Exploring how a patient encounter tracking and learning tool is used within general practice training: a qualitative study

Michael Bentley; Jennifer Taylor; Alison Fielding; Andrew Davey; Dominica Moad; Mieke van Driel; Parker Magin; Linda Klein

doi:10.1071/HC23082

RESEARCH ARTICLE (Open Access)

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Exploring how a patient encounter tracking and learning tool is used within general practice training: a qualitative study

Michael Bentley

¹ , Jennifer Taylor

² , Alison Fielding

¹ ³ , Andrew Davey

¹ ³ , Dominica Moad

¹ ³ , Mieke van Driel

⁴ , Parker Magin

¹ ³ , Linda Klein

¹ ³ ^*

+ Author Affiliations

- Author Affiliations

¹ GP Training Research Department, The Royal Australian College of General Practitioners, Level 1, 20 Mcintosh Drive, Mayfield West, NSW 2304, Australia.

² GP Synergy, NSW & ACT Research and Evaluation Unit, Level 1, 20 Mcintosh Drive, Mayfield West, NSW 2304, Australia.

³ Discipline of General Practice, School of Medicine & Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.

⁴ General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, 288 Herston Road, Brisbane, Qld 4006, Australia.

^* Correspondence to: linda.klein@racgp.org.au

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care 16(1) 41-52 https://doi.org/10.1071/HC23082

Submitted: 27 July 2023 Accepted: 28 October 2023 Published: 27 November 2023

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

In Australian general practitioner (GP) training, feedback and reflection on in-practice experience is central to developing GP registrars’ (trainees’) clinical competencies. Patient encounter tracking and learning tools (PETALs) that encompass an audit of consecutive patient consultations, feedback, and reflection are used to determine registrars’ in-practice exposure and have been suggested as a tool for learning within a programmatic assessment framework. However, there is limited qualitative literature on the utility of PETALs in GP training.

Aim

To provide greater understanding of how PETALs are used in GP training, using Registrars’ Clinical Encounters in Training (ReCEnT) as a case study.

Methods

Medical educators, supervisors, and registrars from two Australian regional GP training organisations participated in focus groups and interviews, designed to explore participants’ perceptions of ReCEnT’s utility. Data were analysed using reflexive thematic analysis.

Results

Eight themes were identified that enhance our understanding of: how ReCEnT reports are used (reassuring registrars, facilitating self-reflection, identifying learning needs), what enables ReCEnT to reach its full potential (a culture of reflection, meaningful discussions with supervisors and medical educators, valuing objective data), and differences in understanding about ReCEnT’s role in a programmatic assessment framework (as a tool for learning, as ‘one piece of the puzzle’).

Discussion

The findings were used to develop a Structure–Process–Outcomes model to demonstrate how ReCEnT is currently used and explores how it can be used for learning, rather than of learning, in a programmatic assessment framework for GP training. ReCEnT’s longitudinal format has potential for enhancing learning throughout training.

Keywords: clinical practice, general practice registrars, healthcare education, patient encounter data, performance and evaluation, primary healthcare, professional education, programmatic assessment, reflective practice.

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