Research Roundup – October

In this edition of Research Roundup we have a selection of 5 papers on some topics close to every GP’s heart!

Selection and recruitment, CPD, emotional intelligence, accreditation and continuity of care.

Feast your eyes on these!

Emotional intelligence – 12 tips

So all of you who have been following developments in GPSA research on the GP Supervisory Relationship Measure for Supervisors (GP-SRMS) and the newly minted partner tool, the GP-Supervisory Relationship Measure for Registrars (GP-SRMR) will have learned about the role that the registrar’s perception of the emotional intelligence of the supervisor plays in the educational alliance.

Beyond that, however, emotional intelligence is rapidly gaining currency for its potential contribution to the development of a culture of professionalism AND the good news is that some elements of it can be learned.

This 12 tips paper covers how to introduce EI into the curriculum.

1. Start with the WHY
2. Use a conceptual framework to organize the material
3. Break up the didactic session into 10-15 minute blocks
4. Create an atmosphere of psychological safety
5. Incorporate a self-awareness exercise
6. Employ multiple teaching methods
7. Make sessions as interactive as possible
8. Contextualize the lessons with clinical vignettes
9. Include visualization exercises in small group discussions
10. Integrate relevant material on leadership development
11. Tailor the presentations’s approach for the appropriate audience
12. Ask for feedback to improve the next iteration (CQI)

This paper is well worth the read. My prediction? EI will be the next big thing.

Read all about it here:

https://doi.org/10.1080/0142159X.2018.1481499

2018 Ottowa Consensus Statement: selection and recruitment to the healthcare professions.

Everyone wants to recruit ‘the best’ people to healthcare, right? And we’ve been experimenting across the globe with all sorts of systems, processes and methods to select ‘the best’.

Well this paper is the update of the 2011 Ottowa consensus statement on selection.

It includes a terrific little summary of the evidence for selection methods including:

• Academic achievement
• Aptitude tests
• Personal statements and CVs
• References and letters of recommendation
• Situational judgement tests
• Personality assessment
• Interviews/MMIs
• Selection centres using work samples and simulations.

This paper goes to the nub of the issue: what outcomes are we trying to predict?

And if there is no generally agreed-upon gold standard that measures the performance of a practicing health professional, how can we choose a selection method that will predict that performance?

A bucket is tipped on some of the more recent trends in selection whilst others are supported.

The paper discusses the merits of these methods and makes 10 recommendations and calls for an expansion of methodological approaches.

Read all about it here:

https://doi.org/10.1080/0142159X.2018.1498589

Translating evidence into practice: lessons for CPD

We all love translational research, right? Getting that evidence into practice – nirvana!

So why does it so often go wrong with CPD?

Well this paper thinks it has the answers! And it involves 4 groups:

• Academic medical institutions, employers and educators need to embrace the principles and practices of self-directed learning.
• Health systems must share responsibility for the physician learning and the performance data and feedback on which such learning is best based.
• Specialist societies and licensing boards must undertake meaningful re-licensure and re-certification processes.
• CPD planners must seek out partnerships with health system leadership and quality improvement managers as they create engaging, integrated and impactful CPD activities.

And there you have it! You don’t have to do a thing!

Read all about it here:

https://doi.org/10.1080/0142159X.2018.1481285

Is accreditation still relevant??

You bet! And for a couple of reasons.

This paper reflects on the role of accreditation as a driver for quality improvement and in particular, Australian Medical Council (AMC) accreditation of specialist training programs and compares accreditation systems internationally.

This paper notes that while the AMC’s objectives are similar to those of other accreditation bodies internationally, practices differ.

The paper goes on to suggest that the AMC could reorient its accreditation of specialist training programs from a focus on compliance and standards to one that emphasizes the colleges’ and facilities’ self-assessment and quality management processes and thus be more in line with international trends where the emphasis is on continuous quality improvement and self-evaluation.

The paper highlights that, in the Australian accreditation process, the colleges are entrusted with significant power and responsibility for training because the colleges set the curriculum and the standards for training and accredit the training sites themselves.

The authors also note that, by comparison with systems in Canada, the US, UK and the Netherlands; the AMC “is remote from the workplace” in terms of accreditation of training sites. They note that these other countries have accreditation processes that focus at a regional or training site level, not the national level as we do here in Australia via the colleges.

With the training program going back to the colleges, who knows what this may mean for accreditation???

Read it for yourself, here:

https://doi.org/10.5694/mja17.00934

Continuity of care and mortality – is there a relationship?

As it turns out, yes, there is.

This paper is a systematic review of continuity of care and mortality and looks at the literature from 1996 to 2017 on continuity of care received by patients from any kind of doctor (i.e. generalist or specialist), in any setting, in any country and the measured mortality of the patients.

Continuity of care is defined here as “repeated contact between an individual patient and a doctor”.

The paper emphasizes the interpersonal aspects of care and challenges the notion that “non-personal care” (read ‘care by app’) should be the default option.

This (I think, scary) scenario was suggested in an opinion piece that describes some developments already happening driven by a business model that puts the face-to-face experience as a last resort option.

Although the evidence is lower quality (i.e. mostly observational) it does show that patients across all cultural boundaries appear to benefit from continuity of care with both generalist and specialist doctors and experience lower mortality rates.

Viva la face-to-face doctor visit!

Read the paper here:

https://doi.org/10.1136/bmjopen-2017-021161

And the scary opinion piece here: https://doi.org/10.1056/NEJMp1710735

You be the judge!