Questions for this month’s clinical challenge are based on articles in this issue. The clinical challenge is endorsed by the RACGP Quality Improvement and Continuing Professional Development (QI&CPD) program and has been allocated 4 Category 2 points (Activity ID:47512).Answers to this clinical challenge are available immediately following successful completion online at http://gplearning.racgp.org.au. Clinical challenge quizzes may be completed at any time throughout the 2014–16 triennium; therefore, the previous months’ answers are not published.
Each of the questions or incomplete statements below is followed by four suggested answers or completions. Select the most appropriate statement as your answer.
Chris is a general practitioner (GP) working in a large private group practice that employs several registrars. Chris is involved in registrar supervision and provides feedback to the registrars as part of his role in supporting their education. Prior to meeting one of his registrars, Chris reflects on the challenges of teaching in the general practice setting.
Which one of the following statements about GP registrar learning is most correct?
- General practice registrars who learn in practices that have non-hierarchical relationships between the doctors are better prepared for practice.
- A single, enthusiastic clinical supervisor is considered to be enough to provide adequate educational support.
- Experienced GPs have no need to deconstruct and clearly articulate skills that have become automatic.
- Empathic negotiation, which is required when considering cultural contexts, is best taught using didactic instruction.
Chris considers the ‘craft’ of general practice and the variety of related topics that might be discussed when supervising general practice registrars. These topics include:
- handling conflicts of interest with pharmaceutical promotional material
- assessing evidence and guidelines for their relevance in different contexts
- thinking logically and creatively to guide patients into addressing their problems
- all of the above.
In association with his role as a general practice supervisor, Chris has recently been more conscious of the differences in clinical activities between general practice registrars and practising registered specialist GPs. He also wonders whether differences may exist between doctors working at teaching practices and non-teaching practices.
Patients seeing general practice registrars, when compared to patients seeing non-registrars at teaching practices, are more likely to be:
- new to the practice
- experiencing chronic conditions.
Patient management by general practice registrars, compared with
non-registrar GPs involves:
- prescribing more medications
- ordering more imaging
- higher rates of non-pharmacological treatments
- ordering fewer pathology tests.
Recently, Chris’s practice has formed a relationship with the regional medical school and has started accepting medical students under a mentorship program.
Mentoring in general practice is:
- a short-term relationship between an experienced GP and the student
- based on shared professional and personal interests
- a caring, supportive relationship within the formalised course of the university environment
- comparable to the shorter term medical placements of the medical course.
An effective mentor needs to be all of the following except:
- a role model
- available for weekly meetings
Which one of the following processes is helpful when mentoring a medical student?
- Summative assessment
- Referring rather than treating impaired medical students
- Doing work on behalf of the student
- Exploring the student’s personal life to better understand their needs
In providing formative feedback, which one of the following sources of information would be most appropriate?
- Examination results
- Formal written assignments
- Progress documented in the learning plan
- Formal oral presentations
Following a long day of reflection and contemplation, Chris lastly considers the role of the GP in public health matters.
According to The Royal Australian College of General Practitioners (RACGP) curriculum for general practice, which one of the following core skills and competencies is included in the domain of population health and in the context of general practice?
- Formulating public policies designed to solve local and national health problems
- Identifying and addressing the impact of the social determinants of health
- Assessing and monitoring the health of communities and populations at risk
- Coordinating public health responses to disease outbreaks