Family physicians require leadership skills to strengthen team-based primary care services. Interviews with South African district managers confirmed the need to develop leadership skills in family ...physicians. The updated national programmatic learning outcomes for South African family physician training were published in 2021. They sparked the need for curriculum renewal at the University of Cape Town's Division of Family Medicine. A review of the leadership and governance module during registrar training showed that the sessions were perceived to be content heavy with insufficient opportunities for reflection. Following a series of stakeholder engagements, the module convenors co-designed a revised module that was blueprinted on the updated learning outcomes. The module incorporates a group coaching style, facilitating learning through reflection on one's experiences. The revised module was implemented in 2022. It aims to provide a transformative learning experience centred on students' perceptions of themselves as leaders, as well as professional identity formation and resilience building. This short report describes preliminary insights from the revised module's developmental phase and forms part of an ongoing iterative evaluation process.Contribution: Family physicians should lead across all their defined roles. Formal and informal learning opportunities are needed to facilitate their growth as leaders and help them to meet the health needs of communities served by an evolving health care system. This short report describes an example of a revised postgraduate module on leadership and governance, which may be of value to clinician educators and academic departments exploring innovative methods for the African region.
Emerging evidence suggests that running gait retraining plays an important role in the treatment and prevention of running-related injury, yet it remains unclear how gait retraining is being utilized ...by family physicians with their patients. By surveying family physicians and residents, this study is the first to investigate the frequency of gait retraining discussions with patients with running-related injuries, barriers to these discussions, and physician confidence and perceived value in engaging in these discussions, so as to better inform family physician training on this subject.
This study investigated family physician attitudes toward gait retraining though a cross-sectional survey administered to 532 military family physicians and residents at the 2019 Uniformed Services Academy of Family Physicians Annual Meeting. Main outcome measures included frequency of, confidence in, and value of discussions of running gait retraining with patients with running-related injuries. Obstacles to discussing gait retraining, knowledge on the topic, and previous training on the topic were also assessed.
With a 72.2% response rate, the majority of respondents (82%) felt discussions on the topic are at least somewhat valuable. However, 63% of respondents infrequently discuss the topic with patients, while 71% lack confidence in engaging in these discussions. The most frequently reported obstacles were lack of knowledge (55%) and time (24%).
Family physicians find value in discussions of running gait retraining with their patients, but discussion frequency and physician confidence are low. Educational interventions increasing physician knowledge and the development of non-time-intensive approaches would be best suited for improving confidence and discussion frequency for this valued skill.
Supporting the development of a professional identity is a primary objective in postgraduate education. Few empirical studies have explored professional identity formation (PIF) in residency, and ...little is known about supervisors' perceptions of their roles in residents' PIF. In this study, we sought to understand how supervisors perceive their roles in the PIF of General Practice (GP) residents.
Guided by principles of qualitative description, we conducted eight focus groups with 55 supervisors at four General Practice training institutes across the Netherlands. Informed by a conceptual framework of PIF, we performed a thematic analysis of focus group transcripts.
Three themes related to how GP supervisors described their roles in supporting residents' PIF: supervising with the desired goal of GP training in mind; role modeling and mentoring as key strategies to achieve that goal; and the value of developing bonds of trust to support the process.
To our knowledge, this study is the first to explore PIF in GP training from the perspective of clinical supervisors. The identified themes mirror the components of the therapeutic alliance between doctors and patients from a supervisor's perspective and highlight the pivotal roles of the supervisor in a resident's PIF.
We studied the changes in presented health problems and demand for primary care since the outbreak of coronavirus disease 2019 (COVID-19) in the Netherlands. We analyzed prominent symptom features of ...COVID-19, and COVID-19 itself as the reason for encounter. Also, we analyzed the number and type of encounters for common important health problems. Respiratory tract symptoms related to COVID-19 were presented more often in 2020 than in 2019. We observed a dramatic increase of telephone/e-mail/Internet consultations in the months after the outbreak. Contacts for other health problems such as prevention and acute and chronic conditions plummeted substantially (
<0.001); mental health problems stabilized.
Over the last decade, the emphasis on improving the education and training of family physicians has increased. World Health Organization has also emphasized the importance of a trained primary care ...workforce. In 2017, Khyber Medical University (KMU) Peshawar initiated a one-year Postgraduate Diploma in Family Medicine for doctors working in primary care, to upgrade their skills and knowledge as Family Physicians. To justify the allocation of resources, there is a need for research on the impact of such programs. This study explores the impact of Diploma in Family Medicine (DFM) on primary care doctors in Khyber Pakhtunkhwa. It also identifies the barriers associated with learning and its translation to practice.
A mixed-method explanatory study was conducted from February 2019-2020. Forty-five graduates from the DFM program at KMU were invited to participate in this study. The quantitative data was collected through questionnaires (n=30) and the results were then explained further through qualitative focus group interviews (n=24). Descriptive statistics were calculated for the quantitative data and thematic analysis was performed for the qualitative data.
The respondents (n=30/45) were satisfied from the course content and delivery. They agreed that the course is useful (93.3%), relevant to their learning needs (86.7%) and they were able apply it to their clinical practice (100%). The qualitative findings also corroborated that the course improved both the clinical and consultation skills of the participants. The learning environment encouraged them to identify their learning needs and attain new competencies. They reported being more patient-centered and evidence-based, which increased patients' satisfaction. The program also resulted in increased career opportunities and other monetary benefits. Despite the blended nature of the program, the participants found it challenging to balance training with the provision of services.
One-year Postgraduate Diploma in Family Medicine is focused, practical and relevant to the learning needs of primary healthcare physicians. The policymakers should consider provision of such training opportunities in both public and private-sector. Future research should explore the long-term impact of such programs on healthcare outcomes.
Khan discusses the additional roles in British general practice. The Additional Roles Reimbursement Scheme (ARRS) aims to fund 26 000 additional roles in general practice, including roles such as ...clinical pharmacists, community paramedics, and physician associates (PAs). While some of the roles under the ARRS, for instance, dieticians and physiotherapists, seem fairly well defined and understood by clinical teams and patients, other roles such as PAs, nurse practitioners, and community paramedics are more recently emerging and involve duties that overlap with the traditional remit of a GP. Patient perceptions can affect whether or not changes to the primary care workforce changes are accepted, and the extent to which new roles gain legitimacy.
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