Early Predictors of Need for Remediation in the Australian General Practice Training Program: A Retrospective Cohort Study

Autor/inn/en	Magin, Parker; Stewart, Rebecca; Turnock, Allison; Tapley, Amanda; Holliday, Elizabeth; Cooling, Nick
Titel	Early Predictors of Need for Remediation in the Australian General Practice Training Program: A Retrospective Cohort Study
Quelle	In: Advances in Health Sciences Education, 22 (2017) 4, S.915-929 (15 Seiten)Infoseite zur Zeitschrift PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (Magin, Parker)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1382-4996
DOI	10.1007/s10459-016-9722-5
Schlagwörter	Foreign Countries; Predictor Variables; Remedial Programs; Medical Education; Medical Students; Cohort Analysis; Trainees; Outcomes of Education; Demography; Formative Evaluation; Multiple Regression Analysis; Evaluation Methods; Feedback (Response); Questionnaires; Physicians; Interpersonal Competence; Health Personnel; Consultation Programs; Scores; Needs Assessment; Decision Making; Job Training; Family Practice (Medicine); Australia + Suchen Sie Ihr Suchwort? Ausland; Prädiktor; Förderprogramm; Medizinische Ausbildung; Kohortenanalyse; Auszubildender; Weibliche Auszubildende; Lernleistung; Schulerfolg; Demografie; Fragebogen; Physician; Doctor; Arzt; Interpersonale Kompetenz; Medizinisches Personal; Fachberatung; Bedarfsermittlung; Decision-making; Entscheidungsfindung; Berufsqualifizierender Bildungsgang; Australien
Abstract	Underperforming trainees requiring remediation may threaten patient safety and are challenging for vocational training programs. Decisions to institute remediation are high-stakes--remediation being resource-intensive and emotionally demanding on trainees. Detection of underperformance requiring remediation is particularly problematic in general (family) practice. We sought to establish early-training assessment instruments predictive of general practice (GP) trainees' subsequently requiring formal remediation. We conducted a retrospective cohort study of trainees from a large Australian regionally-based GP training organization. The outcome factor was requirement for formal remediation. Independent variables were demographic factors and a range of formative assessments conducted immediately prior to or during early-stage training. Analyses employed univariate and multivariate logistic regression of each predictor assessment modality with the outcome, adjusting for potential confounders. Of 248 trainees, 26 (10.5%) required formal remediation. Performance on the Colleague Feedback Evaluation Tool (entailing feedback from a trainee's clinical colleagues on clinical performance, communication and probity) and External Clinical Teaching Visits (half-day sessions of the trainee's clinical consultations observed directly by an experienced GP), along with non-Australian primary medical qualification, were significantly associated with requiring remediation. There was a non-significant trend for association with performance on the Doctors Interpersonal Skills Questionnaire (patient feedback on interpersonal elements of the consultation). There were no significant associations with entry-selection scores or formative exam or assessment scores. Our finding that "in vivo" assessments of complex behaviour, but not "in vitro" knowledge-based assessments, predict need for remediation is consistent with theoretical understanding of the nature of remediation decision-making and should inform remediation practice in GP vocational training. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2020/1/01