Closer supervision in Australian general practice training: planning major system change
Gerard Ingham
A C , Kayty Plastow A , Rebecca Kippen B and Nicky White A
+ Author Affiliations
- Author Affiliations
A Murray City Country Coast GP Training, Level 2, 369 Royal Parade, Parkville, Vic. 3052, Australia.
B Rural Health, Monash University, 26 Mercy Street, Bendigo, Vic. 3550, Australia.
C Corresponding author. Email: drgingham@gmail.com
Australian Journal of Primary Health 26(2) 184-190 https://doi.org/10.1071/PY19156
Submitted: 15 August 2019 Accepted: 23 November 2019 Published: 13 February 2020
Abstract
Major system change involving closer supervision of trainee GP registrars in Australia is warranted. Change management guidelines recommend involving stakeholders in developing change. The views of those involved in general practice training about current and potential supervisory practice were explored. Semi-structured interviews were conducted with a lead medical educator from nine Australian regions. Focus groups were conducted with GP supervisors and GP registrars. Transcripts from the interviews and focus groups were analysed using conventional content analysis, with themes emerging inductively from the data. The findings were that over 1–3 months, a registrar could progress from their supervisor observing all consultations through to the registrar only calling when they identify the need for help. There is strong support from registrars for this change to closer supervision, but less support from supervisors and educators. Barriers to the proposed change include high clinical demand competing with teaching capacity, inadequate payment for closer supervision and supervisors lacking skills or motivation to have a more active role in registrar supervision. If funding and logistic barriers to change are addressed, a change to a closer level of supervision is possible. A pilot study to further refine the change is indicated.
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