Work in Progress: Development of an Inter-Practice Visit Program for GP Registrars

Background: Peer review is a valuable teaching method under utilized in GP registrar training. Presently, rural GP registrars training in 4-7 RRAMA (Rural Remote and Metropolitan Area classification) towns can undertake all of their GP training in one practice. This has the advantage of reducing relocation. The disadvantage is limited exposure to different types of general practice. An educational program was developed to provide exposure to different practices prior to completion of fellowship. Methods: The literature shows mixed findings on peer review: in Tasmania GP inter-practice visits was well rated; but some medical students show reluctance to be involved in peer review, particularly, if linked to assessment. Based on this research and existing external clinical teaching (ECT) materials, a draft external clinical training kit for registrars was developed and piloted with senior medical educators and RACGP officials. The inter-practice kit includes: orientation materials; acknowledgement that participation is voluntary; and consent guidelines for patients involved. The observing registrar records the process and content of consultations. Feedback follows Pendleton rules. Visits also report on organizational practice arrangements. A report is submitted by each registrar based on their two ECT visits. Results: Theme and content analysis of registrar reports have been positive in pilots. This paper will report on initial findings of this program from the North Coast and North West NSW in 2003-2004. Conclusions: Peer review is considered a useful educational tool by GP registrars. This program adds another method for data collection and monitoring of quality in postgraduate GP medical education.