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In Australia, doctors undertaking advanced training to become general practitioners work under the supervision of clinical educators. Primarily clinicians, these clinical educators participate in one day of teaching-related professional development annually, generally a workshop. Shortcomings with this form of professional development led to the development of a quality improvement focused intervention that is facilitated in the workplace and based on the clinical educator's self-identified concerns. Drawing on teacher action research and feasibility study methodologies we explored this novel form of professional development by asking 'Can this intervention work?' We employed an embedded multiple case study design, trialling the intervention in four settings. The intervention's constituent activities were acceptable to participants; including a preparedness to experience discomfort for the purpose of improving their teaching practices. They perceived the intervention as convenient and the workload manageable. Participants were motivated to experiment with new teaching behaviours, but measuring outcomes was challenging. Medical educators facilitating the intervention perceived their tasks as cognitively 'hard work'. The findings provide support for this workplace-based intervention as a feasible form of professional development, which should be implemented on a larger scale and evaluated for impact. [ABSTRACT FROM AUTHOR]

Background: Recent global increases in medical student numbers and shifts in medical education from teaching hospitals to community settings call for effective strategies to meet the demand for general practice teaching placements. It has been proposed that "multi-level learning" (MLL), in which learning and teaching are shared across different levels of learners, may provide teaching efficiencies and valuable experiences for learners and teachers. Aims: To identify, evaluate and synthesize the evidence related to the types, benefits, challenges, and facilitators of MLL in community-based general practice, and the underlying mechanisms and associated contexts to explain the reported outcomes. Method: A realist synthesis approach guided the systematic review. Results: Fifteen papers were identified, providing primary evaluation data predominantly from interviews with or surveys of key stakeholders. Generally, all levels of learners reported overall satisfaction with their MLL experiences. Medical students appreciated learning from prevocational doctors and registrars due to social and cognitive congruence. Mechanisms and contexts that supported our hypotheses regarding successful MLL outcomes were identified, with "a strong teaching culture" being a major mechanism. Conclusions: The findings can help inform practices considering the implementation or enhancement of MLL initiatives in general practice. Further research should include measuring defined learning outcomes. [ABSTRACT FROM AUTHOR]