Learning from the learners: What do trainees want from general practice vocational education?


Jane Stewart, RNZCGP, PO Box 10 440, Wellington, New Zealand. Email: jstewart@rnzcgp.org.nz


Background and Aim: The Royal New Zealand College of General Practitioners offers a two stage General Practice Education Programme, which prepares doctors for general practice in New Zealand. This paper focuses on Stage 1, the Intensive Clinical Training Program.

Method: This paper uses Shipengrover and James’ model, which describes quality in practice based general practice education and suggests methods for evaluating teaching in attachments. The data included in this paper are drawn from two sources – evaluation data collected from 1996 to 1999 and qualitative research data. The data include trainees’ perceptions of aspects of vocational education, which contributed most to their learning.

Results: Registrars consistently note that the most useful aspects of practice attachments include adequate numbers and a good variety of patients, teacher availability and approachability, informal corridor teaching, supportive positive work environment and high quality practices. Learning opportunities during practice attachments would be improved with explicit individual learning goals, guaranteed uninterrupted teaching time each week, more constructive, specific feedback, more involvement with chronic health problems, as well as better information for practice staff. Trainees perceive experience as the primary source of learning for general practice, in particular new experiences that are coupled with reflection on feedback from those experiences. They note the structured support provided by general practitioner teachers, which enhance learning through experience.

Conclusions: Evaluation and research data about practice attachments reinforce the importance of trainees’ clinical experiences, supported by interactions with their teacher, in learning general practice. These data provide feedback to teachers, as well as forming the basis for quality improvement measures over time.