Postgraduate medically related qualifications of early career general practitioners.

Background And Objectives: General practitioners' (GPs) specialised qualifications and upskilling in medical roles strengthen healthcare systems and improve patient outcomes. This study aimed to describe additional qualifications attained, or being undertaken, by early career GPs and establish associations of obtaining/undertaking postgraduate and post-Fellowship qualifications.

Method: This was a questionnaire-based, cross-sectional study of early career college-Fellowed GPs in NSW/ACT, Tasmania and Eastern Victoria (New alumni Experiences of Training and independent Unsupervised Practice [NEXT-UP] study).

Interpractice variability in antibiotic prescribing for acute respiratory tract infections: a cross-sectional study of Australian early-career general practitioners.

Objectives: Frequency of general practitioners' (GPs') antibiotic prescribing for acute, self-limiting respiratory tract infections (aRTIs) is high. The practice environment and culture influence the clinical behaviour, including prescribing behaviour, of GP specialist vocational trainees (registrars). We aimed to assess inter-practice variability in registrars' antibiotic prescribing.

Educational and research utility of the registrar clinical encounters in training (ReCEnT) project: an exploration of mechanisms using the context, input, process and product (CIPP) framework.

Background: The Registrar Clinical Encounters in Training (ReCEnT) project is an Australian general practice vocational training programme with integrated and interdependent education and research functions. Trainees (registrars) contemporaneously document in-consultation clinical experience and actions.

Objectives: Using a realist lens, we elucidate the mechanisms underpinning project outcomes to answer questions around programme effectiveness, impacts, sustainability and the lessons and findings that are translatable to other primary care training programmes.

Inter-Practice Variability in General Practice Consultations With Older Patients: A Cross-Sectional Analysis of the Registrar Clinical Encounters in Training Study.

Rationale: General practice is central to older patient care provision. For GP registrars (specialist GPs in training), exposure to older patients is also vital for developing chronic disease and multimorbidity management skills. However, registrars see fewer older patients, and are less engaged with older patient care, than established GPs.

Changing the antibiotic prescribing of Australian general practice registrars' for acute respiratory tract infections: a non-randomized controlled trial.

Background: Inappropriate antibiotic prescription for self-limiting respiratory tract infections (RTIs) by general practitioner (GP) registrars (trainees) is less common than by established GPs but still exceeds evidence-based benchmarks. A 2014 face-to-face educational intervention for registrars and supervisors reduced registrars' acute bronchitis antibiotic prescription by 16% (absolute reduction). We aimed to establish the efficacy of an updated registrar/supervisor RTI-management intervention (delivered at distance) on antibiotic prescribing.

Prevalence of Antibiotic Prescribing for Acute Respiratory Tract Infection in Telehealth Versus Face-to-Face Consultations: Cross-Sectional Analysis of General Practice Registrars' Clinical Practice.

Background: Antimicrobial resistance is a global threat. Australia has high antibiotic prescribing rates with the majority of antibiotics prescribed by general practitioners (GPs) for self-limiting acute respiratory tract infection (ARTIs). Australian GP trainees' (registrars') prescribing for ARTIs may have been affected by the introduction of remunerated telehealth consultations in 2020.

General practice registrar evaluation of long COVID in patients presenting with fatigue.

Background Long COVID is a new and prevalent condition defined by persistent symptoms following acute COVID-19 infection. While increasing resources are being directed to management, there is little evidence on how general practitioners (GPs) have changed their assessment and differential diagnosis of patients with potential long COVID symptoms including fatigue. This study aimed to examine how often GP registrars consider long COVID in patients presenting with fatigue, how often they think long COVID might be the cause for fatigue, and patient, registrar, practice, and consultation factors associated with these outcomes.

Contextual Factors that Influence Antibiotic Prescribing: A Discrete Choice Experiment of GP Registrars.

Introduction: Antimicrobial resistance is a global emergency related to overprescribing of antibiotics. Few studies have explored how prescribing behaviours may change as the consequence of changing resistance. Understanding how contextual factors influence antibiotic prescribing will facilitate improved communication strategies to promote appropriate antibiotic prescribing.

Increasing access to pain care services to improve rural pain management: a realist review investigating factors affecting uptake, implementation, and sustainability.

Guideline-based care for chronic pain is challenging to deliver in rural settings. Evaluations of programs that increase access to pain care services in rural areas report variable outcomes. We conducted a realist review to gain a deep understanding of how and why such programs may, or may not, work.

Australian general practice registrars' billing patterns: a cross-sectional analysis from the Registrars Clinical Encounters in Training (ReCEnT) study.

Background: In Australia, a government insurance scheme (Medicare) pays set rebates for a range of distinct general practitioner (GP) services. GPs may 'bulk-bill' and accept the Medicare rebate fee directly, or 'privately-bill' by charging the patient a higher fee that is partially reimbursed by Medicare. The billing behaviour of Australian GP registrars (trainees) and their decision to bulk- or privately-bill patients is an evidence gap.

Registrars as teachers: a qualitative study exploring the experiences of Australian general practice registrars in teaching roles.

Background: GP registrars (specialist vocational trainees in general practice) are interested in teaching, and there are considerable benefits to teaching during training. There are, however, significant barriers for registrars as teachers, including inadequate funding, time pressures, and limited teacher training. Current evidence does not include medical educator (ME) perspectives or compare teaching settings (e.

Temporal trends in the prevalence of GP registrars' long-term paediatric asthma control medications prescription.

Asthma is one of the most common chronic illnesses affecting children. Long-term asthma control medications (LTACMs) are an important aspect of asthma management, with under-prescription associated with poor asthma control and increased asthma deaths. This study aimed to document temporal trends in the prescribing of LTACMs for paediatric patients for asthma-related presentations to Australian general practice registrars (trainees).

General practice registrars' practice in outer metropolitan Australia: a cross-sectional comparison with rural and inner metropolitan areas.

Background General practice training in outer metropolitan (OM) areas contributes to patients' access to care. Differences in clinical practice and training in rural versus urban areas have been established, but less is known about OM versus inner metropolitan (IM) differences - whether they offer a trainee learning experience of populations with distinct demographics and healthcare characteristics. This study sought to identify the characteristics and associations of general practice training in New South Wales and Australian Capital Territory OM areas, compared to IM and rural areas.

Factors associated with early-career GPs' retention as independent specialists in former training practices.

Introduction: Retention of general practice registrars in their training practices is important for addressing the GP workforce deficit and maldistribution of GPs. Given that rural and remote general practices are disproportionately affected by low retention, identifying the factors that promote retention may be as important as developing recruitment strategies in these areas. Quantifying the impact of relevant factors on registrar retention will enable a better understanding of how to incentivise retention and attenuate the loss of the rural workforce to other areas.

Discovery of 1,3,4-oxadiazoles with slow-action activity against Plasmodium falciparum malaria parasites.

To achieve malaria eradication, new preventative agents that act differently to front-line treatment drugs are needed. To identify potential chemoprevention starting points we screened a sub-set of the CSIRO Australia Compound Collection for compounds with slow-action in vitro activity against Plasmodium falciparum. This work identified N,N-dialkyl-5-alkylsulfonyl-1,3,4-oxadiazol-2-amines as a new antiplasmodial chemotype (e.

Exploring how a patient encounter tracking and learning tool is used within general practice training: a qualitative study.

Introduction In Australian general practitioner (GP) training, feedback and reflection on in-practice experience is central to developing GP registrars' (trainees') clinical competencies. Patient encounter tracking and learning tools (PETALs) that encompass an audit of consecutive patient consultations, feedback, and reflection are used to determine registrars' in-practice exposure and have been suggested as a tool for learning within a programmatic assessment framework. However, there is limited qualitative literature on the utility of PETALs in GP training.

Utilisation of in-consultation supervisor assistance in general practice training and personal cost to trainees: a cross-sectional study.

Aim The aim of the study was to establish whether two previously described barriers to effective in-consultation assistance-seeking by general practice (GP) vocational specialist trainees (ie concern about patient impressions of their competence, and discomfort presenting to supervisors in front of patients) influenced the frequency of trainee in-consultation assistance-seeking from their supervisor. Methods This was a cross-sectional study nested in the Registrar Clinical Encounters in Clinical Training ongoing cohort study of Australian GP trainees. Trainee participants completed contemporaneous records of 60 consecutive patient consultations, including whether supervisory assistance was sought.

Perceptions of the effectiveness of using patient encounter data as an education and reflection tool in general practice training.

Introduction Patient encounter tools provide feedback and potentially reflection on general practitioner (GP) registrars' in-practice learning and may contribute to the formative assessment of clinical competencies. However, little is known about the perceived utility of such tools. Aim To investigate the perceived utility of a patient encounter tool by GP registrars, their supervisors, and medical educators (MEs).

Prediction of general practice licensure/certification examination performance by a measure of 'questionable' activities in clinical practice: a retrospective cohort study.

Purpose: 'Low-value' clinical care and medical services are 'questionable' activities, being more likely to cause harm than good or with disproportionately low benefit relative to cost. This study examined the predictive ability of the QUestionable In Training Clinical Activities Index (QUIT-CAI) for general practice (GP) registrars' (trainees') performance in Australian GP Fellowship examinations (licensure/certification examinations for independent GP).

Methods: The study was nested in ReCEnT, an ongoing cohort study in which Australian GP registrars document their in-consultation clinical practice.

Video versus telephone for telehealth delivery: a cross-sectional study of Australian general practice trainees.

Background: Remunerated telehealth consultations were introduced in Australia in 2020 in response to the COVID-19 pandemic. Videoconferencing has advantages over telephone-consulting, including improved diagnostic and decision-making accuracy. However, videoconferencing uptake in Australia has been low.

Exam prediction and the general Practice Registrar Competency Assessment Grid (GPR-CAG).

Background: In GP training, identifying early predictors of poor summative examination performance can be challenging. We aimed to establish whether external clinical teaching visit (ECTV) performance, measured using a validated instrument (GP Registrar Competency Assessment Grid, GPR-CAG) is predictive of Royal Australian College of General Practitioners (RACGP) Fellowship examination performance.

Methods: A retrospective cohort study including GP registrars in New South Wales/Australian Capital Territory with ECTV data recorded during their first training term (GPT1), between 2014 and 2018, who attempted at least one Fellowship examination.

'Low-value' clinical care in general practice: a cross-sectional analysis of low-value care in early-career GPs' practice.

Nonevidence-based and 'low-value' clinical care and medical services are 'questionable' clinical activities that are more likely to cause harm than good or whose benefit is disproportionately low compared with their cost. This study sought to establish general practitioner (GP), patient, practice, and in-consultation associations of an index of key nonevidence-based or low-value 'questionable' clinical practices. The study was nested in the Registrar Clinical Encounters in Training study-an ongoing (from 2010) cohort study in which Australian GP registrars (specialist GP trainees) record details of their in-consultation clinical and educational practice 6-monthly.

General practice registrars training part-time: a cross-sectional analysis of prevalence and associations.

While GPs are working fewer clinical hours and many GP trainees (registrars) do not foresee themselves working full-time in clinical practice, little is known of the epidemiology of registrars training part-time. We aimed to establish the prevalence of general practice part-time training (PTT), and part-time registrars' characteristics and practice patterns. A cross-sectional analysis was conducted of data from the Registrar Clinical Encounters in Training project, an ongoing cohort study of Australian GP registrars' clinical experiences over 60 consecutive consultations in each of three training terms.