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Open Access Research article

The learner’s perspective in GP teaching practices with multi-level learners: a qualitative study

Jennifer S Thomson1*, Katrina Anderson1, Emily Haesler1, Amanda Barnard2 and Nicholas Glasgow3

Author Affiliations

1 Academic Unit of General Practice, Medical School, College of Medicine, Biology & Environment, Australian National University, Acton, ACT, Australia

2 Rural Clinical School, Medical School, College of Medicine, Biology & Environment, Australian National University, Acton, ACT, Australia

3 Medical School, College of Medicine, Biology & Environment, Australian National University, Acton, ACT, Australia

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BMC Medical Education 2014, 14:55  doi:10.1186/1472-6920-14-55

Published: 19 March 2014

Abstract

Background

Medical students, junior hospital doctors on rotation and general practice (GP) registrars are undertaking their training in clinical general practices in increasing numbers in Australia. Some practices have four levels of learner. This study aimed to explore how multi-level teaching (also called vertical integration of GP education and training) is occurring in clinical general practice and the impact of such teaching on the learner.

Methods

A qualitative research methodology was used with face-to-face, semi-structured interviews of medical students, junior hospital doctors, GP registrars and GP teachers in eight training practices in the region that taught all levels of learners. Interviews were audio-recorded and transcribed. Qualitative analysis was conducted using thematic analysis techniques aided by the use of the software package N-Vivo 9. Primary themes were identified and categorised by the co-investigators.

Results

52 interviews were completed and analysed. Themes were identified relating to both the practice learning environment and teaching methods used.

A practice environment where there is a strong teaching culture, enjoyment of learning, and flexible learning methods, as well as learning spaces and organised teaching arrangements, all contribute to positive learning from a learners’ perspective.

Learners identified a number of innovative teaching methods and viewed them as positive. These included multi-level learner group tutorials in the practice, being taught by a team of teachers, including GP registrars and other health professionals, and access to a supernumerary GP supervisor (also termed “GP consultant teacher”). Other teaching methods that were viewed positively were parallel consulting, informal learning and rural hospital context integrated learning.

Conclusions

Vertical integration of GP education and training generally impacted positively on all levels of learner. This research has provided further evidence about the learning culture, structures and teaching processes that have a positive impact on learners in the clinical general practice setting where there are multiple levels of learners. It has also identified some innovative teaching methods that will need further examination. The findings reinforce the importance of the environment for learning and learner centred approaches and will be important for training organisations developing vertically integrated practices and in their training of GP teachers.

Keywords:
Postgraduate training; Workplace based learning; General Practice Education; Teaching innovation; Vertical integration of GP education; Multi-level learning; Learning culture