General practice training in regional and rural Australia: A cross-sectional analysis of the Registrar Clinical Encounters in Training study.

Autor: Tapley A; School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.; GP Synergy Regional Training Organisation, Newcastle, NSW, Australia., Davey AR; School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.; GP Synergy Regional Training Organisation, Newcastle, NSW, Australia., van Driel ML; Discipline of General Practice and Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia., Holliday EG; School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.; Clinical Research Design IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, New Lambton, NSW, Australia., Morgan S; GP Synergy Regional Training Organisation, Newcastle, NSW, Australia., Mulquiney K; School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.; GP Synergy Regional Training Organisation, Newcastle, NSW, Australia., Turnock A; School of Medicine, University of Tasmania, Hobart, TAS, Australia.; Department of Health, Health Professional Policy and Advisory Services, Hobart, TAS, Australia., Spike NA; Eastern Victoria General Practice Training (EVGPT), Hawthorn, Vic., Australia.; Department of General Practice and Primary Health Care, University of Melbourne, Carlton, Vic., Australia., Magin PJ; School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.; GP Synergy Regional Training Organisation, Newcastle, NSW, Australia.
Jazyk: angličtina
Zdroj: The Australian journal of rural health [Aust J Rural Health] 2020 Feb; Vol. 28 (1), pp. 32-41. Date of Electronic Publication: 2020 Jan 17.
DOI: 10.1111/ajr.12591
Abstrakt: Objective: We aimed to investigate registrar, practice and consultation characteristics associated with varying degrees of GP registrars' practice rurality.
Design: A cross-sectional analysis of 12 rounds of data collection (2010-2015) from the longitudinal Registrar Clinical Encounters in Training study, an ongoing, cohort study of Australian GP registrars. The principal analysis used was a generalised ordered logistic regression.
Setting/participants: GP registrars in training practices within five of 17 GP regional training providers in five Australian states.
Main Outcome Measure: Degree of rurality of the practice in which the registrar undertook training terms was calculated from the practice postcode using the Australian Standard Classification-Remoteness Area classification.
Results: A total of 1161 registrars contributed data for 166 998 patient consultations (response rate 95.5%). Of these, 56.9% were in major city practices (ASGC-RA1), 25.7% were in inner-regional practices (ASGC-RA2) and 17.4% were in outer-regional/rural practices (ASGC-RA3-5). Several statistically significant associations (P = < .001) were found within regional/rural practices (ASGC-RA2-5), when compared with major city practices (ASGC-RA1). These included registrar characteristics such as being in Term 1, being medically trained overseas, and having worked at the practice previously; patient characteristics such as the patient being an existing patient, being older and being Aboriginal or Torres Strait Islander; and consultation characteristics such as performance of procedures.
Conclusion: Our findings suggest that registrars are undertaking rural practice early in their GP training and are being exposed to a rich and challenging mix of clinical and educational practice.
(© 2020 National Rural Health Alliance Ltd.)
Databáze: MEDLINE
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