Firth Adam, Wass Val
Academic Clinical Fellow in General Practice, University of Manchester, Manchester, UK.
Educ Prim Care. 2011 Sep;22(5):314-20. doi: 10.1080/14739879.2011.11494025.
Modernising Medical Careers saw the introduction of four-month attachments in primary care during the second Foundation Year, to foster a broader understanding of healthcare settings. The North West Deanery offered this opportunity to virtually all trainees. Previous work had captured poor impressions of undergraduate experience in general practice. This study aimed to explore Foundation Doctors' perceptions of Foundation primary care attachments before and after the experience. Qualitative methodology was used. Two focus groups were held with 12 trainees at the end of their first Foundation Year to explore their expectations of pending rotation in general practice. Eighteen individual interviews were conducted with Foundation Doctors after the attachment. Themed analysis of transcripts revealed a striking contrast between trainees' perceptions of general practice before and after undertaking F2 rotations. Undergraduate exposure and secondary care bias in training had a significant negative impact on trainees' perceptions of general practice. The one-to-one opportunities for educational supervision, the range of patients seen and the opportunity to understand communication at the primary/secondary interface dispelled these concerns. The findings highlighted the beneficial impact of foundation posts in general practice for training, career planning in general and, as outlined in the initial goals of the programme, the interaction between primary and secondary care.
“现代医学职业发展计划”引入了在第二年基础培训阶段进行为期四个月的基层医疗实习，以促进对医疗环境有更广泛的了解。西北地区培训中心几乎为所有实习生提供了这一机会。此前的研究反映出本科生在全科医疗实习中的体验不佳。本研究旨在探讨基础培训医生在经历基层医疗实习前后对该实习的看法。研究采用了定性研究方法。在第一年基础培训结束时，与12名实习生进行了两个焦点小组讨论，以了解他们对即将到来的全科医疗轮转的期望。在实习结束后，对基础培训医生进行了18次个人访谈。对访谈记录的主题分析显示，实习生在进行F2轮转前后对全科医疗的看法存在显著差异。本科阶段的接触以及培训中的二级医疗偏向对实习生对全科医疗的看法产生了重大负面影响。一对一的教育督导机会、所接触患者的范围以及理解基层/二级医疗衔接中沟通情况的机会消除了这些担忧。研究结果凸显了全科医疗基础培训岗位在培训方面、总体职业规划方面以及正如该计划初始目标中所概述的基层医疗与二级医疗之间的互动方面所产生的有益影响。
