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FAQ: Effective use of HealthPathways
in clinical practice and GP training

WHAT IS HEALTHPATHWAYS?
HealthPathways offers clinicians locally agreed information to support clinical decision-making at the point of care. It integrates clinical guidance, service and referral options, and patient resources into a single platform tailored for specific local contexts. It is a useful resource for clinical practice and GP training, and enables reflective learning, quality improvement and audit.

HealthPathways

HOW ARE THE PATHWAYS DEVELOPED?
Community HealthPathways is developed by GPs and primary care clinicians for general practice teams. Local GP or primary care clinical editors collaborate with specialists, subject matter experts, and health system and community stakeholders to create and regularly update pathways to ensure they are practical, reflect local reality, and are evidence-based.

Local clinical editors adapt pathways to regional contexts, aligning them with referral criteria, healthcare system processes, and regional services.

Localised pathways are updated regularly. Urgent changes are flagged with “clinical editor notes” until formal reviews are completed.

WHO FUNDS AND RUNS HEALTHPATHWAYS?
In Australia, depending on the area, HealthPathways is funded and supported by state services, the Commonwealth-funded Primary Health Networks (PHNs), or a collaboration of the two. In New Zealand, it is funded and supported by Health New Zealand | Te Whatu Ora.

Streamliners host the platform, partnering with and bringing together HealthPathways Community members in Australia, New Zealand, the UK, and Canada.

Pathways can be shared across the community where appropriate, then customised for local care. Some regions also use hospital-specific pathways, Hospital HealthPathways.

  1. Clinical Pathways: Assessment, management, and referral guidance for conditions. It includes both presentation-based pathways for undifferentiated conditions e.g. headaches or eye problems in children, alongside condition-based pathways e.g. diabetes.
  2. Request Pathways: Information for access and referral to local services.
  3. Resource Pages: Supplementary materials, including medication guides, infection control protocols, and health system information e.g. MBS claim.

Patient information, such as handouts or credible website links, is embedded into pathways to enhance consultations. This is also available at the bottom of the pathways in the patient information section.

HealthPathways provides structured guidance for consultations, refining differential diagnosis, managing rare conditions, curated resources, and insights into the local health system. It helps GPs know local, “how things are done around here” information.

Supervisors can use it for teaching and reflective learning and to identify knowledge gaps. It can support audit and quality improvement.

Information, services and resources for diverse populations, such as interpreter services and community support, enable more equitable care.

Use the “Feedback” button at the bottom right of any page to report issues, suggest improvements, or engage with your local HealthPathways team, including GP colleagues.

They can integrate it into teaching sessions, model its use during case discussions, and encourage registrars to access it regularly.

HealthPathways supports learning and is embedded in GP training to prepare trainees for assessments like the Fellowship exams.

This creates a teaching opportunity to discuss new information with supervisors, evaluate its relevance, and explore its application.

Understanding what resources registrars use, and how they are using them, ensures that registrars are relying on credible tools and using them effectively. It also allows supervisors to align teaching with those resources.

Patients benefit from high-quality, understandable information, evidence-based practices, and streamlined referrals.

A search tip is to use the “Expand All” option or Ctrl+F to find terms within a pathway.

AI assisted Smart Search allows you to navigate directly to the location on the pathway that contains the information you require. This new feature is being progressively released and will be available on all HealthPathways sites by mid-2025.

No, it complements clinical judgement and supports individualised decision-making while enhancing patient care.

Unlike general guidelines, it is tailored to GPs, integrating evidence-based recommendations with local healthcare requirements. Unlike some resources available on the internet, there is robust clinical governance over content.

It provides transparency about what information is needed for a quality referral, increasing the chance of acceptance. It also explains the referral and access criteria within the limitations of a public health system.

Sharing its benefits, demonstrating its use, and promoting frequent reference can encourage adoption.

It enables knowledge sharing and collective improvement through user feedback and updates.

Yes, the CPD reporting feature allows you to log reflective notes on pathway usage, fostering integration of reflective learning into practice. Your personal data is confidential and not shared with anyone. This feature is being progressively released and will be available on all sites by mid-2025.

Pathways also make a useful basis for an audit of your practice and for practice improvement activities.

healthpathwayscommunity.org/Home/Access-to-HealthPathways

HealthPathways is free for clinicians to use.

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Date reviewed: 23 October 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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FAQ Empowering Neurodivergent Registrars

Neurodiversity in General Practice

Neurodivergent individuals, including those with ADHD and autism, bring unique strengths to medical practice. However, without adequate support, they may struggle with the demands of general practice training. They may come into general practice training with a diagnosis, or somewhere on their journey of learning more about their neurodiversity.

ADHD is a disorder of regulation. Approximately 4% of Australians under age 45 have a diagnosis of ADHD. Cognitive, physical and emotional dysregulation all feature to some degree in all people with ADHD. Doctors with ADHD often have strengths in creativity and cognitive dynamism. They may have excellent problem-solving skills and have clinical courage. In general practice, they may be excellent diagnosticians and have the capacity to manage uncertainty. However, they may struggle with overly creative lists of differential diagnoses and be prone to over-investigation.

To have been successful in medical studies with ADHD, a doctor must have a high intellect and resilience. They often have high energy, take calculated risks and exhibit attention variability. They can excel in environments where quick thinking and adaptability are required. If undiagnosed and untreated, they may struggle with executive dysfunction, time management, organisation and attention. Exam preparation can be very challenging and ultimately impact success.

Autism is a difference of communication and affects approximately 1% of Australians. Autistic people often have strengths in attention to detail, ethics, rules and heightened sensory awareness. Again, these can be very beneficial traits for diagnostic medicine and creating evidence-based management plans. Autistic doctors are deeply empathetic (emotional empathy is over-developed while cognitive empathy is reduced) with obvious benefit in the general practice environment. Evidence has shown that when appropriately supported autistic people are highly productive.

Many neurodivergent doctors face stigma, with some reluctant to disclose their diagnosis due to fear of discrimination. In those undiagnosed, stigma can lead to a blind spot in professional awareness and personal development. With the constant demands of masking in an environment with high level communication, autistic doctors are at a higher risk of burnout. Anxiety and depression are much more common in the autistic population. In a recent survey by Autistic Doctors International, as many as 77% had ever considered suicide. Autistic doctors may misunderstand hierarchy and have been labelled as demanding, or troublemakers, having only been victim of “talking truth to power”.

When discussing neurodiversity with a registrar, it’s important to approach the topic sensitively and compassionately, as neurodivergent conditions can be stigmatised. A supervisor may notice issues like executive dysfunction, anxiety, feeling overwhelmed, exam difficulties, or feedback on communication from staff or patients. Supervisors might consider raising the topic by focusing on observed concerns. Instead of making a direct diagnosis, it is helpful to ask questions about potential underlying issues and offer support to help the registrar identify possible challenges. A compassionate and understanding approach is key.

Supervisors can:

  • Offer personalised accommodations for learning
  • Be aware of and sensitive to the needs of neurodivergent registrars
  • Focus on strengths and provide practical support to address challenges
  • Foster a supportive, inclusive work environment that recognises the value of neurodiversity.

Support can include reasonable workplace accommodations such as part-time work, flexible hours, and emotional support from supervisors. Structuring training requirements, like project planning and deadlines, can help neurodivergent registrars manage their tasks. Small group learning adjustments and informing medical educators about a registrar’s condition can also provide tailored support. Consider stepping through the Autistic SPACE model. ADHD Registrars may need assistance with directing the creative process and focusing on key features of a clinical presentation rather than becoming overwhelmed with masses of details.

There are various resources available for neurodivergent doctors, including psychologists, ADHD coaches, and professional job coaching services. Additionally, support groups like Autistic Doctors International and ADHD Coaches Australasia provide valuable connections and training for neurodivergent medical professionals.

While exam formats remain the same, registrars with neurodiverse conditions may be eligible for accommodations such as extended time or breaks during exams. These adjustments can help registrars perform at their best without feeling overwhelmed.

Summary
What are the key points for medical educators and supervisors?

  • The importance of adapting teaching and supervision methods to support neurodivergent registrars.
  • A strengths-based approach that values the unique qualities neurodivergent doctors bring to the profession.
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Date reviewed: 23 October 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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Supporting and Training Registrars in Poorly Resourced Environments

How is it possible to effectively support and train registrars in poorly resourced environments?

To effectively support and train registrars in poorly resourced environments, RVTS has identified that addressing the registrar’s professional and non-professional needs is crucial. By considering the contexts of person, place, and program, a supportive environment can be created where registrars feel comfortable, confident, competent, and have a sense of belonging and bonding with peers. This promotes effective training in challenging settings.

The Remote Vocational Training Scheme (RVTS) uses distance education and remote supervision to deliver training without requiring registrars to leave their communities. This model has proven successful over 24 years, training more than 500 doctors in 350 communities. Almost 80% of participants achieve fellowship while providing an average of 5.2 years of service in their training location.

Three key take-home points:

  1. Training registrars in resource-poor environments involves more than providing remote supervision; a holistic professional support package must be in place for success.
  2. It’s not for everybody. Training in poorly resourced environments requires resilience and resourcefulness and is better suited to more experienced doctors.
  3. Family support as part of the training package is highly valued.

What strategies can be implemented to support registrars in poorly resourced environments?

RVTS has used multiple strategies over the years, each tailored to individual registrars and settings. However, the following have been important.

  • Regular Contact and Supervision: Frequent interactions with supervisors and medical educators through phone calls, emails, and visits ensure continuous support and guidance. RVTS employs a structured supervision schedule with initial frequent contacts tapering over time as registrars become more confident and experienced.
  • Flexible Approach: Adopting a flexible training approach to account for the varied situations faced by remote doctors is crucial. This involves tailoring supervision and support to meet individual needs and circumstances.
  • Face-to-Face Meetings: Organising regular face-to-face meetings to build group cohesiveness and update essential skills, especially in emergency medicine. RVTS schedules workshops twice a year, which also include social events to foster building a network and community.
  • Collegial and Peer Support: Encouraging peer interactions through weekly teletutorials, WhatsApp groups, and peer study groups, fostering a sense of belonging to a special group.
  • Family Support: Incorporating family support in the training package, such as enabling families to attend workshops, significantly contributes to retention and well-being.
  • Simple Technology Solutions: Using straightforward technology solutions such as phone, email, web-based resources, and Zoom/Teams meetings.to avoid the need for on-site technical support.

What is an evidence-based framework for supporting registrars in poorly resourced environments, and how can I apply it?

The University of Queensland recently undertook an evaluation of RVTS since its inception in 2000 and found evidence to support the effectiveness of RVTS ‘ efforts in training doctors in poorly resourced environments. This has informed the development of an evidence-based framework that includes:

  • Personalised Support: Tailored education and personal support from supervisors, many of whom are former registrars familiar with the local context. These supervisors serve as independent longitudinal mentors throughout the training, providing continuous, unbiased, and empathetic guidance that is relevant to the specific challenges faced by registrars.
  • The provision of holistic professional support that promotes comfort, confidence, competency, belonging, and professional bonding (the “3Cs and 2Bs”) among the registrars.
  • Continuity of Care: Provides consistent, quality care tailored to community needs in low-resource areas. This fosters…
  • Community Trust: Doctors’ longer tenure builds patient trust and deeper learning. RVTS Doctors spend an average of 5.2 years in the same practice, fostering stability.

To effectively apply this framework:

  • Consider the registrar as a whole person by recognising the educational and psychosocial needs of registrars.
  • Encourage registrars to stay in the same practice for stability and community integration.
  • Implement supervision models that ensure independent, structured, unbiased, and continuous support throughout training.
  • Tailor training to the registrar’s specific work environment.
  • Foster community building through social and professional networks.

What resources are available to support training registrars in poorly resourced environments?

The following resources are helpful:

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Date reviewed: 23 October 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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How can GP supervisors better facilitate reflective practice in their registrars?

What is reflective practice?

‘The aim of all supervision and feedback is to make learners reflect on their practice’.

Clinical practice is far from straightforward. GPs practice complex competencies in a clinical world rich with uncertainty and where the textbook knowledge only provides some of the answers. Clinical decision-making therefore requires GPs to combine experience-based knowledge with evidence-based knowledge, but also to constructively process both formal and informal feedback.

The ability to reflect is necessary for efficient use of feedback and essential when performing complex competencies in practice. It has been argued that the ability to reflect on one’s own role and performance is the key factor in expertise development – indeed, that the aim of all supervision and feedback should be to facilitate the learner’s reflection on their own practice.

What is the difference between ‘clarifying supervision’ and ‘expanding supervision’?

‘Clarifying supervision’ is based on direct instruction and confirmation of a decision, whereas ‘expanding’ or ‘broadening supervision seeks to generate reflection through questions that create ‘productive struggle’, link knowledge with practice, or broaden the case. The nature of the registrar and situation may determine which type of supervision is most appropriate, but expanding supervision allows for significantly greater reflection and professional development.

How do I enhance reflection?  Asking good questions is the key. For example:

  • What are your considerations?
  • Why did you choose… (to give an ACE/these tests)?
  • Why do you think she seeks the doctor just now?
  • Is this normal for… (people at that age)?
  • Did you ask about… (symptoms/concerns)?
  • Is that a high ALAT value?
  • What could have made you choose to refer the patient?
  • How does this situation differ from..
  • What if… (the patient had a fever)
  • Would it affect your decision if you knew that…?
  • What would be the next step?
  • What would be your second choice in case of side effects?
  • What else could it be?

Reflective questions can be used at all times of case discussion, even in the brief corridor consultation.

It is important to not ‘examine’ the registrar and make them feel uncomfortable.

  • Time
  • Registrar preparation
  • Choosing the right material (e.g. patient case)
  • Thinking about what they need your help with
  • 40-20-40 model (40% of the learning happens before the session (preparation) and 40% afterwards (implementation))

How can we assess reflection? What is the GAR tool?

Some competencies require discussions broader than a series of patient cases. It is important to assess reflection because of its link to good clinical practice. A new tool has been developed called the Global Assessment of Reflection Ability (GAR) (Lillevang et al. BMC Medical Education (2020) 20:352).
The GAR is a tool for formative and summative assessment of the ability to reflect. It works in two parts.

Part 1 – Preparation:

This begins with the trainee presenting his/her mind map/written presentation which then is the basis for a structured discussion between trainer and trainee that includes references to the concrete experience that the trainee has had.

Part 2 – Structured discussion:

The trainee produces a mind map or similar written presentation in a concept formation process addressing a concrete, complex competency. The trainee is given 1-2 weeks for the preparation and uses the description of the competency in the curriculum.

During the discussion the trainer assesses the following:

  • Does the trainee show ability to reflect on the problem/competency and on his/her own role as a GP according to the matter?
  • Does the trainee demonstrate relevant analytical skills concerning the problem/competency?
  • Is the trainee able to participate in an open-minded dialogue and demonstrate relevant flexibility?

The focus of the discussion is on formative aspects leading to a plan for further learning, but it also includes a summative assessment of whether the competency is successfully achieved.

What are the three most important take away points?

  1. The aim of all supervision and feedback is to make learners reflect on their practice
  2. Reflection is facilitated by asking good questions
  3. Preparation by the registrar (where able) significantly enhances learning

What are some useful references and resources?

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Date reviewed: 23 October 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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Medico-Legal Risks of After-Hours/On-Call for GP registrars and supervisors FAQ

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file.

Date reviewed: 25 October 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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FAQ: Helping Regisrars Shine - Assessing and Managing Registrars with Performance Issues to Work Well

This FAQ provides essential guidance on assessing and managing registrars facing performance issues to enhance their work efficiency. It addresses common concerns and offers practical solutions for improving registrar performance.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file.

Date reviewed: 21 October 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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FAQ: Clinical Supervision and Random Case Analysis

The FAQ explains the role of clinical supervision and the use of Random Case Analysis (RCA) in general practice. It covers how these practices ensure patient safety while enhancing the learning experience for medical trainees

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file.

Date reviewed: 21 October 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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FAQ: Ad Hoc Supervision and Informal Teaching

This FAQ resource explains the distinction between ad-hoc supervision and informal teaching in general practice, emphasising the roles and expectations for medical supervisors and trainees. It highlights the importance of structured, formal teaching to support effective learning and development in clinical settings.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file.

Date reviewed: 21 October 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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FAQ: An Introduction to Supervision

This FAQ provides an overview of GP supervision, including the roles, responsibilities, and rewards involved. It’s a valuable resource for aspiring and current GP supervisors.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file.

Date reviewed: 21 October 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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FAQ: ReCEnT Project

This FAQ provides insights on how the findings of the ReCEnT project can enhance supervisors’ training of registrars in the medical field. It focuses on evidence-based strategies to improve supervision practices and better prepare future healthcare professionals.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file.

Date reviewed: 10 November 2025

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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