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Steering the patient mix of GP trainees: Results of a randomized controlled intervention

机译：指导全科医生学员的患者组合：随机对照干预的结果

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Background: In studies exploring the patient mixes of general practitioner (GP) trainees, gaps were repeatedly found, as there were disparities between the patient mixes of GP trainers and trainees. This reduces the opportunities of trainees to acquire enough competence. Aims: To investigate whether steering the patient mix can be effectuated by instructing medical receptionist, trainer and trainee, and to study the effects of this intervention on trainee's self-efficacy (SE) and knowledge. Method: Randomized Controlled Trial (RCT). After a six-month basic registration period, 73 trainees were randomized. Patients with skin conditions and psychosocial conditions were actively assigned to trainees in the intervention group (n=35) during two successive periods of three months. The patient mix was measured by extracting data from electronic patient records. Learning outcomes were measured by SE questionnaires and by a knowledge test. Results: No increase was found in patient volume and diversity of the steered conditions in the intervention group as compared to the control group. However, the percentual increase of exposure to skin conditions was greater in the intervention group. No difference in skin SE and psychiatric knowledge was found. The increase of psychosocial SE was greater in the intervention group. In a regression analysis, patient volume was a significant predictor of both skin and psychosocial SE. Conclusions: Despite the difficulty in implementing steering in daily practice, tailoring the patient mix to the individual learning needs of trainees could be considered.
机译：背景：在探索全科医生（GP）受训者的患者组合的研究中，重复发现了差距，因为GP培训师与受训者的患者组合之间存在差异。这减少了学员获得足够能力的机会。目的：通过指导医疗接待员，培训师和受训者来研究是否可以控制患者混合，并研究这种干预对受训者的自我效能（SE）和知识的影响。方法：随机对照试验（RCT）。经过六个月的基本注册期后，随机分配了73名学员。在三个月的连续两个月中，将皮肤状况和社会心理状况良好的患者主动分配给干预组的受训人员（n = 35）。通过从电子患者记录中提取数据来测量患者混合情况。通过SE问卷和知识测试来衡量学习成果。结果：与对照组相比，干预组的患者数量和转向情况的多样性均未增加。但是，干预组中皮肤状况暴露的百分比增加更大。皮肤SE和精神病学知识无差异。在干预组中，社会心理SE的增加更大。在回归分析中，患者数量是皮肤和社会心理SE的重要预测指标。结论：尽管在日常练习中难以实施指导，但可以考虑根据学员的个人学习需求量身定制患者组合。

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