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Early predictors of need for remediation in the Australian general practice training program: a retrospective cohort study
Citation
Magin, P and Stewart, R and Turnock, A and Tapley, A and Holliday, E and Cooling, N, Early predictors of need for remediation in the Australian general practice training program: a retrospective cohort study, Advances in Health Sciences Education, 22, (4) pp. 915-929. ISSN 1382-4996 (2017) [Refereed Article]
Copyright Statement
Copyright 2016 Springer Science+Business Media Dordrecht
DOI: doi:10.1007/s10459-016-9722-5
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.
Item Details
Item Type: | Refereed Article |
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Keywords: | education, medical, graduate, educational measurement, family practice, general practice, professional competence, remedial teaching |
Research Division: | Education |
Research Group: | Curriculum and pedagogy |
Research Field: | Medicine, nursing and health curriculum and pedagogy |
Objective Division: | Health |
Objective Group: | Other health |
Objective Field: | Other health not elsewhere classified |
UTAS Author: | Turnock, A (Dr Allison Turnock) |
UTAS Author: | Cooling, N (Dr Nick Cooling) |
ID Code: | 113019 |
Year Published: | 2017 (online first 2016) |
Web of Science® Times Cited: | 5 |
Deposited By: | Medicine |
Deposited On: | 2016-12-07 |
Last Modified: | 2018-03-20 |
Downloads: | 0 |
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