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Open Access Research article

What are the perceived learning needs of Australian general practice registrars for quality prescribing?

Rola Ajjawi1*, Jill E Thistlethwaite2, Parisa Aslani3 and Nick B Cooling4

Author Affiliations

1 Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC 3168, Australia

2 Institute of Clinical Education, The University of Warwick, Coventry, UK CV4 7AL, UK

3 Faculty of Pharmacy, The University of Sydney, NSW 2006 Australia

4 GP Training Tasmania, New Town, Tasmania 7008, Australia

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BMC Medical Education 2010, 10:92  doi:10.1186/1472-6920-10-92

Published: 9 December 2010

Abstract

Background

Little is known about the perceived learning needs of Australian general practice (GP) registrars in relation to the quality use of medicines (QUM) or the difficulties experienced when learning to prescribe. This study aimed to address this gap.

Methods

GP registrars' perceived learning needs were investigated through an online national survey, interviews and focus groups. Medical educators' perceptions were canvassed in semi-structured interviews in order to gain a broader perspective of the registrars' needs. Qualitative data analysis was informed by a systematic framework method involving a number of stages. Survey data were analysed descriptively.

Results

The two most commonly attended QUM educational activities took place in the workplace and through regional training providers. Outside of these structured educational activities, registrars learned to prescribe mainly through social and situated means. Difficulties encountered by GP registrars included the transition from hospital prescribing to prescribing in the GP context, judging how well they were prescribing and identifying appropriate and efficient sources of information at the point of care.

Conclusions

GP registrars learn to prescribe primarily and opportunistically in the workplace. Despite many resources being expended on the provision of guidelines, decision-support systems and training, GP registrars expressed difficulties related to QUM. Ways of easing the transition into GP and of managing the information 'overload' related to medicines (and prescribing) in an evidence-guided, efficient and timely manner are needed. GP registrars should be provided with explicit feedback about the process and outcomes of prescribing decisions, including the use of audits, in order to improve their ability to judge their own prescribing.