Wilson A, Fraser R, McKinley R K, Preston-Whyte E, Wynn A
Department of General Practice and Health Care, University of Leicester.
Br J Gen Pract. 1996 Aug;46(409):457-60.
All UK medical schools are revising their curricula following the General Medical Council recommendations to increase general practice involvement in undergraduate education. However, workload in general practice has increased in recent years, raising questions about its ability to maintain, let alone extend, its educational activities.
The aim of this study was examine whether recent changes in general practice have affected delivery of practice-based undergraduate education and to assess the extent to which practices will be able to increase their involvement in teaching.
A postal questionnaire survey was conducted of the lead clinical teachers and their partners in the practices to which students from Leicester Medical School had been attached in the last 2 years.
The questionnaire was completed by 32 out of the 39 lead teachers and 134 of the 150 partners, an overall response rate of 88%. There was widespread support for departmental teaching requirements, but only 17 lead teachers (44%) felt that the suggested reduction by 25% of patients seen per session while teaching was feasible. A total of 14 lead teachers (47%) felt that the ability of their practice to deliver high-quality teaching had declined since 1990. Altogether, 113 (87%) of all doctors in teaching practices felt that time pressures had increased during this period, and 139 (88%) felt that present levels of remuneration were inadequate. The majority of these doctors felt that general practice was the preferred location for learning generic clinical skills and were interested in participating. Nevertheless, most were not prepared to increase their involvement in teaching under present arrangements.
Practice-based teachers appreciate the need for quality teaching, remain enthusiastic about teaching and are, in principle, willing to take an increased teaching load. However, recent changes have made delivery of teaching more difficult, and if an expansion in practice-based teaching is to occur, more realistic levels of funding and support are a prerequisite.
英国所有医学院校都在根据英国医学总会的建议修订课程，以增加全科医疗在本科教育中的参与度。然而，近年来全科医疗的工作量有所增加，这引发了人们对其维持甚至扩大教育活动能力的质疑。
本研究的目的是调查全科医疗近期的变化是否影响了基于实践的本科教育的提供，并评估各医疗机构能够增加其教学参与度的程度。
对莱斯特医学院的学生在过去两年所实习的医疗机构的首席临床教师及其合作伙伴进行了邮寄问卷调查。
39位首席教师中有32位、150位合作伙伴中有134位完成了问卷，总体回复率为88%。大家普遍支持部门教学要求，但只有17位首席教师（44%）认为在教学时每次诊疗所见患者数量减少25%的建议是可行的。共有14位首席教师（47%）认为自1990年以来他们所在医疗机构提供高质量教学的能力有所下降。在参与教学的所有医生中，共有113位（87%）认为在此期间时间压力增加了，139位（88%）认为目前的薪酬水平不足。这些医生中的大多数认为全科医疗是学习一般临床技能的首选场所，并且有兴趣参与。然而，大多数人不准备在目前的安排下增加他们的教学参与度。
基于实践的教师认识到高质量教学的必要性，对教学仍充满热情，原则上也愿意承担更多的教学任务。然而，近期的变化使教学的开展更加困难，如果要扩大基于实践的教学，更现实的资金和支持水平是前提条件。
