Discipline of General Practice, School of Medicine, Faculty of Health Sciences, The University of Queensland, Brisbane, Queensland, Australia.
Med Educ. 2011 Jul;45(7):722-30. doi: 10.1111/j.1365-2923.2011.03930.x.
Medical student attachments in general practices play an important role in undergraduate medical education internationally. The recruitment by universities of new teaching practices or an increase in the teaching commitment of existing practices will be necessary to address rising medical student numbers. General practitioners (GPs) are likely to weigh the perceived rewards of practice-based teaching against the perceived costs and challenges in deciding whether to accept a student placement and how to teach. These aspects of the 'lived experience' of the GP-teacher have not been adequately investigated.
This study aims to enhance understanding of the GP clinical teacher experience in order to inform strategies for the recruitment, retention, training and support of teaching general practices.
Sixty GP clinical teachers in Brisbane-based urban teaching general practices were interviewed individually face-to-face by the principal investigator, using a semi-structured interview plan. Representativeness was ensured through quota sampling. The interview data were analysed thematically by two of the investigators independently, following member checking of interview transcripts.
The results demonstrate a number of key inter-related perceived rewards, costs and challenges of teaching, including intellectual stimulation, cognitive fatigue and student characteristics.
The findings extend reports in the previous literature by offering a richer description of current GP-teacher experience. Participants identified teaching rewards in a manner largely consistent with previous research, with the exception of enhanced practice morale and teamwork. Findings confirm that reduced productivity and increased time pressures remain key perceived negative impacts of teaching, but also reveal a number of other important costs and challenges. They emphasise the diversity of GP experience and practice cultures, and the need for teaching to enhance both GP and patient perceptions of consultation quality without increasing the load on the GP-teacher. Recruitment and retention strategies should promote the rewards of teaching, and teacher training should respond to the costs and challenges of practice-based teaching, and facilitate the growth of GPs in their role as clinical educators.
在国际上，医学生在全科诊所的实习对于本科生医学教育起着重要作用。为了应对不断增加的医学生人数，各大学有必要招募新的教学实践基地，或增加现有实践基地的教学投入。全科医生（GP）在决定是否接受学生实习以及如何教学时，可能会权衡基于实践的教学的预期收益与预期成本和挑战。GP 教师的这种“实际体验”的各个方面尚未得到充分研究。
本研究旨在深入了解全科临床教师的经验，以便为招聘、保留、培训和支持教学实践基地提供策略。
通过主要调查员对布里斯班市的 60 名全科临床教师进行了面对面的个人半结构式访谈，采用了定额抽样法确保代表性。两名调查员独立对访谈数据进行了主题分析，并对访谈记录进行了成员检查。
结果表明，教学存在一些关键的相互关联的收益、成本和挑战，包括智力刺激、认知疲劳和学生特点。
这些发现通过提供更丰富的当前 GP 教师经验描述，扩展了之前文献中的报告。与之前的研究相比，参与者在很大程度上认同教学收益，但除了增强实践士气和团队合作外，还发现了其他一些重要的成本和挑战。研究结果证实，生产力下降和时间压力增加仍然是教学的主要负面影响，但也揭示了其他一些重要的成本和挑战。它们强调了 GP 经验和实践文化的多样性，以及教学需要提高 GP 和患者对咨询质量的看法，而不会增加 GP 教师的负担。招聘和保留策略应促进教学收益，教师培训应针对基于实践的教学的成本和挑战，并促进 GP 在临床教育者角色中的成长。
