Protected teaching time in general practice training: The GP Supervisor as teacher – the how, what and why.

Tim Clement, MCCC research fellow, presented the following paper at Rural Medicine Australia 2018. The research was funded by the Australian College of Rural and Remote Medicine, via a competitive Education Research Grant.  Members of the MCCC research team are Tim Clement, Dr Eldon Lyon, Dr Duncan Howard, and Professor John Loughran of Monash University.

Introduction

GP-registrars primarily learn their craft through supervised workplace learning. Supervisors must ensure the delivery of structured educational activities, including one-on-one ‘protected teaching’. Protected teaching is a significant ‘space’ for learning, teaching, and assessing GP-registrars, yet we know very little about what goes on inside this educational space and how effective it is in enabling registrars’ learning. The purpose of this project was to investigate GP-supervisors’ understanding of subject matter content and the relationship between such understanding and the instruction they provide for vocational trainees.

Methodology

Pedagogical Content Knowledge (PCK) was used as a theoretical lens to guide the study. Although a well-accepted and well-researched construct in mainstream education, it has been little applied to general practice education. A multiple-case study design using qualitative methods provided the framework for the study. Video-recordings of protected-teaching sessions were used to undertake stimulated recall interviews with a purposive sample of supervisors. Template analysis was used to analyse the data.

Results/findings

Although the protected teaching of each supervisor-registrar pair had unique features, there was a discernible pattern across pairs. Patient cases, brought by registrars, featured strongly as a basis for teaching and learning. Supervisors interrogated the cases and the registrars until they reached a point where they opted to teach something. Supervisors varied in the extent to which they employed thoughtful or automatic pedagogical approaches.

Discussion

Making protected teaching observable and understandable is important for individual supervisors and the profession more generally. It opens professional practice to scrutiny in ways that highlight the skills, knowledge and abilities of GP-supervisors and adds to what we know about ‘good’ teaching. PCK proved to be a helpful construct to think about the nature of teaching, which has implications for GP-supervisors’ continuing professional development. Knowledge about PCK may help supervisors improve their effectiveness as teachers.

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