Education in general practice encompasses education as it applies to all general practitioners (GPs) in a variety of contexts. Opportunities for teaching, learning, supervising, mentoring, or role modelling occur within the practice or outside it, and educational skills may be used by GPs in their interactions with other health professionals, peers, students, individual patients, or community groups.
Teaching is an integral part of good medical practice.1 While adages such as ‘see one, do one, teach one’ reflect the long history of intertwined clinical and educational practice, modern medical education no longer views a skilled clinician as automatically a skilled educator.2 Gaining the skills of an educator is an endeavour in its own right.3
Within general practice training, there have been calls to improve vertical integration of teaching and learning.4 While GPs in training cannot take final responsibility for care of patients seen by medical students,5 they can play an important role in medical student education.6-8 GPs may also be called upon to educate peers,9 support interdisciplinary learning, or provide education for local community groups. Some GPs may be interested in acquiring extended skills to become a GP supervisor or medical educator.9
Teaching occurs in many circumstances: planned and unplanned, with or without a patient present, and with single or multiple learners. There are a range of theories on adult learning,10 and the use of these theories is important for education in general practice. Learners are not empty containers into which knowledge is poured by the teacher. General practice education is experiential and is context and learner dependent. Therefore, educational approaches need to be adapted to the circumstance.
Adult learning theories suggest that adults plan, manage and assess their own learning to accomplish self-motivation and independence in their learning.11 Learners are internally motivated to learn if they understand why something is important, or how knowledge and skills can be applied practically. Consequently, active learning methods are most effective using strategies such as case-based learning.11,12
Coaching is an essential technique. Coaching differs from mentoring in that it does not focus just on advice and counselling but rather requires the provision of feedback and a combination of questioning, challenging, and encouragement to help the coached person achieve their full potential.12 There is no one right way to coach a learner, the most appropriate approach will depend on the individual coaches and learners involved.13
Feedback is an essential tool of coaches and an indispensable element of effective clinical learning.14 Feedback should be dialogic, specific, in real time, and learner-focused to help them achieve their goals.12 There is no one-size-fits all approach to feedback. When, how, and by whom feedback is delivered matters.15
Feedback also does not occur in a vacuum; learning cultures facilitate and constrain the exchange of good feedback. The ‘learning environment’, which includes the psychological states and relationships between participants,16 significantly impacts how feedback occurs.17,18 While transformative learning can eventuate from disorientating discomfort,19 unsafe experiences can be damaging.20 It is important that learning environments are free from bullying and harassment, are inclusive and culturally safe and allow educational discourse to occur with a focus on improvement.1,21,22
Learning also occurs through observing and imitating others.23 Medical students view GP trainees, as well as supervisors, as role models and identify this as one of the most important ways they learn.24 Role-modelling of both positive and negative behaviours can influence the formation of a learner’s professional identity,24 and it is therefore an important role for all GPs to facilitate learning for peers and those less experienced than themselves.