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Background: Medical boards and healthcare providers internationally are coming under increasing pressure to attract international medical graduates (IMGs) and overseas trained doctors (OTDs) to cope with predicted general practice (GP) doctor shortages. Various pathways to registration are made available for this purpose. There is very little understanding of the effects of different training pathways to licensing and registration on the ability of IMGs and OTDs, as well as locally trained doctors, to acquire the desirable professional skills deemed necessary for working effectively in the primary care sector., Methods: Feedback from patients was collected at the end of their scheduled consultation with their doctor using a questionnaire consisting of 13 Likert scale items that asked them to rate their experience of the consultation. Feedback was obtained for doctors going through the Royal Australian College of General Practice (RACGP) Practice Experience Program (PEP) and the Australian General Practice Training Program (AGPT), with the former intended primarily for IMGs and OTDs, and the latter for local medical graduates including from New Zealand. Patient feedback was also obtained for patients visiting already Fellowed and experienced GPs for comparative purposes, resulting in data for three groups of doctors (two trainee, one already Fellowed). Rater consistency and agreement measures, analysis of variance, principal component analysis, t-tests and psychometric network analysis were undertaken between and within groups to identify similarities and differences in patient experience and professionalism of doctors., Results: There was a small but significant difference in average patient raw scores given to PEP and AGPT doctors (90.25, 90.97%), with the highest scores for 'Respect shown' (92.24, 93.15%) and the lowest for 'Reassurance' 89.38, 89.84%). Male patients gave lower scores (89.56%) than female patients (91.23%) for both groups of doctors. In comparison, patients gave experienced GPs an average 91.38% score, with male patients giving a lower average score than female patients (90.62, 91.93%). Two components were found in the patient data (interpersonal communication, caring/empathy) that account for over 80% of the variance. When patient scores were aggregated by doctor, the average PEP and AGPT doctor scores received were 90.27 and 90.99%, in comparison to the average experienced GP score of 91.43%. Network analysis revealed differences in the connectedness of items between these two groups as well as in comparison with experienced GPs, suggesting that PEP doctors' skills are less cohesively developed in the areas of listening ability, explaining and providing reassurance., Conclusions: The small but statistically significant differences between doctor groups reported in this preliminary study are supplemented by percentile analysis, network analysis and principal component analysis to identify areas for further exploration and study. There is scope for improving the integration of interpersonal communication skills of GPs in Training with their caring and empathy skills, when compared with experienced GPs as a benchmark. Suggestions are made for enhancing professional skills from a patients' perspective in future training programs., (© 2022. The Author(s).)

Background: Multisource feedback is an evidence-based and validated tool used to provide clinicians, including those in training, feedback on their professional and interpersonal skills. Multisource feedback is mandatory for participants in the Royal Australian College of General Practitioners Practice Experience Program and for some Australian General Practice Training Registrars. Given the recency of the Practice Experience Program, there are currently no benchmarks available for comparison within the program and to other comparable cohorts including doctors in the Australian General Practice Training program. The aim of this study is to evaluate and compare colleague feedback within and across General Practice trainee cohorts., Methods: Colleague feedback, from multisource feedback of Practice Experience Program participants and Australian General Practice Training Registrars, collected between January 2018 and April 2020, was compared to identify similarities and differences. Analyses entailed descriptive statistics, between and within groups rater consistency and agreement measures, principal component analysis, t-tests, analysis of variance, and psychometric network analysis., Results: Colleague ratings of Practice Experience Program participants (overall average 88.58%) were lower than for Registrars (89.08%), although this difference was not significant. 'Communication with patients' was rated significantly lower for Practice Experience Program participants (2.13%) while this group was rated significantly better for their 'Ability to say no' (1.78%). Psychometric network analyses showed stronger linkages between items making up the behavioural component (compared to the items of the performance and self-management components, as found by principal component analysis) for Practice Experience Program participants as compared to Registrars. Practice Experience Program participants were stronger in clinical knowledge and skills as well as confidentiality, while Registrars were stronger in communicating with patients, managing their own stress, and in their management and leadership skills., Conclusions: The multisource feedback scores of doctors undertaking the Practice Experience Program suggests that, while all mean values are 'very good' to 'excellent', there are areas for improvement. The linkages between skills suggests that Practice Experience Program doctors' skills are somewhat isolated and have yet to fully synthesise. We now have a better understanding of how different groups of General Practitioners in training compare with respect to professional and interpersonal skills. Based on the demonstrated differences, the Practice Experience Program might benefit from the addition of educational activities to target the less developed skills., (© 2022. The Author(s).)

Feedback from colleagues and patients is a core element of the revalidation process being developed by the General Medical Council. However, there are few feedback tools which have been specifically developed and validated for doctors in primary care. This paper presents data demonstrating the reliability and validity of one such tool. The CFEP360 tool combines feedback from the Colleague Feedback Evaluation Tool (CFET) and the Doctor's Interpersonal Skills Questionnaire (DISQ). The analysis of over 10 000 completed questionnaires presented here identifies that colleague feedback is essentially two-dimensional (i.e. clinical and non-clinical skills) and that patient feedback is one-dimensional. However, items from both scales also effectively predict combined global ratings, indicating that colleagues and patients are identifying similar levels of performance as accessed by the feedback. Doctors who receive low feedback scores may require further attention, meaning the feedback potentially has diagnostic value. Reliable feedback on this tool, as indicated by this analysis, requires 14 colleague responses and 25 patient responses, figures comparable to other MSF tools if CFEP360 is to be used for a high stakes performance evaluation and possible revalidation (generalisability statistic G⩾0.80). For lower stakes performance evaluations, such as personal development, responses from 11 colleagues and 16 patients will still return reliable results (G⩾0.70). [ABSTRACT FROM AUTHOR]

There is still very little understanding of what exactly is being measured when peer review is undertaken and how it should be measured for different target groups. The aim of this study is to determine the basis on which raters distinguish between two sets of colleagues: GPs and consultants. From March to July 2005 a study was run to test a newly created peer assessment tool for doctors in primary and secondary care settings. A total of 33 doctors took part — 14 GPs and 19 hospital consultants. Each of the participants was asked to identify 15 colleagues as appraisers to complete the colleague feedback evaluation tool questionnaire. Factor analysis demonstrates that colleagues have rated all doctors along the four dimensions of effective communication, clinical competence, time- management and trust. After separating GP colleague responses from consultant colleague responses, the application of cluster analysis clearly demonstrates that overall ability as a GP is strongly linked to effective communication with colleagues, whereas for consultants overall ability is based mainly on clinical competence alone. The implications of these findings for the development of future peer evaluation tools are discussed. [ABSTRACT FROM AUTHOR]

WHAT IS ALREADY KNOWN IN THIS AREA • The improving practice questionnaire (IPQ) is a valid and reliable practical tool and process for measuring quality in primary care, feeding back patient perceptions of clinicians' interpersonal skills and other aspects of the running of the practice. • Some practices have established critical friends groups (CFGs) to help them interpret results of systematic patient feedback. WHAT THIS WORK ADDS • CFGs help practices make changes to their services in order to be more patient focused. • This cluster randomised controlled trial, incorporating qualitative inquiry methods, indicated that several issues were discussed in CFGs. Some, notably privacy in reception areas, led to significant changes in IPQ scores. • Other issues discussed by CFGs included telephone systems, information and dissemination, appointments, waiting room facilities, the role of the practice nurse, repeat prescriptions, the use of computers and out-of-hours arrangements. SUGGESTIONS FOR FUTURE RESEARCH • In order to maximise the impact of CFGs in improving quality from a patient's perspective, more research is required in exploring the dynamics of CFGs and their sustainability. In other words, which aspects of the CFGs are more influential in bringing about improvements in services? [ABSTRACT FROM AUTHOR]

Context General practice. Objectives To compare ratings of GP registrars' communication skills by patients and GP examiners. Design A comparative study where the communication skills of GP registrars were assessed both by patients, using a validated tool called the Doctors' Interpersonal Skills Questionnaire (DISQ), and by GP examiners as part of the Fellowship examination of the Royal Australian College of General Practitioners (RACGP). Participants These included 138 GP registrars, 6075 patients, and more than 70 GP examiners. Results Spearman rank correlations were used to test the strength of the relationship between Fellowship examination and DISQ scores. Findings showed that there were several communication skills areas with mild (but significant) correlations between patient and GP examiner ratings. These areas included warmth of greeting, listening skills, respect, and concern for the patient as a person. No significant correlations were detected for explanation skills. Interestingly, the correlations between GP examiner and patient ratings were stronger for female GP registrars. Conclusion There is some evidence that patients' ratings of GP registrars' communication skills is aligned to ratings made by GP examiners as part of the summative RACGP Fellowship examination. However, further work is required to assess the strength of this alignment, given that patient–doctor communication is assessed more widely through new components of the examination. [ABSTRACT FROM AUTHOR]

There is growing interest in the adoption of patient-based assessments for the training of general practitioners. Consumers are in a unique position to comment on the quality of the doctor-patient interaction. Involving consumers as partners with general practice (GP) registrars and GP educators in the development of a patient feedback instrument enhances the relevance and acceptability of consumers as educators in GP training. It also demonstrates that social and medical agendas can be harmonized. Two patient feedback instruments on interpersonal skills were trialed in a training program for general practitioners in Australia. It was found that one of the instruments was more discriminating than the other because of its different response scale. [ABSTRACT FROM AUTHOR]