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A Critical Evaluation of the London GP Trainer Programme

In 2018 the Research Department of Medical Education was commissioned by Health Education England London and South East to evaluate the London General Practitioner Trainer Course

The London General Practitioner Trainer Course (LGPTC) was mandatory for general practitioners (GPs) who wanted to train or supervise GP Registrars in London and the South East.

Here we present a brief summary of the research, and then discuss how the research was used in creating a new GP supervisors’ programme: the Introduction to Supervising, Learning and Assessment for Primary Care Professionals (ISLA) programme.

The research

The aim of the evaluation is to inform future developments in a course for trainers and supervisors, by understanding what aspects of the course are working, for whom and why.

Research questions

  1. What are the perceived strengths and weaknesses of the course?
  2. To what extent does this course effectively prepare GPs to work as Educational Supervisors in Primary Care?
  3. To what extent did the online and pre-course elements prepare participants for learning on the course days?
  4. What aspects of the course could be further developed to improve its design, delivery and overall effectiveness?
  5. Does the course curricular alignment support the development of key transferable skills?

Educational interventions are inherently complex to evaluate. Mindful of this complexity we undertook a critical realist review.

Reflecting the multifaceted and blended nature of the programme, we conducted a qualitative study in which data obtained from analysis of course materials, participants’ reflective portfolios, observations of course days, and individual and group interviews with stakeholders and participants is synthesised.

What we found

  • GP trainers wanted a pragmatic training programme. This meant they wanted a course that was not overly long and had a practical orientation including the judicious use of education theory;
  • GP trainers valued small group work, tailored for participants’ learning needs and practice;
  • Formative assessment i.e. feedback on participants’ progress was important for them in order to understand their own progress and they wanted recognition of their attendance;
  • Some form of summative assessment would make GP trainers feel that they have achieved a recognised standard;
  • Making correct assessments of trainees was also critical for them and they wanted hands-on experience regarding content on GP registrar assessments (AKT and CSA).
  • GP trainers felt that opportunity to practice teaching skills in a safe space was helpful and would increase their confidence;
  • Educational research and theory were reported to be ‘dry’ and could be off putting, therefore GP trainers valued discussing them at face-to-face days; which helped them understand the value and practical use of theory;
  • In some instances, too much theory deterred participants from engaging in further study, for example a postgraduate certificate in education;
  • Ongoing support after the course was reported to be beneficial because it would enable new trainers to consolidate their learning and seek help with real-world difficulties that often arise once GPs are in a formal training role.

What happened next

The Postgraduate Medical Education Department (PGME) built on findings from the critical realist evaluation. They successfully won a competitive tender to deliver the new GP supervisor programme, ISLA.

Key features of this new programme are to introduce pedagogic principles in a way that balances the need for delegates develop their supervision practice in way that is informed by pedagogic principles, with their desire for a pragmatic focus on the practice-based component.

This has facilitated engagement with the programme and helped ensure supervisors are empowered to practice in a way which is underpinned by a sound understanding of relevant pedagogy.

By including an option for progressing to Master’s level academic study, this approach has also allowed delegates with an academic interest to engage in depth with the academic and theoretical components, and to support their academic professional development.

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