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.Aim To provide greater understanding of how PETALs are used in GP training, using Registrars' Clinical Encounters in Training (ReCEnT) as a case study.Methods Medical educators, supervisors, and registrars from two Australian regional GP training organisations participated in focus groups and interviews, designed to explore participants' perceptions of ReCEnT's utility. Data were analysed using reflexive thematic analysis.Results Eight themes were identified that enhance our understanding of: how ReCEnT reports are used (reassuring registrars, facilitating self-reflection, identifying learning needs), what enables ReCEnT to reach its full potential (a culture of reflection, meaningful discussions with supervisors and medical educators, valuing objective data), and differences in understanding about ReCEnT's role in a programmatic assessment framework (as a tool for learning, as 'one piece of the puzzle').Discussion The findings were used to develop a Structure-Process-Outcomes model to demonstrate how ReCEnT is currently used and explores how it can be used for learning, rather than of learning, in a programmatic assessment framework for GP training. ReCEnT's longitudinal format has potential for enhancing learning throughout training. What is already known: In Australia's apprenticeship-style model of GP training, in-practice learning and experience for GP registrars is central to the development of their confidence and clinical competencies. The Registrar Clinical Encounters in Training (ReCEnT) project is a patient encounter tracking and learning tool (PETAL) that has been shown to provide opportunities for GP registrars along with their supervisors and medical educators (MEs) to reflect on registrars' clinical practice and identify their learning needs, leading to change in practice. There is limited qualitative literature on how registrars, supervisors and MEs describe the utility of workplace-based assessment tools such as PETALs, particularly within proposed programmatic assessment frameworks. What this study adds: This study builds on previous survey findings, providing greater depth of understanding from the perspective of GP registrars, supervisors and MEs regarding how ReCEnT can be useful as an educational and reflective PETAL tool for GP registrars during their training. Meaningful engagement between GP registrars and their supervisors and MEs enables ReCEnT to be more effective as a tool for learning in general practice training. More work needs to be done on how PETALs, such as ReCEnT, best fit within a programmatic assessment framework for general practice training.