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GPARTs 2020 Start



Set up for Success? How do we best implement Near Peer Teaching within the General Practice workplace?

Dr Kelly Doherty

Academic Supervisors: Dr Jenny Johnston & Dr Davina Carr

Clinical Supervisor: Dr Siobhan Harkin at Salisbury Medical Centre, Belfast

Summary of Project

Medical education is undergoing significant changes across the UK. Generalist skills are increasingly important and of a greater focus in the undergraduate curriculum. Whilst this change is welcome, it presents further pressure on struggling general practices to provide the teaching required to students. Near peer teaching (NPT) (teaching between a GP trainee and undergraduate student) presents an effective strategy to this challenge and has benefits for both teacher and learner. Existing literature, however, lacks information on formal integration of such programs. To optimise conditions for NPT, it is important to understand the processes of this type of learning within the workplace, and the influence of different contexts on those processes. My research seeks to add to the literature by doing a formal realist synthesis with the following review question; how can we best implement NPT in general practice? Realist synthesis is a theory-driven summary of the literature and can help us understand why educational interventions work. Three main concepts central to this philosophy are context, mechanism, and outcomes; only in a particular context will mechanisms within an educational intervention operate to generate an outcome.

This research will translate the findings of empirical studies into context, mechanism and outcome configurations and identify those causal relationships that allow for effective NPT implementation in the general practice workplace. This work aims to provide a deeper understanding of how we can best implement NPT within general practice. The results of this synthesis will be useful to policymakers and practitioners in NPT, who will be able to apply the findings within their own contexts and thus design a clinical learning environment that is more effective for learning.


Pursuing flourishing General Practice: understanding the pressures affecting Practices at the ‘coal face’

Dr Richard Dillon

Academic Supervisors: Dr Grainne Kearney & Prof Michael Donnelly

Clinical Supervisor: Neil Stockman at Regency Medical Practice, Newtownards

Summary of Project

My project aims to look at the current pressures within general practice. There has been unprecedented demand in Primary Care in recent times. Over the last 4years, there has been a reduction in the number of GP surgeries. This is either through closures or mergers. A BMA report identified several different factors that may play a part. Since then a number of things have changed (MDT involvement with Physios, Social workers etc and the increased use of telephone triage). My research is focused on reviewing the survey previously carried and trying to identify what factors would help to generate flourishing primary care.


In situ simulation for Paediatric Emergencies in Primary Care

Dr Sarah O’Hare

Academic Supervisors: Professor Gerry Gormley

Clinical Supervisor: Dr Paul Carlisle, Hillhead Family Practice, Belfast

Summary of Project

I am completing a project on the use of in situ simulation training in managing paediatric emergencies in general practice. A wide range of emergencies may present including anaphylaxis, and meningitis. Paediatric emergencies pose a particular challenge, as treating children requires specific knowledge, skills and equipment.

Existing evidence shows that in-situ simulation training is an acceptable and feasible way of developing interprofessional skills in primary care settings. The aim of this research is to investigate the use of simulation to improve preparedness to manage paediatric emergencies in primary care.

I am currently completing a literature review, to establish what is known about how in-situ simulation achieves its outcomes. I will develop and implement a programme of in-situ simulation relating to primary care paediatric emergencies. Using participatory research methodology, supported by multimodal evaluation using video, field notes and interview data, I will explore its effects on learning and organisational change.


Moving More: How can we reduce sedentary behaviour in Primary Care?

Dr Richard Mayne

Academic Supervisors: Dr Neil Heron & Dr Nigel Hart

Clinical Supervisor: Dr David Moore at Struell Surgery in Downpatrick

Summary of Project

Sedentary time (assessed as either daily overall sedentary time, sitting time, television or screen time, or leisure time spent sitting) is independently associated with a greater risk for all-cause mortality, cardiovascular disease incidence or mortality, cancer incidence or mortality (breast, colon, colorectal, endometrial, and epithelial ovarian), and type 2 diabetes in adults.

Reducing sedentary behaviour and increasing physical activity in the Primary Care setting could lead to extensive benefits at an individual and population level. Potential individual-level benefits include improved physical and mental health (reducing workplace absenteeism and early retirement) and improved workplace satisfaction. This could lead to population level benefits, whereby General Practitioners subsequently encourage patients, colleagues, relatives, friends and family to reduce their sedentary behaviour and increase their levels of physical activity. Doctors who follow healthier lifestyles are more likely to advise patients on improving their own health behaviours. Patients are also more likely to act on health behaviour guidance if the doctor giving the guidance is seen to follow the guidance within their own life. Patients who act on guidance to reduce sedentary behaviour and increase physical activity will gain improved physical and mental health, making them more likely to advise their colleagues, relatives, friends and family to reduce their sedentary behaviour and increase their levels of physical activity.


Social Prescribing in Primary Care

Dr Katherine McCracken

Academic Supervisors: Dr Diarmuid O’Donovan & Dr Helen Reid

Clinical Supervisor: Dr Adrian Johnston, Toome Surgery, Toome

Summary of Project

Social prescribing is being widely advocated as a tool to help address patients’ complex health and social care needs. Social prescribing refers to linking patients with sources of support in the community. It seeks to address patients’ needs in a holistic way and empower individuals to take greater control of their health. Social prescribing is a key component of the NHS Long Term Plan and one of the ten high impact actions to release time for care in the NHS General Practice Forward View. A stronger evidence base is required to support continued interest and innovation in social prescribing. I will start with a scoping review which will guide my empirical work. I will potentially use qualitative interview approaches to examine the perceptions of healthcare professionals regarding social prescribing.


‘Gut feeling, gestalt or guesswork?’ The lived experiences of GP trainees managing uncertainty in remote consulting

Jill Christy

Academic Supervisors: Prof. Gerry Gormley, Dr. Grainne Kearney, Dr. Richard Conn; Centre for Medical Education

Clinical Supervisor: Dr. Daniel Hayes, Redwood Surgery, Bangor Health Centre

Summary of Project

Remote consultation has been increasingly promoted as the NHS pursues its Long Term Plan with aims to offer digital first primary care by 2023-24, and the COVID-19 pandemic has expedited this with a switch to a telephone first system being strongly encouraged. It is likely going forward that an increasing proportion of primary care consultations will take place remotely, by telephone or video consultations. Literature to date has focussed on the acceptability and functionality of these more varied consultation forms and whilst there are benefits and drawbacks to moving away from face-to-face consultations as standard, little is known about how these changes are impacting certain aspects of GP consulting. Of note little research has focussed on the educational impact of these changes and how clinical decision making is experienced within telephone or video consultations. 

The aim of my research is to better understand how clinicians experience remote consultations particularly General Practice trainees. The overall objective is to better understand uncertainty and decision-making within remote consulting amongst trainees. A narrative literature review has been undertaken and to continue our research we hope to undertake qualitative, semi-structured interviews to explore the experiences of this group of GPs in training with a view to expanding our knowledge in this area so that we can better inform educational and training facilities.