RACGP educational framework

RACGP educational framework: Summary

RACGP educational framework: Summary
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  1. RACGP educational framework: Summary
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Last revised: 25 Feb 2021

The RACGP educational framework provides a conceptual representation of the RACGP’s approach to education across the learning continuum of the Australian general practitioner. The interrelated components of RACGP education are the:

  • educational imperatives
  • guiding principles
  • guiding instruments
  • educational programs.

The educational framework is intended to guide RACGP educational development and orient learners, educators and institutions.

Download the full version of the RACGP educational framework , the framework summary, or the list of guiding principles.

RACGP educational framework: Summary

The Royal Australian College of General Practitioners (RACGP) educational framework provides a conceptual representation of the RACGP’s approach to education. It brings together the components of RACGP education across the learning continuum of the Australian general practitioner (GP), demonstrating their interrelationships.
 
Central to the RACGP educational framework is the RACGP educational guiding principles. These principles express the values, priorities, educational philosophy and scope of education to which the RACGP is committed. The guiding principles themselves are based on RACGP educational imperatives. The educational imperatives are:

  • the RACGP strategic vision and plan
  • the Australian community health needs
  • Aboriginal and Torres Strait Islander needs
  • medical education scholarship
  • ethical and regulatory requirements.

The guiding principles inform RACGP educational structures and programs. The key educational structures are the:

  • Profile of the general practitioner, which is a statement of the RACGP’s view of a GP in Australia. It outlines the roles GPs perform, the values they uphold, the behaviours they exhibit, and the capabilities they hold at different stages of the GP professional journey and different contexts.
  • Curriculum for Australian General Practice, which details the intended outcomes of RACGP education across the general practice learning continuum. It provides direction for general practice educational content, processes and assessment methods and ensures that general practice education is relevant, high quality and effective.
  • RACGP education policies and standards, which outline the parameters for RACGP education delivery and engagement. These aim to ensure high-quality, effective education and safe clinical practice in workplace training.

We have called these three structures the ‘RACGP guiding instruments’. Together, they provide direction for learners and education providers at all levels of general practice education, from medical school through to post-Fellowship education. Further detail regarding these guiding instruments, a vision of their future state and recommendations for their revision is provided in the full version of the RACGP educational framework.

The educational framework provides direction for RACGP educational development. It is also provides an orientation for learners, educators and institutions engaged with RACGP education. It was developed in broad consultation with internal and external stakeholders. It is a living document that is under regular consultative review as the educational imperatives and environment change.


RACGP educational framework  core components

Educational imperatives

RACGP stategic vision and plan
Community health needs
Aboriginal and Torres Strait Islander needs
Medical education scholarship
Ethics and regulations

RACGP educational guiding principles

1. Prioritises holistic, person-centred healthcare
2. Addresses the health needs of all people living in Australia in an equitable way
3. Is founded on ethical and socially responsible practice
4. Promotes innovation in healthcare and general practice
5. Is founded on evidence-based best practice and strives to be a leader in medical education
6. Values the skills of GP supervisors, educators and researchers
7. Promotes professional and personal development and selfcare throughout a GP's career
8. Enables GPs to meet the particular needs of those living in rural and remote regions
9. Equips GPs to provide healthcare that meets the needs of Aboriginal and Torres Strait Islander peoples
10. Meets the requirements of regulatory bodies

Guiding instruments

Profile of the general practitioner
Curriculum for Australian General Practice
RACGP education policies and standards

Educational programs

Primary medical degree
Prevocational
Pre-Fellowship
Extended skills
Post-Fellowship



Guiding principles of the  RACGP educational framework

RACGP education:

1
prioritises holistic, person-centred healthcare
2
addresses the health needs of all people living in Australia in an equitable way
3
is founded on ethical and socially responsible practice
4
promotes innovation in healthcare and general practice
5
is founded on evidence-based best practice and strives to be a leader in medical education
6
values the skills of GP supervisors, educators and researchers
7
promotes professional and personal development and selfcare throughout a GP’s career
8
enables GPs to meet the particular needs of those living in rural and remote regions
9
equips GPs to provide healthcare that meets the needs of Aboriginal and Torres Strait Islander peoples
10
meets the requirements of regulatory bodies
 


Basis of the RACGP educational guiding principles

 


Holistic, person-centred healthcare is necessary for meeting the complex needs of patients in a respectful way. This approach is recognised as a core feature of general practice.1

Holistic or ‘whole-person’ healthcare considers the multiple dimensions of a patient’s life and addresses these in an integrated way. These dimensions include biological, psychological, spiritual, social and environmental domains. Holistic healthcare employs a broad range of treatment modalities centred on the therapeutic value of a supportive and collaborative doctor–patient relationship. Holistic care recognises the doctor’s humanity and their need to be self-aware and attentive to their own health. Holistic care adopts a view that health is more than the absence of disease.1

Person-centred care is healthcare that respects and responds to the preferences, needs and values of the individual patient.

It involves seeking out and understanding what is important to the patient, fostering trust, establishing mutual respect and working together for shared decisions and care planning.2
 


GPs are the primary means of access to healthcare in Australia3 and provide the basis of an effective healthcare system. GPs address both individual and community health needs.4 The diversity of sociocultural, economic and environmental contexts within Australia means that the healthcare needs of patients and communities vary across different contexts. Access to healthcare is not currently equitable across Australia.3 To address this, RACGP education is attentive to different community needs. It is also responsive to local, state and national government health priorities.5

RACGP education enables GPs and GPs in training to meet these diverse needs and contexts to improve health outcomes and address health inequalities.6–8 This is particularly important for:

  • Aboriginal and Torres Strait Islander peoples
  • rural and remote communities
  • minority and disadvantaged groups including, but not limited to, people who
    • are refugees and migrants
    • are from culturally and linguistically diverse (CALD) backgrounds
    • have disabilities
    • are lesbian, gay, bisexual, transgender/gender diverse, intersex and queer (LGBTIQ+)
    • are economically challenged.

RACGP education equips GPs to be sensitive to the health needs of all people living in Australia and supports GPs in being advocates for individuals and communities.

RACGP education also supports GPs to engage in population health initiatives, including infectious disease screening and containment, disaster response, provision of public health education and public health advice to health authorities and the government.9

 

 


GPs and GPs in training are required to conduct themselves ethically, professionally and in a way that is consistent with the expectations of Australian society and the profession of general practice.10 Ethical medical practice is based on four principles:11

  • respect for autonomy – the right of individuals to make their own decisions
  • beneficence – the duty to act in the best interests of the patient
  • non-maleficence – the duty to do no harm
  • justice – equity and fair distribution.

Society expects particular professional characteristics and behaviours from GPs. These include trustworthiness, truthfulness, integrity, commitment to competency, commitment to patient safety, appropriate doctor–patient boundaries, confidentiality, compassion, respect for cultural differences, self-awareness and reflective practice.10,11 When healthcare does not go to plan, GPs are expected to acknowledge and learn from errors, create safe spaces for open dialogue about adverse events, and engage in honest, open disclosure.12 Learning how to respond to and learn from errors is an educational priority.13

GPs have a social responsibility to provide the best possible care for patients and the community while considering cost-effective and equitable use of limited public resources. It is paramount that healthcare for those most disadvantaged is resourced.6 Local, state and federal government health priorities inform this imperative.5


Healthcare practices need to constantly change and evolve for quality improvement and to meet the changing expectations and needs of patients, communities and regulatory bodies. This means that evidence-based innovation is important for general practice and the healthcare it provides.14,15

The RACGP supports education that enables GPs and GPs in training to engage in innovative evolution of healthcare and the profession.6

Innovations in digital technology are enabling more effective and equitable healthcare,14,15 particularly for isolated populations. RACGP education helps GPs and GPs in training to confidently adopt innovations in digital healthcare technology and be leaders in developing these innovations.


RACGP education is theoretically sound, based on current scholarship in medical education.16,17 Two important areas of educational theorising are adult learning and work-based learning. Adult learning theory foregrounds the learner, with a focus on self-directed, experiential and reflective learning.18–20 Work-based learning theories foreground the workplace as a learning environment, focusing on work activity, the interface between the learner and the work community, and the identity development of the learner.21–23

RACGP education uses competency- and outcomes-based education, with robust assessment methodologies that are fit for purpose.24–28 Assessment is both for learning and for privileging (refer to glossary). In its use for privileging it is clear, transparent and equitable.29

RACGP education recognises its international context. It contributes to the international advancement of general practice education, keeps abreast of advances beyond Australia, and supports research literacy and engagement in research. The RACGP directs a program of research to address educational problems and to inform the development of educational practice. Technological innovation is an important area of education research. Through evaluation, research and innovation, the college provides leadership in general practice education development in Australia and internationally.


Sustainable delivery of high-quality education and healthcare depends on well-trained and supported GP supervisors, medical educators and researchers.30–32

GPs with extended skills in supervision, medical education and research are crucial for ensuring a sustainable and skilled GP workforce.31 RACGP education supports development and use of educational and research skills. It also supports a career pathway for academic GPs.6

 

 


GPs require broad professional knowledge, skills and attributes.6 All GPs require core skills in the areas of:

  • communication and the patient–doctor relationship
  • applied professional knowledge and skills
  • population and public health
  • organisation and leadership skills
  • academic skills, including education and research
  • working effectively with other professionals
  • self-reflection and quality improvement.

The community and the profession also require GPs with extended skills in these areas and skills in specialist areas such as military medicine, business management, healthcare policy, and health service planning and development.6 GPs need to maintain, improve and expand their expertise over the course of their career depending on the context of their work and on their interest. They need to be responsive to changing clinical, technological and community contexts.6,10 RACGP education helps GPs maintain and develop, throughout their career, expertise in core areas of practice, as well as expertise in specialised fields.

General practice presents a challenging workplace environment where GPs can experience stress and isolation.33 RACGP education helps GPs and GPs in training adopt self-care habits, build resilience, attend to their physical and mental wellbeing through a healthy work–life balance, and develop effective and sustainable work environments and practices.34


The RACGP recognises the difficulty those living in rural and remote Australia can have in accessing healthcare. The GPs and GPs in training who work in rural and remote Australia also require specific resourcing to meet their educational needs. The RACGP prioritises education that helps meet the needs of patients living in rural and remote Australia, as well as provision of the educational resources needed by GPs and GPs in training who work in these areas.8

There are particular challenges in meeting the healthcare needs of Australia’s rural and remote communities. These communities depend on GPs capable of meeting those challenges. This may require GPs to have skills extending into areas normally delegated to other specialties in metropolitan areas.35

Currently, there is a maldistribution of GPs leading to a workforce shortage in rural and remote communities.35 Addressing this is a priority for the RACGP and RACGP education.8 RACGP education aims to provide the additional training and support needed to attract and enable GPs and GPs in training to learn and work effectively in rural and remote communities.


The RACGP is committed to the health of Aboriginal and Torres Strait Islander peoples and the ‘Close the Gap’ initiative.36 It prioritises working collaboratively and effectively with Aboriginal and Torres Strait Islander peoples to support the health of their peoples and communities in a way that is culturally safe and optimises their health outcomes.37

RACGP education collaborates with Aboriginal and Torres Strait Islander peoples and communities in both educational programs and in identifying and prioritising health interventions for specific communities and contexts. GP cultural competency is essential, and cultural educators are a necessary and integral part of GP cultural competency training.30 The RACGP recognises that healthcare and education must draw on the strength and resilience present in Aboriginal and Torres Strait Islander communities today, and needs to be developed in partnership with Aboriginal and Torres Strait Islander peoples and communities.37

The RACGP will therefore partner with Aboriginal and Torres Strait Islander peoples, health workers, cultural educators and cultural mentors to design, deliver, assess and evaluate education related to holistic, person-centred healthcare for Aboriginal and Torres Strait Islander peoples. Ongoing cultural competency education forms a key part of this, and all individuals and organisations are required to demonstrate that they can and will work in a way that is culturally safe, as defined by Aboriginal and Torres Strait Islander peoples.

Aboriginal and Torres Strait Islander peoples are also supported and enabled to train as GPs to address workforce inequity and increase the number of Aboriginal and Torres Strait Islander GPs. The needs of GPs and GPs in training who identify as Aboriginal and/or Torres Strait Islander are a priority of RACGP education, and appropriate support and resources are provided to these individuals.


The RACGP considers the education of GPs a social responsibility. Part of meeting this responsibility is addressing the priorities and requirements of local, state and federal government regulatory bodies. Regulatory requirements inform RACGP education and help ensure it provides high-quality training that is responsive to community healthcare needs. Of particular consideration are the regulatory requirements prescribed by the Health Practitioner Regulation National Law Act 2009 (Qld) through the Medical Board of Australia (MBA).38 The RACGP must meet these requirements to maintain accreditation for its Fellowship pathways, educational programs and Continuing Professional Development (CPD) Program. It is also necessary for the continued statutory recognition of

GPs as medical specialists and the assessment of international medical graduates for general practice.39,40

RACGP education supports GPs and GPs in training to understand and meet their responsibilities in complying with regulatory requirements.

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