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      Student supervision by trainee doctors in GP teaching practices: Win-win situation or additional burden? An interview study on current practices and acceptance Translated title: Studierendenbetreuung durch Ärzt*innen in Weiterbildung in hausärztlichen Lehrpraxen: Win-win-Situation oder zusätzliche Belastung? Eine Interviewstudie zu aktueller Praxis und Akzeptanz

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          Abstract

          Objective:

          Teaching by trainee doctors is also established practice in general practice in English-speaking countries. This study examines the involvement of trainee doctors in the supervision of students in German general practices and the acceptance of trainee doctors as teachers from the perspective of physicians with a license for post-graduate training (PLT) and the trainee doctors themselves.

          Methodology:

          Semi-structured qualitative interviews were conducted with 9 PLTs and 9 trainees. The interview guide was developed based on the Theoretical Framework of Acceptance. Interviews were recorded, transcribed and evaluated using Kuckartz’s qualitative analysis.

          Results:

          Trainee doctors are involved in student supervision in GP teaching practices to varying degrees and often in unstructured ways. Supervision by trainees is considered advantageous as they are closer in terms of hierarchy, possess more up-to-date knowledge and are less far ahead in terms of knowledge and function as role models. However, professional uncertainty or revealing knowledge gaps to patients and students is experienced as difficult by some trainees. Competing for time with patient care is seen as a challenge. Better time planning and didactic preparation could avoid pressure in this area. Teaching is seen as part of the GP profession, especially by trainee doctors. However, a potential obligation to teach is seen as more of a hindrance to encouraging the next generation of doctors by both trainee doctors and PLTs.

          Conclusion:

          The inclusion of trainee doctors in student teaching is frequently practiced by those surveyed, which suggests a high level of acceptance but is not consistently implemented. Structured organization of teaching in real life, didactic qualifications and offering credits for teaching activities might further improve inclusion and acceptance.

          Zusammenfassung

          Zielsetzung:

          Lehre durch Ärzt*innen in Weiterbildung (ÄiW) ist in angelsächsischen Ländern auch in der Allgemeinmedizin etabliert. Diese Studie untersucht die Einbindung von ÄiW in die Betreuung von Studierenden in deutschen Hausarztpraxen und die Akzeptanz von ÄiW als Lehrende aus der Sicht von Weiterbildungsbefugten (WBB) und ÄiW selbst.

          Methodik:

          Es wurden semistrukturierte qualitative Interviews mit 9 WBB und 9 ÄiW durchgeführt. Der Interviewleitfaden wurde ausgehend vom Theoretical Framework of Acceptance entwickelt. Interviews wurden aufgezeichnet, transkribiert und mit der qualitativen Analyse nach Kuckartz ausgewertet.

          Ergebnisse:

          ÄiW werden in den befragten hausärztlichen Lehrpraxen in heterogenem Umfang und häufig unstrukturiert in die Studierendenbetreuung eingebunden. Die Betreuung durch ÄiW wird durch die geringere Hierarchie, aktuelleres Wissen und weniger Wissensvorsprung und ihre Vorbildfunktion als vorteilhaft erachtet. Fachliche Unsicherheit bzw. Offenlegen von Wissenslücken vor Patient*innen und Studierenden wird jedoch von einigen ÄiW als schwierig erlebt. Die zeitliche Konkurrenz zur Patient*innenversorgung wird als Herausforderung benannt. Hier könnte eine bessere zeitliche Planung und didaktische Vorbereitung Belastungen vermeiden. Lehre wird vor allem von ÄiW als Teil des hausärztlichen Berufsbilds betrachtet. Verpflichtungen zur Lehrtätigkeit werden jedoch sowohl von ÄIW als auch von WBB eher als hinderlich für die Nachwuchsförderung eingeschätzt.

          Schlussfolgerung:

          Die Einbindung von ÄiW im Studierendenunterricht wird von den Befragten häufig praktiziert, was auf eine hohe Akzeptanz schließen lässt, aber sehr heterogen umgesetzt. Strukturierte Lehrorganisation in der Praxis, didaktische Qualifizierung und Anerkennung der Lehrtätigkeit könnten Einbindung und Akzeptanz weiter verbessern.

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          Most cited references43

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          Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework

          Background It is increasingly acknowledged that ‘acceptability’ should be considered when designing, evaluating and implementing healthcare interventions. However, the published literature offers little guidance on how to define or assess acceptability. The purpose of this study was to develop a multi-construct theoretical framework of acceptability of healthcare interventions that can be applied to assess prospective (i.e. anticipated) and retrospective (i.e. experienced) acceptability from the perspective of intervention delivers and recipients. Methods Two methods were used to select the component constructs of acceptability. 1) An overview of reviews was conducted to identify systematic reviews that claim to define, theorise or measure acceptability of healthcare interventions. 2) Principles of inductive and deductive reasoning were applied to theorise the concept of acceptability and develop a theoretical framework. Steps included (1) defining acceptability; (2) describing its properties and scope and (3) identifying component constructs and empirical indicators. Results From the 43 reviews included in the overview, none explicitly theorised or defined acceptability. Measures used to assess acceptability focused on behaviour (e.g. dropout rates) (23 reviews), affect (i.e. feelings) (5 reviews), cognition (i.e. perceptions) (7 reviews) or a combination of these (8 reviews). From the methods described above we propose a definition: Acceptability is a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention. The theoretical framework of acceptability (TFA) consists of seven component constructs: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Conclusion Despite frequent claims that healthcare interventions have assessed acceptability, it is evident that acceptability research could be more robust. The proposed definition of acceptability and the TFA can inform assessment tools and evaluations of the acceptability of new or existing interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2031-8) contains supplementary material, which is available to authorized users.
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            Applying critical realism in qualitative research: methodology meets method

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              Peer teaching in medical education: twelve reasons to move from theory to practice.

              To provide an estimation of how often peer teaching is applied in medical education, based on reports in the literature and to summarize reasons that support the use of this form of teaching. We surveyed the 2006 medical education literature and categorised reports of peer teaching according to educational distance between students teaching and students taught, group size, and level of formality of the teaching. Subsequently, we analysed the rationales for applying peer teaching. Most reports were published abstracts in either Medical Education's annual feature 'Really Good Stuff' or the AMEE's annual conference proceedings. We identified twelve distinct reasons to apply peer teaching, including 'alleviating faculty teaching burden', 'providing role models for junior students', 'enhancing intrinsic motivation' and 'preparing physicians for their future role as educators'. Peer teaching appears to be practiced often, but many peer teaching reports do not become full length journal articles. We conclude that specifically 'near-peer teaching' appears beneficial for student teachers and learners as well as for the organisation. The analogy of the 'journeyman', as intermediate between 'apprentice' and 'master', with both learning and teaching tasks, is a valuable but yet under-recognized source of education in the medical education continuum.
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                Author and article information

                Journal
                GMS J Med Educ
                GMS J Med Educ
                GMS J Med Educ
                GMS Journal for Medical Education
                German Medical Science GMS Publishing House
                2366-5017
                16 September 2024
                2024
                : 41
                : 4
                : Doc46
                Affiliations
                [1 ]Charité – University Hospital Berlin, Institute of General Practice, Berlin, Germany
                [2 ]Ruhr University Bochum, Department for General Practice, Bochum, Germany
                Author notes
                *To whom correspondence should be addressed: Sabine Gehrke-Beck, Charité – University Hospital Berlin, Institute of General Practice, Charitéplatz 1, D-10117 Berlin, Germany, E-mail: sabine.gehrke-beck@ 123456charite.de
                Article
                zma001701 Doc46 urn:nbn:de:0183-zma0017010
                10.3205/zma001701
                11474648
                39415810
                ce0f9e46-6586-49ba-bb89-c7e7697035e4
                Copyright © 2024 Gehrke-Beck et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

                History
                : 08 April 2024
                : 04 July 2024
                : 10 June 2024
                Categories
                Article

                general practice,junior physicians,undergraduate medical education,vocational training,teaching methods

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