49CAS |
[12] Pullon S, Lum R. Clinical teaching capacity in New Zealand general practice. N Z Med J 2008; 121 U2895
[13] Illing J, Taylor G, Zwanenberg T. A qualitative study of pre-registration house officers in general practice. Med Educ 1999; 33 894–900.
| A qualitative study of pre-registration house officers in general practice.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2FltV2htg%3D%3D&md5=b8dd52eab9d1dbd4424b2edf913b47fdCAS |
