Metamorphosis: Mapping the Journey of the GPT1 Registrar

Project team:
  • Dr Duncan Howard (MCCC)
  • Christine Bottrell (MCCC)
Funders:

RACGP

Dates:

1 July 2018 – 31 June 2019

Description of project:

The focus of this project is to explore and understand more clearly the experience of registrars in their first six-month general practice term.   A large body of literature exists related to assessment in and of the GP registrar training experience, including contemporary ideas of programmatic assessment and development of professional competencies. Much of this research looks at the progress as measured external to the GPT1 registrar. Mapping the Journey of the GPT1 registrar is designed to examine the internal narrative and lived experience of the registrar – an ongoing and internal assessment rather than imposed external assessment of development. There is a gap in this area, no studies which have a focus on the registrars’ own experience throughout the training program were identified during the literature exploration. Research literature on professional identity formation has been identified as closer to the core of this study, although much of it deals with medical students and hospital doctors rather than primary care practitioners[1].

Registrars are significantly challenged in their first GP placement and this drives an intense motivation to learn. Understanding what experiences are most influential and how these impact on learning, can inform how to best support registrar learning in this critical time in their development as a GP. A focus on this key learning time for registrars will uncover the significant contributions made by the Training program to this learning, and thus contribute to the development and improvement within the Program[2]. By improving our understanding of learning, we can better focus on the development of curriculum and aspects of teaching.

The methodology is a relational one in that it is based on a relationship between registrar and researcher (CB). An initial interview was done after which the researcher sent out fortnightly prompts to the registrar. The registrar’s spoken or written reflection is in response to the prompt and performed knowing it will be heard or read by the researcher. This narrative inquiry approach aims to uncover the story and therefore what is important to each registrar in their situation. It explores the temporal, social and spatial/geographical experience of the participants[3]. The project uses qualitative methodology based on gathering regular audio reflections analysed using Constant Comparative Analysis. We want to honour those individual stories through the narrative inquiry and make use of them individually and communally to inform the ongoing development of General Practice Education.

[1] Monrouxe L.V. Negotiating professional identities: dominant and contesting narratives in medical students’ longitudinal audio diaries. Curr Narratives 2009 (1):41-59

[2] Wald H. Professional Identity (Trans)Formation in Medical Education: Reflection, Relationship, Resilience. Acad Med 2015 June 90(6) 701-706

[3] Clandinan, J., Cave, M., & Berendonk, C. (2017). Narrative inquiry: a relational research methodology for medical education. Medical Education, 51, pp. 89-96. doi:doi: 10.1111/medu.13136

 

Publications and presentations

Howard D., Bottrell C., Metamorphosis – Becoming a GP, GP19. 25 October. Adelaide, South Australia.

Howard, D., Bottrell, C., Transitioning from hospital doctor to GP – understanding the registrar experience. GPTEC 2019. 4 September. Melbourne, Australia.

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