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Fifteen years ago, a European survey demonstrated widespread adoption of early clinical exposure (ECE) programmes but little emphasis in the curricula of medical schools. We now repeat the survey in light of the ample emerging data suggesting multiple positive outcomes of ECE. Online cross-sectional survey in European medical schools conducted by the EURACT Basic Medical Education Committee in 2021. Descriptive quantitative analyses and a thematic analysis approach were used. Eighy-nine (48%) medical schools in 30 European countries responded. ECE was used in 65 (73%) of the medical schools, and 88% of ECE programmes took place in primary care. The median total time spent on the ECE programme was 5 days. Teaching methods covered unstructured learning opportunities such as observation or shadowing doctors, as well as work-based learning whilst seeing real patients or reflecting on own encounters. Learning goals included knowledge, skills, and attitudes. More than half of the respondents expressed barriers to implementing or expanding ECE. Compared to the previous survey, there was no significant change in the adoption or curricular emphasis of ECE programmes. Institutional attitudes towards certain disciplines and a lack of willingness to experiment with new teaching methods may be partially responsible. [ABSTRACT FROM AUTHOR]

There is compelling evidence that general practice (GP) is the most effective form of healthcare. However, healthcare policy appears independent of evidence and GP is woefully under-resourced in all countries, and this affects recruitment. Recruitment to GP is proportional to the quantity and quality of undergraduate experience and national and transnational guidelines can improve undergraduate experiences by defining both the desired quantity and quality. There is good evidence that these professionally developed guidelines can be effective in changing Government policy if they are used as a touchstone to collaborate with policymakers. EURACT (European Academy of Teachers in General Practice / Family Medicine) have therefore developed transnational guidelines covering the European region. The guidelines cover the desired quantity, quality and support for undergraduate experience. Three main design principles have been used. Firstly, it is democratic. Secondly it is evidence-based, using extensive literature searching, situational analysis and surveys. Finally, it adopts a 'principles-based approach'. Generalist medicine is articulated as a series of interconnected principles that integrate and then re-focus specialist medicine to achieve the enhanced patient-orientated outcomes of primary-care. This way of articulating generalist practice delivers general principles, which can be used as learning outcomes, that are adaptable to a wide range of learning environments. Most clinical learning documents are irrelevant and are destined for dusty drawers or forgotten digital files. We therefore encourage primary care educators to use these guidelines to work with policy-makers at all levels to advocate for change, strengthening primary care education at local, national and international levels. [ABSTRACT FROM AUTHOR]

'Participation' in a 'community of practice' is often proposed as a mechanism for clinical learning; however, the use of both terms is variable – ranging from technical to vernacular. Belongingness is a related single concept and development of a tool that measures belongingness may therefore be useful in adding to our understanding of when participation and hence learning takes place in clinical settings. After identifying relevant material from the literature, a draft belongingness assessment tool was developed, based on previously published work. This was piloted on 181 undergraduate medical students and the results subjected to factor analysis. The final version was then used to identify whether differences exist between two different clinical teaching environments. Our belongingness assessment tool had internal and external validity, with Cronbach's alpha = 0.940, and detected statistically significant differences between primary and secondary care teaching environments. The belongingness scale described in this paper is a valid tool for the study of undergraduate medical students. This has the potential to investigate how variation in student experiences of participation in communities of practice influences learning. This tool revealed significant differences in student belongingness between primary and secondary care learning environments. [ABSTRACT FROM AUTHOR]

A national undergraduate curriculum for General Practice might address current concerns regarding intellectual challenge and recruitment through articulating disciplinary knowledge and providing teaching guidance. However, there is ambivalence regarding this idea and the reasons appear incompletely understood. Aims: To better understand ambivalence towards a GP curriculum and to assess the acceptability of a new approach to national curriculum design. Methods: Questionnaire informed by Kotter's model of change, distributed to Heads of Teaching (HOTs) at each UK medical school, regarding the acceptability of both conventional and new approaches to the design of national curriculum guidelines. Qualitative and quantitative data collection with grounded theory-informed analysis of qualitative data. Results: Support for a conventional, detailed curriculum of clinical conditions is weak but there is strong support for a curriculum outlining general disciplinary principles. Identification with general practice as an independent academic discipline is important in predicting support or otherwise for any type of national curriculum. Conclusion: The identity of GP as an independent academic discipline emerges as a key issue. Further research on designing and implementing curricula that use principles rather than detailed outcomes is needed. [ABSTRACT FROM AUTHOR]

Audit and feedback is an effective method to improve attending physician performance. However, there are limited data on how audit and feedback impacts care provided by resident physicians. The authors conducted a 3-arm randomized clinical trial among internal medicine resident physicians to examine the impact of an audit and feedback intervention on ambulatory quality measures (AQMs). Residents in all 3 groups received an email containing the contact information of a population health coordinator and a list of AQMs (control). In addition, the Practice Target group received individual AQM data compared to the target AQM goals for all primary care practices. The Peer Comparison group received information on individual AQM data compared to the average performance of residents in the same postgraduate year. Residents in each intervention group received updated information 6 months later. Ten AQMs related to diabetes care, hypertension management, lipid control, and cancer screening, as well as a composite quality score, were examined at baseline, 6 months, and 13 months. At 13 months follow-up, the Practice Target group had statistically significant improvement in cervical cancer screening rate (77% vs. 65.3%), colorectal cancer screening rate (72.5% vs. 64.6%), and composite quality score (71.7% vs 65.4%) compared to baseline. Providing internal medicine residents with individual AQMs data compared to target goal for the practice led to statistically significant improvement in cancer screening rates and the composite quality score. Audit and feedback may be a relatively simple yet effective tool to improve population health in the resident clinic setting. [ABSTRACT FROM AUTHOR]

WHAT IS ALREADY KNOWN IN THIS AREA Studies in general practice have identified relevant themes concerning motivation to teach undergraduate medical students, such as feelings of moral obligation, the importance of educational support, financial arrangements and space constraints. Most studies have come from established medical schools. The views of participating GPs are usually positive in well-resourced educational interventions. WHAT THIS WORK ADDS New and old themes concerning student placements are linked to generate a hypothesis suggesting that as teaching load increases, motivation to teach and personal interest in students may wane. Prioritising organisational and administrative aspects of teaching may be a sign of this. Two factors may protect against diminishing motivation: adequate resourcing of teaching and support from colleagues and teaching institutions. The views of participating GPs are not always positive regarding new educational initiatives. SUGGESTIONS FOR FUTURE RESEARCH A larger study to confirm or refute the findings, as there are significant resource implications. Further work regarding costing models for the large increases in teaching load in general practice. [ABSTRACT FROM AUTHOR]

There is increasing interest in LICs. However for use in the UK and Europe, both the name and nature of LICs need considerable adaption. [ABSTRACT FROM AUTHOR]

The author talks about the need for an undergraduate general practitioner (GP) curriculum in Great Britain. Topics discussed include the primary care education in the country, the issue with defining the core principles of GP, and the history of curriculum development in GP. Also mentioned is the place of medical specialty in GP.

The article presents the author views over development of clinical learning approaches. Topics discussed include consideration of practice idea adoption by medical students in clinical practice conditions by learning through participation in groups; analysis of socio-material learning theory with an impact of interpersonal and cultural influence of learning; and illustration of computers involvement in an inhibition condition for learning network formation.

The article focuses on the joint postgraduate and undergraduate practice visits in general practice (GP) education. It says that joint visits were efficient, enjoyable, and a better learning experience. It explores the overlapping areas of interest determined during the series of meetings organized to develop joint guidelines. It mentions that the visits might be beneficial in promoting a more inclusive and wider teaching practices and ethos.

The relative wealth of bacterial mutagenicity data available in the public literature means that in silico quantitative/qualitative structure activity relationship (QSAR) systems can readily be built for this endpoint. A good means of evaluating the performance of such systems is to use private unpublished data sets, which generally represent a more distinct chemical space than publicly available test sets and, as a result, provide a greater challenge to the model. However, raw performance metrics should not be the only factor considered when judging this type of software since expert interpretation of the results obtained may allow for further improvements in predictivity. Enough information should be provided by a QSAR to allow the user to make general, scientifically-based arguments in order to assess and overrule predictions when necessary. With all this in mind, we sought to validate the performance of the statistics-based in vitro bacterial mutagenicity prediction system Sarah Nexus (version 1.1) against private test data sets supplied by nine different pharmaceutical companies. The results of these evaluations were then analysed in order to identify findings presented by the model which would be useful for the user to take into consideration when interpreting the results and making their final decision about the mutagenic potential of a given compound. [ABSTRACT FROM AUTHOR]