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Training needs for staff providing remote services in general practice: a mixed-methods study.
Greenhalgh, Trisha; Payne, Rebecca; Hemmings, Nina; Leach, Helen; Hanson, Isabel; Khan, Anwar; Miller, Lisa; Ladds, Emma; Clarke, Aileen; Shaw, Sara E; Dakin, Francesca; Wieringa, Sietse; Rybczynska-Bunt, Sarah; Faulkner, Stuart D; Byng, Richard; Kalin, Asli; Moore, Lucy; Wherton, Joseph; Husain, Laiba; Rosen, Rebecca.
Afiliación
  • Greenhalgh T; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Payne R; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Hemmings N; Nuffield Trust, London; Health Education England, London, UK.
  • Leach H; Unit of Academic Primary Care, University of Warwick, Coventry, UK.
  • Hanson I; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Khan A; GP trainer, and MRCGP examiner, Ching Way Medical Centre, London, UK.
  • Miller L; Health Education England, London, UK.
  • Ladds E; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Clarke A; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Shaw SE; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Dakin F; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Wieringa S; Centre for Sustainable Health Education, University of Oslo, Oslo, Norway.
  • Rybczynska-Bunt S; Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
  • Faulkner SD; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Byng R; Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
  • Kalin A; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Moore L; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Wherton J; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Husain L; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Rosen R; Nuffield Trust, London, UK.
Br J Gen Pract ; 74(738): e17-e26, 2024 Jan.
Article en En | MEDLINE | ID: mdl-38154935
ABSTRACT

BACKGROUND:

Contemporary general practice includes many kinds of remote encounter. The rise in telephone, video and online modalities for triage and clinical care requires clinicians and support staff to be trained, both individually and as teams, but evidence-based competencies have not previously been produced for general practice.

AIM:

To identify training needs, core competencies, and learning methods for staff providing remote encounters. DESIGN AND

SETTING:

Mixed-methods study in UK general practice.

METHOD:

Data were collated from longitudinal ethnographic case studies of 12 general practices; a multi-stakeholder workshop; interviews with policymakers, training providers, and trainees; published research; and grey literature (such as training materials and surveys). Data were coded thematically and analysed using theories of individual and team learning.

RESULTS:

Learning to provide remote services occurred in the context of high workload, understaffing, and complex workflows. Low confidence and perceived unmet training needs were common. Training priorities for novice clinicians included basic technological skills, triage, ethics (for privacy and consent), and communication and clinical skills. Established clinicians' training priorities include advanced communication skills (for example, maintaining rapport and attentiveness), working within the limits of technologies, making complex judgements, coordinating multi-professional care in a distributed environment, and training others. Much existing training is didactic and technology focused. While basic knowledge was often gained using such methods, the ability and confidence to make complex judgements were usually acquired through experience, informal discussions, and on-the-job methods such as shadowing. Whole-team training was valued but rarely available. A draft set of competencies is offered based on the findings.

CONCLUSION:

The knowledge needed to deliver high-quality remote encounters to diverse patient groups is complex, collective, and organisationally embedded. The vital role of non-didactic training, for example, joint clinical sessions, case-based discussions, and in-person, whole-team, on-the-job training, needs to be recognised.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicina General Límite: Humans Idioma: En Revista: Br J Gen Pract Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicina General Límite: Humans Idioma: En Revista: Br J Gen Pract Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido