Dataset Information

DEGAM criteria catalogue for training practices in primary care--a proposal for the assessment of the structural quality of training practices.

ABSTRACT:

Background

Whilst the structure of primary care vocational training in Germany is being increasingly formalized there remains an abundance of disparate locally defined criteria for the training practices. Advanced medical training in the ambulatory setting has also been identified as an area of need by other specialties.

Goal

In contrast to the current practice of a unregulated authorization by regional medical associations this catalogue provide transparent, clearly defined criteria for the assignment of training practice status.

Methods

The first draft of the criteria catalogue integrates feedback from 30 academic general practitioners. The feasibility of the catalogue was tested by a further 30 surgeries. Analysis included an assessment of the sociodemographic characteristics of the trainers and their practices as well as satisfaction of the participants with the approved authorization period.

Results

The criteria catalogue comprises 19 items within the domains of trainer qualification, practice infrastructure and patient specific factors as well as mandatory criteria. The points scored through this system confer a variable period of authorization. Of the 30 participants 17 were satisfied with the period of authorization they received, 10 were dissatisfied, and one was indifferent. Satisfaction showed no correlation with sex, experience as a trainer, or with the score achieved through the criteria catalogue. It correlated little with the length of time practicing as a doctor.

Conclusion

The criteria catalogue reflects both the breadth of general practice as well as the skills of the trainers. Satisfaction of participants in the test group was good, and infers a basis for applying the catalogue through regional medical associations to assign teaching practice status. It may also be used as a blue-print for other medical specialties.

SUBMITTER: Egidi G

PROVIDER: S-EPMC3935169 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

DEGAM criteria catalogue for training practices in primary care--a proposal for the assessment of the structural quality of training practices.

Egidi Günther G Bernau Ruben R Börger Matthias M Mühlenfeld Hans-Michael HM Schmiemann Guido G

GMS Zeitschrift fur medizinische Ausbildung 20140217 1

<h4>Background</h4>Whilst the structure of primary care vocational training in Germany is being increasingly formalized there remains an abundance of disparate locally defined criteria for the training practices. Advanced medical training in the ambulatory setting has also been identified as an area of need by other specialties.<h4>Goal</h4>In contrast to the current practice of a unregulated authorization by regional medical associations this catalogue provide transparent, clearly defined crite ...[more]

PMID: 24575159

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Project description:Introduction: In different German regions, seminar programs have been conducted for General practice residents. In each region, selection and teaching of learning content is conducted in a different manner. So far, no structured, standardized curriculum has been implemented nationwide. We have investigated, if the development of a common 5-year program of learning topics is conceivable between the different university departments of General practice in Germany. Method: The seminar program working group of the DEGAM (German College of General Practitioners and Family Physicians) has conducted an online survey based on information gathered via preliminary telephone conference (n=7; physicians with postgraduate teaching experience) among all German university departments of General Practice and two non-university teaching institutions, identified via the internet. 884 topics were extracted from 14 Seminar programs. The topics were entered in a database, discussed and categorized: Practice management/practice work flow/standardized documentation forms/quality management (n=33 topics), common acute and chronic diseases, including disease management programs (n=29 topics), communication, neurological, psychological and psychiatric consultations (n=24 topics), common medical problems, including eye, ear, nose, throat, skin and pediatric problems (n=99 Topics) family physicians general approach, including epidemiology, shared decision making, test of time (n=42 Topics). These topics have been rated for priority and desirable number of teaching-units. Results: A catalogue of 111 topics was designed, encompassing 160 teaching units. There is a suggestion of wide topics collections plus an add-on catalogue. Conclusion: A proposal for a 5-year-thematic catalogue for postgraduate training of general practice residents in Germany has been developed. This newly developed curriculum has the potential to improve knowledge and skills that have not been covered during in-house and ambulatory general practice residencies.

Project description:PURPOSE: Preparing residents for future practice, knowledge, and skills in quality improvement and safety (QI/S) is a requisite element of graduate medical education. Despite many challenges, residency programs must consider new curricular innovations to meet the requirements. We report the effectiveness of a primary care QI/S curriculum and the role of the chief resident in quality and patient safety in facilitating it. METHOD: Through the Veterans Administration Graduate Medical Education Enhancement Program, we added a position for a chief resident in quality and patient safety, and 4 full-time equivalent internal medicine residents, to develop the Primary Care Interprofessional Patient-Centered Quality Care Training Curriculum. The curriculum includes a first-or second-year, 1-month block rotation that serves as a foundational experience in QI/S and interprofessional care. The responsibilities of the chief resident in quality and patient safety included organizing and teaching the QI/S curriculum and mentoring resident projects. Evaluation included prerotation and postrotation surveys of self-assessed QI/S knowledge, abilities, skills, beliefs, and commitment (KASBC); an end-of-the-year KASBC; prerotation and postrotation knowledge test; and postrotation and faculty surveys. RESULTS: Comparisons of prerotation and postrotation KASBC indicated significant self-assessed improvements in 4 of 5 KASBC domains: knowledge (P < .001), ability (P < .001), skills (P < .001), and belief (P < .03), which were sustained on the end-of-the-year survey. The knowledge test demonstrated increased QI/S knowledge (P = .002). Results of the postrotation survey indicate strong satisfaction with the curriculum, with 76% (25 of 33) and 70% (23 of 33) of the residents rating the quality and safety curricula as always or usually educational. Most faculty members acknowledged that the chief resident in quality and patient safety enhanced both faculty and resident QI/S interest and participation in projects. CONCLUSIONS: Our primary care QI/S curriculum was associated with improved and persistent resident self-perceived knowledge, abilities, and skills and increased knowledge-based scores of QI/S. The chief resident in quality and patient safety played an important role in overseeing the curriculum, teaching, and providing leadership.

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Project description:BACKGROUND: The European Practice Assessment program provides feedback and outreach visits to primary care practices to facilitate quality improvement in five domains (infrastructure, people, information, finance, and quality and safety). We examined the effectiveness of this program in improving management in primary care practices in Germany, with a focus on the domain of quality and safety. METHODS: In a before-after study, 102 primary care practices completed a practice assessment using the European Practice Assessment instrument at baseline and three years later (intervention group). A comparative group of 102 practices was included that completed their first assessment using this instrument at the time of the intervention group's second assessment. Mean scores were based on the proportion of indicators for which a positive response was achieved by all of the practices, on a scale of 0 to 100. RESULTS: We found significant improvements in all domains between the first and second assessments in the intervention group. In the domain of quality and safety, improvements in scores (mean scores were based on the proportion of indicators for which a positive response was achieved by all of the practices, on a scale of 0 to 100) were observed in the following dimensions: complaint management (from a mean score of 51.2 at first assessment to 80.7 at second assessment); analysis of critical incidents (from 79.1 to 89.6); and quality development, quality policy (from 40.7 to 55.6). Overall scores at the time of the second assessment were significantly higher in the intervention group than in the comparative group. INTERPRETATION: Primary care practices that completed the European Practice Assessment instrument twice over a three-year period showed improvements in practice management. Our findings show the value of the quality-improvement cycle in the context of practice assessment and the use of established organizational standards for practice management with the Europeaen Practice Assessment.

Dataset Information

DEGAM criteria catalogue for training practices in primary care--a proposal for the assessment of the structural quality of training practices.

Background

Goal

Methods

Results

Conclusion

Publications

DEGAM criteria catalogue for training practices in primary care--a proposal for the assessment of the structural quality of training practices.

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