Contraceptive Implanon: Why do GPs get asked to remove it early?

Nineteen women aged 18 to 39 years of age from four Coast City Country GP Training practices were interviewed regarding their experiences with Implanon and the reasons for early removal. All participants were in relationships and approximately half had children

A feasibility study of team-based primary care for chronic disease management training in rural Australia

Increasing rates of chronic disease management (CDM) are projected to contribute to significant effective shortfalls in the primary care workforce in Australia.1 Additionally, rural Australia carries a higher burden of chronic illness2 and has existing medical workforce shortages.3 Therefore, it is imperative that rural primary care maximises the efficiency of the CDM it provides

Patients\u27 attitudes towards chaperone use for intimate physical examinations in general practice

BACKGROUND: The objective of this article is to investigate patients\u27 attitudes to the use of chaperones for intimate physical examinations (IPEs) in a sample of Australian general practices. METHODS: A cross-sectional survey of adult patients from 13 randomly selected general practices in regional New South Wales was conducted between September and November 2012. Generalised linear mixed models were used for analysis. RESULTS: Of 780 surveys distributed, 687 (88%) were returned; the age range was 18-91 years and 356 (52%) were from female patients. Most women had never had a chaperone present for a Papanicolaou (Pap) smear (82.6%). Between 23% and 33% of respondents preferred a chaperone with their usual general practitioner (GP) across IPEs and gender of the respondents. The odds of preference for a chaperone were significantly less with a GP whom the respondents did not know well, compared with their usual GP, for a Pap smear (female) or genital examination (male). DISCUSSION: Individualised discussion regarding chaperone use for IPEs is warranted, especially with patients seeing their usual GP

Panning for gold: unearthing reliable variables for electronic medical data research

Abstract of a poster presentation at the 2015 PHC Research Conference, Adelaide, 29-31 July, 2015

Development of an Australian practice-based research network as a community of practice

There are many aspects of the communities of practice (CoP) framework that are applicable to the development of a practice-based research network (PBRN), where the focus is upon building primary health-care workers\u27 research capacity and research questions. However, there is limited literature focussed on the application of CoP principles applied to research capacity building in Australia. The purpose of this paper is to demonstrate, through a case study, how a developing PBRN, the Illawarra and Southern Practice Research Network, successfully applied the theoretical foundation of CoP to develop a PBRN in a time- and resource-limited context

Understanding expectations of 1st year medical students on primary care clinical placements

Clinical experience in a primary care setting is an important learning tool in the new University of Wollongong medical programme. In addition to hospital clinical placements, year 1 students are also exposed to early primary care settings where their experiences, under the guidance of a General Practitioner (GP) preceptor, can be broadly categorised under four main headings: communication, physical examination, procedures, clinical reasoning. The aim of our study was to explore these experiences from the perspectives of both the medical students and their preceptors. Data was collected from preceptor and student surveys that invited them to state their expectations of their primary care clinical placements. Questions in the clinical placement surveys were designed to reflect the primary care placement objectives as stated in the Year 1 placement handbook (Hudson 2011), which focused on communication and physical examination objectives, to a greater extent than procedure and clinical reasoning skills. The results of these surveys allowed us to determine whether both students and preceptors had the same expectations about their primary care clinical placements. Survey results revealed that the there was a mismatch between the expectations of both students and preceptors with regard to undertaking procedures and developing clinical reasoning skills. Unlike preceptors, medical students placed high importance on these activities. Student success on primary care placement can be achieved through understanding student and preceptor expectations as it allows medical faculties to improve the communication of the curriculum to the key participants in these placements

Development of an Australian practice based research network in a resource limited context

The Australian Government’s Primary Health Care Research, Evaluation and Development (PHCRED) strategy has been operational since 2000. The strategy’s Research Capacity Building Initiative, which had supported the development of five Practice Based Research Networks (PBRNs) within Australia, was terminated at the end of 2011. This study examines the development of a PBRN, the Illawarra and Southern Practice Research Network (ISPRN), in a time of change in Australian government funding. It aims to explore the PBRN’s development in a resource and time limited context based within a communities of practice (CoP) theoretical framework. A CoP involves ‘groups of people who share a concern, a set of problems or passions about a topic and through interaction on an ongoing basis extend their knowledge and expertise around the topic’. Data were collected from the start of the network in February 2011, including workshop and conference evaluations, research support networks, web based resource utilisation, project records and academic outputs. These data were analysed using a case study approach from the perspective of the formation of the development of a CoP. Four projects have been developed within the network, three have ethics approval and two are underway. In addition, two externally funded projects have engaged ISPRN as a research partner. The network size has increased over the 12 months, with 30 practices currently involved in some degree. Results suggest that despite members having little or no research experience, a CoP approach to research development can be successful in assisting early career researchers develop achievable projects. The key aspects of CoP that were applied to ISPRN included engaged leadership; the development of relationships; the evolution of communication pathways; and the formulation of shared goals. ISPRN has been successful in securing two year’s funding from the University of Wollongong to continue the network

Building year 1 medical student relationships in primary care clinical placements

Historically teaching hospitals have been the main centre for teaching medical students in a clinical environment. However, recently the focus for medical education has shifted to the primary care setting. The new medical programme at University of Wollongong introduces year 1 students to early primary care clinical exposure allowing students to establish relationships with both their General Practitioner (GP) preceptors and patients within the practice. The aim of this project was to explore the relationships of the year 1 student and the preceptors in their primary care clinical placements. Data was collected using both quantitative data from closed ended questions and qualitative data from open ended in a post-clinical placement survey. Quantitative results from the survey showed that 69% of students and 96% preceptors reported that taking a patient history was a very important aspect of the placement, with 80% of students and 96% of GP preceptors reporting that communicating together about the patient’s history was also very important. Qualitative results from the student survey outlined that interacting with and observing their preceptors in a real life setting as well as interaction with patients was an important element of the placements. The impact of this relationship determined whether a medical student found a placement enjoyable or challenging. These results are supported by previous literature demonstrating that building relationships is an important experience for both student and preceptor, particularly when relationships with patients are further enhanced by preceptors encouraging students to reflect on patient encounters

No nursing homes\u27: General Practitioner attitudes to residential aged care facility visiting

Abstract of a poster presentation at the 2015 PHC Research Conference, Adelaide, 29-31 July, 2015

Weighing in General Practice: Does it have an impact on weight management? Results of an innovative research study

Patients were weighed each time they presented to the practice over a 12 month period. 198 patients aged between 20 to 70 were recruited from six general practices