Implementing a Virtual Community of Practice for Family Physician Training: A Mixed-Methods Case Study

Background

GP training in Australia can be professionally isolating, with trainees spread across large geographic areas, leading to problems with rural workforce retention. Virtual communities of practice (VCoPs) may provide a way of improving knowledge sharing and thus reducing professional isolation.

Objective

The goal of our study was to review the usefulness of a 7-step framework for implementing a VCoP for general practitioner (GP) training and then evaluated the usefulness of the resulting VCoP in facilitating knowledge sharing and reducing professional isolation.

Methods

The case was set in an Australian general practice training region involving 55 first-term trainees (GPT1s), from January to July 2012. ConnectGPR was a secure, online community site that included standard community options such as discussion forums, blogs, newsletter broadcasts, webchats, and photo sharing. A mixed-methods case study methodology was used. Results are presented and interpreted for each step of the VCoP 7-step framework and then in terms of the outcomes of knowledge sharing and overcoming isolation.

Results

Step 1, Facilitation: Regular, personal facilitation by a group of GP trainers with a co-ordinating facilitator was an important factor in the success of ConnectGPR. Step 2, Champion and Support: Leadership and stakeholder engagement were vital. Further benefits are possible if the site is recognized as contributing to training time. Step 3, Clear Goals: Clear goals of facilitating knowledge sharing and improving connectedness helped to keep the site discussions focused. Step 4, A Broad Church: The ConnectGPR community was too narrow, focusing only on first-term trainees (GPT1s). Ideally there should be more involvement of senior trainees, trainers, and specialists. Step 5, A Supportive Environment: Facilitators maintained community standards and encouraged participation. Step 6, Measurement Benchmarking and Feedback: Site activity was primarily driven by centrally generated newsletter feedback. Viewing comments by other participants helped users benchmark their own knowledge, particularly around applying guidelines. Step 7, Technology and Community: All the community tools were useful, but chat was limited and users suggested webinars in future. A larger user base and more training may also be helpful. Time is a common barrier. Trust can be built online, which may have benefit for trainees that cannot attend face-to-face workshops. Knowledge sharing and isolation outcomes: 28/34 (82%) of the eligible GPT1s enrolled on ConnectGPR. Trainees shared knowledge through online chat, forums, and shared photos. In terms of knowledge needs, GPT1s rated their need for cardiovascular knowledge more highly than supervisors. Isolation was a common theme among interview respondents, and ConnectGPR users felt more supported in their general practice (13/14, 92.9%).

Conclusions

The 7-step framework for implementation of an online community was useful. Overcoming isolation and improving connectedness through an online knowledge sharing community shows promise in GP training. Time and technology are barriers that may be overcome by training, technology, and valuable content. In a VCoP, trust can be built online. This has implications for course delivery, particularly in regional areas. VCoPs may also have a specific role assisting overseas trained doctors to interpret their medical knowledge in a new context.     

A commentary on the practice of integrated medical curriculum in the interdisciplinary field of medical engineering

Shanghai University School of Medicine was a newly established medical college in 2018. It is founded on the national health development policies, international medical development trends and the close relationship between the advantages of new medical courses and medical artificial intelligence, it is dedicated to using intelligent medicine as the breakthrough point, training graduate students in two interdisciplinary medical engineering subjects as the priority, and implementing the integrated medical curriculum teaching reform. In this paper, we introduce the background of the integrated medical curriculum system at the Shanghai University School of Medicine, the horizontal and vertical integration of medical courses in interdisciplinary medical engineering subjects, the cross-integration of traditional integrated medical courses with other disciplines and specialties, and the transformation mode of medical science and technology innovation led by artificial intelligence under the support of three-dimensional curriculum integration, putting forward the prospect of the curriculum integration system and providing experiences and references for other medical schools.

KEY MESSAGES

• This paper introduces the necessity and feasibility of implementing integrated medical course teaching in a newly established medical college.
• This paper introduces the strategies and concrete measures we took to implement integrated medical course teaching.
• The analysis of examination papers and other evaluations revealed that the integrated medical teaching for graduate students with non-medical professional backgrounds is feasible.

     

高校毕业生择业焦虑问卷的初步编制

目的:编制高校毕业生择业焦虑问卷并考察毕业生择业焦虑的影响因素。方法:对内蒙古师范大学2005届毕业生133名(男生42名,女生91名)的试测结果进行探索性因素分析。对内蒙古自治区七所高校的2005届毕业生918名(男生354人,女生564人)施测。结果:经探索性因素分析,问卷由就业竞争压力、缺乏就业支持、自信心不足、担忧就业前景四个因素构成,累积解释率为59.40%,各因子负荷分别为:0.57～0.74、0.38～0.80、0.49～0.72、0.39～0.78。重测信度为0.79(P<0.01),内部一致性系数为0.71。女性、蒙族学生的择业焦虑较男性、汉族高。经济、医学和工科学生的择业焦虑较文科和理科低。结论:自编问卷具有较好的信度、效度,可用于高校毕业生择业焦虑的测量。     

军校研究生主观幸福感和人格特征的关系研究

目的探讨军校研究生主观幸福感与人格特征之间的关系。方法采用幸福感指数量表和EPQ问卷时281名军校研究生进行调查。结果①军校研究生的主观幸福感水平在中等程度以上．体验到的正性情感较多,负性情感较少,对生活较为满意。②外向性与正性情感、生活满意度显著相关,神经质与幸福感的3个指数都显著相关,精神质则与负性情感、生活满意度相关显著。结论军校研究生主观幸福感各指数与其人格特征关系密切。     

Integrative Review of the Experiences of Registered Nurses Who Support Breastfeeding Women

ObjectiveTo describe the experiences of registered nurses (RNs) who support breastfeeding women and to understand the factors that they believe affect practices that support breastfeeding.Data SourcesWe conducted an online search using five databases: Scopus, MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Cochrane Database of Systematic Reviews, and Joanna Briggs Institute of Systematic Reviews.Study SelectionWe included original research articles on the experiences of RNs who support breastfeeding women that were published in 2009 or after and were available in English. After title and abstract review of 785 articles, we included 22 articles for full text review. Nine articles met the eligibility criteria and were included in the review.Data ExtractionWe used Whittemore and Knafl’s five-step framework and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines to guide this integrative review. Three authors reviewed and appraised the articles independently.Data SynthesisWe categorized the findings into three themes: Workplace Issues, Personal Experiences, and Breastfeeding Knowledge and Education. Workplace Issues included the subthemes Lack of Time and Workload and Infant Health Stability. Personal Experiences included the subthemes Attitudes, Individual Experiences With Breastfeeding, and The Experiences of Family and Friends. Breastfeeding Knowledge and Education included the subthemes Prelicensure Education and Workplace Education and Training. Most researchers identified deficits in knowledge and education among RNs. The concept of confidence was influenced by all the other themes. Participants in the included studies reported that they developed confidence after learning from lactation consultants and having role models who supported the development of their knowledge and skills.ConclusionDespite the heterogeneity among the studies, findings highlighted the need for an increased focus on the preparation of RNs to support women to effectively breastfeed within health care organizations. Multitargeted efforts, such as orientation programs and in-depth breastfeeding education using role modeling, mentorship, and role playing with practical scenarios, may improve RNs’ abilities and confidence to support breastfeeding women.     

我国普通外科专科医师规范化培训历史、现状和展望

上海市普通外科专科医师规范化培训自2013年开始试行至今已有9年,作为毕业后医学教育的重要组成部分,其核心培养目标、培训内容、培训模式通过学习欧美国家的先进经验并结合自身特点而逐步形成了国内的标准和体系,对于专培医师职业胜任力的培养具有深远的意义,尤其是其考核模式成为专科医师规范化培训考核极为有益的创举和探索,也为全国范围内推广实施起到了引领作用和示范效应。目前,仍然需要正视在专科医师规范化培训实施过程中出现的问题和带来的困惑,及时认识和突破这些瓶颈并补上持之以恒的短板,从而进一步推动我国毕业后医学教育继续向前迈进。