Chaudhry Umar, Ibison Judith, Harris Tess, Rafi Imran, Johnston Miles, Fawns Tim
Clinical Teaching Fellow, Population Health Research Institute (PHRI), St George's University of London (SGUL), London, UK
Reader in Primary Care, Institute of Medical and Biomedical Education (IMBE), St George's University of London (SGUL), London, UK.
BJGP Open. 2020 May 1;4(1). doi: 10.3399/bjgpopen20X101008. Print 2020.
Primary care telephone consultations are increasingly used for patient triage, reviews, and providing clinical information. They are also a key postgraduate training component yet little is known about GP trainees' preparation for, or experiences and perceptions of, them.
To understand the experiences, perceptions, and training of GP trainees in conducting telephone consultations.
DESIGN & SETTING: A mixed-methods study was undertaken of North Central and East London (NCEL) GP trainees.
A cross-sectional electronic survey of trainees was performed with subsequent semi-structured interviews. Survey data were analysed using descriptive statistics, and qualitative data using thematic analysis.
The survey response was 16% ( = 100/618), and 10 participated in semi-structured interviews. Trainees felt least confident with complicated telephone consulting, and there was a strong positive correlation between the percentage reporting having received training and their confidence ( = 0.71, <0.0001). Positive experiences included managing workload and convenience. Negative experiences included complex encounters, communication barriers, and absence of examination. Trainees reported that training for telephone consultations needed strengthening, and that recently introduced audio-clinical observation tools (COTs) were useful. Positive correlations were found between the length of out-of-hours (OOH) but not in-hours training and the level of supervision or feedback received for telephone consultations.
This project sheds light on GP trainees' current experiences of telephone consultations and the need to enhance future training. The findings will inform a wider debate among stakeholders and postgraduate learners regarding training for telephone consultations, and potentially for other remote technologies.
基层医疗电话咨询越来越多地用于患者分诊、复查以及提供临床信息。它们也是研究生培训的关键组成部分，但对于全科医生培训生对其的准备情况、经验和看法却知之甚少。
了解全科医生培训生进行电话咨询的经验、看法和培训情况。
对伦敦中北部和东部（NCEL）的全科医生培训生进行了一项混合方法研究。
对培训生进行了横断面电子调查，并随后进行了半结构化访谈。使用描述性统计分析调查数据，使用主题分析分析定性数据。
调查回复率为16%（n = 100/618），10人参与了半结构化访谈。培训生对复杂的电话咨询最缺乏信心，报告接受过培训的比例与他们的信心之间存在很强的正相关（r = 0.71，P<0.0001）。积极的经验包括管理工作量和便利性。消极的经验包括复杂的会诊、沟通障碍和无法进行检查。培训生报告称，电话咨询培训需要加强，最近引入的音频临床观察工具（COTs）很有用。非工作时间（OOH）而非工作时间培训的时长与电话咨询获得的监督或反馈水平之间存在正相关。
该项目揭示了全科医生培训生目前电话咨询的经验以及加强未来培训的必要性。这些发现将为利益相关者和研究生学习者之间关于电话咨询培训以及可能对其他远程技术培训的更广泛辩论提供信息。
