Practice Based Teaching
Practice based teaching can be formal or informal (opportunistic or corridor) and practice centred (focused on what practice and doctors specifically offers) or learner centred (identified by the learners needs).
The requirements at each training level are outlined in the table.
|GP extended skills or|
|3 hours total
||3 hours total
||1.5 hours total
||No formal requirement
||No formal requirement|
contiguous 1:1 teaching
contiguous 1:1 teaching
contiguous 1:1 teaching
To ensure that doctors-in-training receive the required hours of teaching, GP Supervisors are encouraged have a structured approach and plan for the in-Practice education sessions. There should be a good balance between practice centred teaching and learner centred teaching.
|Identify aspects of your practice that are unique and plan for the doctor-in training to experience these.
Use the clinical skills and expertise of other GPs and clinical staff in your Practice.
|Identify the doctor in training’s experience, competence, strengths and needs by talking with them and reviewing any documented needs assessments (eg Personal Education matrix, Patient logs, MCQ and EMQ questions, patient survey, ECT visit reports etc)|
|This reduces the formal teaching load of the GP Supervisor and provides the Doctor in training with a breadth of experience and a broader group of clinicians to seek advice from during their placement
||This means that the a proportion of the practice based teaching will be different for each doctor in training! |
Often problems arise because of perceptions of what is considered to be teaching (formal versus informal teaching or teaching delivery mode). Talking through the teaching plans and reaching agreement on how, where, when and what will occur can prevent most of these problems.
Some points to consider in providing Practice-based education.
- Planning regular teaching sessions can eliminate all but the urgent questions from the Doctor in training if they know that there is a scheduled time when general questions and non-urgent patient cases can be discussed in depth.
- Teaching should be done during paid consulting time for the doctor in training.
- Set aside quarantined time for in-Practice teaching, trying to avoid times where the demands of the practice may mean sessions start late or don’t happen. Once a few sessions have been missed it will be very difficult to ‘make up’ the time.
- Negotiate with the doctor in training when education sessions can be best scheduled to meet everyone’s needs – this is particularly important for part-time GP Registrars.
Teaching delivery mode
Don’t feel limited to topic based tutorials for teaching, use a variety of approaches:
- Topic based tutorials. You can present the tutorials or get the doctor in training to present part, or do “homework” before or after the session. These may be conducted by any other doctors or staff in the practice eg practice nurse, practice manager
- Case discussion. The doctor in training can present a number of cases that raised questions for them for discussion.
- Random case review. Discussion of randomly selected cases seen during a session enables review of management, investigations and referrals.
- Teaching practical procedures – simple practical procedures are often not taught in large teaching hospitals so GP Registrars may need a demonstration and then supervision.
- Audits. Audits of referrals, investigations can be undertaken by the doctor in training and provides valuable material for reflection and discussion.
- Direct consultation observation and feedback:
- Doctor in training observes GP Supervisor - many things in general practice are better shown than talked about (e.g. the way you relate to patients, beginning and ending consultations etc).
- GP Supervisor observes Doctor in training – allows the GP Supervisor to observe the consultation followed by discussion on the patient seen, feedback on consultation skills and identification of areas for inclusion in teaching time.
- Video consultation review and feedback. Following Supervisor feedback this is now a compulsory component of in-practice teaching.
- Doctor in training observes GP Supervisor
- GP Supervisor observes Doctor in training
- Providing constructive appraisal and assessment feedback. This can be a formal process using the mid and end of term assessment forms or an informal one.
- Review of progress against the GP registrar plan for learning
- Role play. This can be integrated into teaching sessions to demonstrate and explore consultation approaches.
- Local hospital, nursing home or home visits with the GP supervisor
- Allied health professionals. These professionals eg physio, pharmacist, local palliative care team etc may provide tutorials in the practice or the doctor in training can visit their workplace
- Attendance at any regular practice education meetings. However, these cannot make up the total 1:1 teaching time requirement.
- Attendance at Regular Practice meeting for all staff looking at the operation of the Practice. However, these cannot make up the total 1:1 teaching time requirement.
- Small group learning between different Practices, perhaps involving other Training Practices in the area
- Projects. You can encourage the doctor in training to complete a project in the practice eg. undertaking work to develop resources for the Practice. Registrars in their subsequent term are required to complete a project.