Configurations for obtaining in-consultation assistance from supervisors in general practice training, and patient-relat
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RESEARCH ARTICLE
Open Access
Configurations for obtaining in-consultation assistance from supervisors in general practice training, and patient-related barriers to trainee help-seeking: a survey study Nancy J. Sturman1* , Amanda Tapley2,3, Mieke L. van Driel1, Elizabeth G. Holliday2, Jean I. Ball4, Andrew R. Davey2,3, Alison Fielding2,3, Kristen FitzGerald5,6, Neil A. Spike7,8 and Parker J. Magin3,4
Abstract Background: General practice (GP) trainees may seek supervisor assistance to complete their patient consultations. This in-consultation assistance plays a key role in the supervisory oversight of trainees and in trainee learning. It may be obtained face-to-face, or using phone or messaging systems, and either in front of patients or outside their hearing. Trainee concerns about decreased patient impressions of their competence, and discomfort presenting patients within their hearing, act as barriers to seeking help during consultations. Little is known about the frequency and associations of trainee concerns about these patient-related barriers, or the various trainee-supervisor-patient configurations used to obtain in-consultation assistance. Methods: Australian GP trainees rated their frequency of use of five specific configurations for obtaining inconsultation assistance, perceived change in patient impressions of their competence after this assistance, and relative trainee comfort presenting patients outside, compared to within, patients’ hearing. Statistical analyses included descriptive statistics and multivariable logistic regression. Results: Responses were received from 778 Australian GP trainees (response rate 89%). Help-seeking configurations did not differ between trainees at different training stages, except for greater use of electronic messaging in later stages. In-consultation assistance was most commonly provided by phone between trainee and supervisor consulting rooms, or outside the trainee’s patient’s hearing. Supervisor assistance in the trainee’s room face-to-face with the patient was reported as either never or rarely obtained by 12% of respondents. More trainees (25%) perceived that patient impressions of their competence increased after help-seeking than perceived that these impressions decreased (19%). Most trainees (55%) preferred to present patients outside their hearing. Trainee age was the only variable associated with both patient-related barriers. (Continued on next page)
* Correspondence: [email protected] 1 Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, 8th Floor, Health Sciences Building, Royal Brisbane Hospital, Herston, Brisbane 4006, Australia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creativ
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