Evaluation of the representativeness of consultations n family medicine residency training. A comparative study
DOI:
https://doi.org/10.32385/rpmgf.v21i2.10120Keywords:
Training, Vocational Training, Reasons for Encounter, Health ProblemsAbstract
Background: In GPs Vocational Training (VT), the choice of the trainers whole patient list as the trainees study unit in the 3rd year of formation, selecting each day the patients that he or she shall observe, is an alternative to the organization of an autonomous list to be managed by the trainee. However, patients are usually selected on a non-random basis, which can lead to a distorted representation of the demography and epidemiology of reasons for encounter (RFE) and diagnosis (DG) existing in the trainers list. Aim: To determine the degree of representation in a GP trainees consultation of the main RFE, DG and consultation types observed in the clinical activity of the trainer. Methods: Descriptive, cross-sectional study of all the encounters occurred during a period of 5 months in the clinical activity of a trainee working with the whole patient list of the trainer, a GP in Horizonte Family Health Unit, Matosinhos, Portugal. Both the trainee and the trainer registered the consultation types and the demographic characteristics of the observed patients; the RFE and DG were coded using ICPC-2. A satisfactory representation rate was defined as the presence of 70% or more of the 20 commonest trainers RFE and DG in the 20 more frequent in the trainees consultation. Results: Higher proportions of maternal health, family planning and domiciliary consultations were observed in the trainees activity. The 20 more frequent RFE in this consultation (ICPC pattern KRALX) included 80% of the 20 commonest in the trainers activity (pattern KALRP); the 20 more frequent DG (pattern KTAPL) contained about 85% of the 20 commonest in the trainers consultation (pattern KTPLD). Discussion: The RFE and DG registered in the trainees consultation achieved a good level of representation of the patterns observed in the trainers activity. The described strategy can be a valid alternative to the constitution of a patient list to be managed by the trainee when limited acceptability to join it is perceived in the patients. Studies in different settings can be useful to validate these conclusions.Downloads
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