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Dissertations / Theses on the topic 'Physicians (General practice) Education'

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Published: 10 December 2022
Last updated: 29 January 2023

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1

Louw, Charmaine. "General practitioners' familiarity attitudes and practices with regard to attention deficit hyperactivity disorder in children and adults." Thesis, Link to the online version, 2006. http://hdl.handle.net/10019/433.

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2

Munro, Neil Macarthur. "Postgraduate attachment to general practice : influence on doctors’ future career intentions." Thesis, University of Sussex, 2011. http://sro.sussex.ac.uk/id/eprint/6915/.

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Recruitment of medical graduates to general practice careers in the UK, as in other developed countries, remains challenging. Currently general practice attracts fewer doctors than health care planners anticipate will be needed to meet the burgeoning health needs of an ageing population. Understanding the factors that influence doctors in their career choices is important to manpower planners, the profession and society as a whole. A two year postgraduate foundation programme for all doctors was introduced into the UK in 2006. One of its main intentions was to provide doctors with postgraduate clinical attachments that would assist them in making informed career choices. This has resulted, for the first time, in large numbers of recent medical graduates experiencing several specialties before applying for specialty specific training programmes. The main aim of this thesis was to assess the influence of a four month postgraduate attachment in general practice in the second foundation year on doctors' career intent. It was hypothesised that the attachment would have a positive impact on recruitment to general practice careers. This hypothesis was tested using a combined quantitative and qualitative approach. A literature review examined career decision making in medicine. It was divided chronologically into sections covering decision making at school, university and in the early postgraduate years. In addition a section focussed on decision making in careers other than medicine. A validated career inventory (sci 59) measuring change in career preference was selected for use in this study. The output is in the form of career rankings among 59 medical specialties. In addition, a semi-structured interview questionnaire was developed based on themes emerging from the literature review and was refined following piloting. Interviews were recorded, transcribed and thematically analysed using NVivo 7. The study was conducted in the Kent, Surrey and Sussex Deanery between 2005 and 2008. Participants (n=225) included all doctors whose second foundation year programme included a four month attachment in general practice. They were sent a sci 59 questionnaire at the beginning of their attachment and a further questionnaire at the end. Those responding to both questionnaires were invited to take part in an interview. 112 participants completed sci 59 questionnaires at the beginning and end of their 4 months attachment. Initial analysis demonstrated a small, statistically non-significant improvement in career intent towards general practice. Using a measure that reflects movement in ranking between the two questionnaires, further analysis showed a small, statistically significant, improvement in the ranking of general practice among participants who had low initial rankings for general practice. 30 participants were interviewed. Placements in general practice during the second foundation year were generally regarded in a very positive light. Doctors particularly valued ongoing relationships with patients as well as involvement with local communities. They commented on the high quality of supervision and the structured learning environment of their attachments. General practice was also seen as a better lifestyle option than other main specialties as well as offering flexible working opportunities. New findings included the observation that career ranking for general practice improved following a four month postgraduate attachment in general practice among those less inclined to general practice as a career in the first place. Thematic analysis of transcribed interviews revealed enhanced respect, among foundation doctors, for general practice as a career option irrespective of their own eventual career intent. This improved regard for general practice among doctors intent on specialising may be important in the context of persisting disparagement of general practice by some students, clinicians and teachers. It may also be helpful in engendering mutual respect and more effective working relationships between specialists and generalists in the future.
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3

McCall, Louise 1965. "Can continuing medical education in general practice psychiatry aid GPs to deal with common mental disorders ? : a study of the impact on doctors and their patients." Monash University, Faculty of Education, 2001. http://arrow.monash.edu.au/hdl/1959.1/8363.

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4

Mash, Bob. "The development of distance education for general practitioners on common mental disorders through participatory action research." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/53100.

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5

Deutsch, Tobias, Stefan Lippmann, Thomas Frese, and Hagen Sandholzer. "Who wants to become a general practitioner?" Universitätsbibliothek Leipzig, 2015. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-162522.

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Objective: Because of the increasing shortage of general practitioners (GPs) in many countries, this study aimed to explore factors related to GP career choice in recent medical graduates. Particular focus was placed on the impact of specific practice-orientated GP courses at different stages of the medical undergraduate curriculum. Design: Observational study. Multivariable binary logistic regression was used to reveal independent associations with career choice. Setting: Leipzig Medical School, Germany. Subjects: 659 graduates (response rate = 64.2%). Main outcome measure: Choice of general practice as a career. Results: Six student-associated variables were found to be independently related to choice of general practice as a career: age, having family or friends in general practice, consideration of a GP career at matriculation, preference for subsequent work in a rural or small-town area, valuing the ability to see a broad spectrum of patients, and valuing long-term doctor – patient relationships. Regarding the curriculum, after adjustment independent associations were found with a specifi c pre-clinical GP elective (OR = 2.6, 95% CI 1.3 – 5.3), a four-week GP clerkship during the clinical study section (OR = 2.6, 95% CI 1.3 – 5.0), and a four-month GP clinical rotation during the final year (OR = 10.7, 95% CI 4.3 – 26.7). It was also found that the work-related values of the female participants were more compatible with those of physicians who opt for a GP career than was the case for their male colleagues. Conclusion: These results support the suggestion that a practice-orientated GP curriculum in both the earlier and later stages of undergraduate medical education raises medical schools’ output of future GPs. The findings are of interest for medical schools (curriculum design, admission criteria), policy-makers, and GPs involved in undergraduate medical education. More research is needed on the effectiveness of specific educational interventions in promoting interest in general practice as a career.
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6

Holt, Jackie. "Psychological distress amongst general practitioners /." [St. Lucia, Qld.], 2002. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17113.pdf.

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7

Hays, Richard B. "Improving standards in rural general practice /." St. Lucia, Qld, 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17837.pdf.

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8

Moorhead, Robert George. "Communication skills training for general practice." Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09MD/09mdm825.pdf.

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Bibliography: leaves 554-636. Examines aspects of teaching medical students communication skills at a time when they are entering their clinical years. Integrates reports of 12 data-gathering exercises centred on medical student communication skills with the international literature, and with the author's reflections as an experienced educator and G.P. Recommends that communication skills training in a general practice setting should be a crucial factor in all future training of medical students.
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9

Buhler, Patricia Lynn. "Prenatal care : a comparative evaluation of nurse-midwives and general practitioners." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24489.

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The practice of midwifery by those other than physicians is illegal in Canada and despite recommendations of nursing, medical and consumer groups, no trials evaluating the effectiveness of the nurse-midwife as a member of the modern obstetrical team have occurred here. To demonstrate a nurse-midwifery model, four nurse-midwives provided primary care to forty-seven childbearing women and their families over a twenty-two month period in a maternity teaching hospital. This clinic presented a unique opportunity for comparing the prenatal care provided by nurse-midwives with that of general practitioners who attended deliveries in the same setting. Utilizing a retrospective chart audit, case control study design, the nurse-midwife cases (NM cases) were each matched to two general practitioner controls (GP controls) through the use of the hospital's prenatal data base. The matching characteristics included low risk status, date of delivery, age, parity, gravidity, previous pregnancy losses and census tract income. Prenatal criteria that had been developed and tested in "The Burlington Randomized Clinical Trial of the Nurse Practitioner" for assessing the quality of care were reviewed and updated for this study. With these criteria two blinded abstractors audited the prenatal record forms of all the subjects and scored them as either "superior", "adequate" or "inadequate". Seventy-seven percent of the records of the NM cases received a "superior" score, where as 60% of the GP controls' records received an "inadequate" score [mathematical formula omitted] Overall, the general practitioners' records indicated more erratic care than those of the nurse-midwives. Although the physicians met most of the initial assessment criteria, they failed to meet the criteria that evaluated the ongoing routine assessment process by recording an inadequate number of prenatal visits (36%), or by omitting urine test results (38$) and blood pressure readings (21%). No differences were found in variables relating to labour and delivery with the exception of the incidence of episiotomies. The results indicate that nurse-midwives as part of an obstetrical team are able to provide safe prenatal care to a low risk population in a Canadian urban context, and that their records are thorough and more consistent than those of general practitioners.
Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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10

McCleary, Nicola. "Relationships between perceived decision difficulty, decision time, and decision appropriateness in General Practitioners' clinical decision-making." Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=229003.

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The aim of this project was to use patient scenarios (clinical/case vignettes) to explore three aspects of General Practitioners' (GPs') clinical decision-making: how difficult decisions are perceived to be, the time taken to make decisions, and the appropriateness of decisions relative to evidence-based clinical guideline recommendations. A systematic review synthesised the results of published scenario studies. A secondary analysis of scenario studies which investigated antibiotic prescribing for upper respiratory tract infection (URTI) and x-ray referral for low back pain was performed. Relationships between the three aspects of decision-making were investigated, and scenario and GP characteristics associated with these aspects were identified. An online scenario study further refined these relationships for two specific URTI types: sore throat and otitis media. Cognitive processes involved in clinical decision-making were investigated in a Think-Aloud interview study, where GPs verbalised their thoughts while making prescribing decisions for URTI scenarios. There was some evidence that inappropriate antibiotic prescribing for URTI was associated with greater decision difficulty and longer decision time. Decisions made using a more effortful cognitive process may therefore be less likely to be appropriate. Illness durations of four or more days and, in otitis media, unilateral ear examination findings were related to inappropriate prescribing. Based on these results, suggestions have been made for informing the design of interventions to support GPs in making appropriate decisions. A secondary aim was to provide an overview of the methodology and reporting of scenario studies. The systematic review indicated a lack of consistency in methodologies, while reporting is often inadequate. Formats less similar to real consultations (e.g. written scenarios) are commonly used: the results of studies using these formats may be less likely to reflect real practice decision-making than studies using more realistic formats (e.g. videos). Based on these findings, methodological recommendations for scenario studies have been developed.
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11

Askew, Deborah Anne. "A study of research adequacy in Australian general practice /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18717.pdf.

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12

Nelson, Mark 1957. "Aspects of pharmacological management of hypertension in general practice." Monash University, Dept. of Epidemiology and Preventive Medicine, 2002. http://arrow.monash.edu.au/hdl/1959.1/7923.

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13

Blaney, David. "The learning experiences of general practice registrars in the South East of Scotland." Thesis, University of Stirling, 2005. http://hdl.handle.net/1893/2003.

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To train to be a general practitioner in the U.K. a doctor must spend two years in hospital training posts and one year in general practice as a general practice registrar (GPR). Concern has been expressed in the literature about both the duration and adequacy of general practice training. A literature review identified that there was limited knowledge of and understanding about the learning experiences of GPRs. The aim of the study was to describe and interpret the learning experiences of GPRs in the South East of Scotland during their year in general practice. The methodology was derived from Denzin's concept of Interpretivism and involved in depth interviews over time with GPRs and thick description to capture and interpret the GPRs learning experiences. Two cohorts of 24 GPRs were recruited, cohort one ran from September 2002 to July 2003 and cohort two from September 2003 to August 2004. The GPRs were interviewed on three occasions during their year. In addition to the interviews six GPR focus groups and six GP trainer focus groups were held over the period December 2002 to September 2003. 21 GPRs in cohort one completed all three interviews and 20 GPRs in cohort two. All the participating GPRs completed at least two interviews. The results were interpreted within the educational concept of the curriculum. Four main curricula were identified during the GPR year: these were the formal, assessment, individual and hidden. Each independently contributed to the GPRs learning and also interacted synergistically at various times during the year. In the last quarter of the year there was a tension between the requirements of the assessment and individual curricula. The individual curriculum which was composed of the GPRs clinical experiences and in particular epiphanies was the main driver of GPR learning. Epiphanies were identified by GPRs as having the most significant impact on their learning. Central to this learning was the contribution of their general practice trainer who supported their learning both through the development of the practice learning environment and the promotion of reflection and self directed learning. GPR learning during the year was an iterative process, which involved a reflective and supported interaction between the GPR, their clinical experiences, epiphanies and their trainer. Through this process the GPRs became self directed and reflective learners and developed individual learning networks which led to changes in the way they practiced medicine. This process also led to the socialisation of their learning and promoted their integration into the culture of working general practice, through which they were exposed to the working realities of life as a general practitioner and these experiences had a critical effect on their future career choice. A number of important policy implications were identified which have implications for the present and future direction of training for general practice. The process of thick description and the longitudinal nature of the study allowed for a new interpretation of the learning experiences of GPRs and added to the knowledge and understanding of how GPRs learn during their training.
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14

Edwards, Kelly Alison. "Teaching for professional responsibility in medical practice /." Thesis, Connect to this title online; UW restricted, 2000. http://hdl.handle.net/1773/7649.

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15

Simkin, Sarah. "End-of-Career Practice Patterns of Primary Care Physicians in Ontario." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/35777.

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Incomplete understanding of attrition from the physician workforce has hampered policy-makers’ efforts to achieve optimal alignment of the supply of physicians with population demand for medical services. This longitudinal study of Ontario primary care physicians uses health administrative data to characterize changes in physicians’ practice patterns over time. We examined the workload and scopes of practice of 21,240 physicians between 1992 and 2013. We found that physicians reduce their workloads gradually as they age, retiring from clinical practice at an average age of 70.5. Furthermore, we found that 60% of family physicians who stop providing comprehensive primary care continue to provide clinical services for an average of three years, with reduced workloads, before retiring fully. Our findings clarify the process of physician attrition from the workforce and will help to improve estimates of attrition and make physician workforce planning more accurate and effective.
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16

Young, Megan. "General practitioners' familiarity with and practices related to haemochromatosis /." [St. Lucia, Qld.], 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17037.pdf.

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17

Braunack-Mayer, Annette. "General practitioners doing ethics : an empirical perspective on bioethical methods /." Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09PH/09phb8253.pdf.

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18

Visser, Henriette. "An exploration of the nature of a private general medical practice as a social system : a case study." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/884.

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This research study explores in general the nature of a private general medical practice [PGMP] and whether analysis of the PGMP as a social system can lead the Group Dynamics Practitioner towards developing interventions that will enhance group effectiveness in the PGMP support staff group. The main assumption is that, through the application of a framework of analysis based on that of G. C. Homans and the AGIL functional prerequisites developed by T. Parsons, a structured analysis of the external and internal variables that impact on the PGMP as a social system can be undertaken. The findings of the analysis would lead to the formulation of interventions that would improve the performance effectiveness of the PGMP as a social system. Following a two-questionnaire survey of 17 practices that provided demographic information as well as soft skills training needs, a single PGMP was identified for the case study. Data pertaining to the group as a social system were collected, and by using direct observation, content analysis and a sociometric test, the practice support staff sub-system, being the main focus of this research, could be analysed. By linking the findings to the elements of the framework of analysis, areas of ineffective group functioning could be identified and interventions suggested. This research indicates that the choice of soft skills is associated with the nature and size of the practice, as well as the dynamics of the sociometric patterns characteristic of the relations within the practice support staff subsystem; that while some practice support staff have preferences for sociometric task and socio-emotional relations outside their work clusters, these seem to serve as a buffer against clique forming, thus enhancing the function of integration within the social system as a whole; and that the physical practice layout, and the interaction dynamics that it creates, tend to hinder integration between the members of the practice support staff group, as a social subsystem.
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19

Lake, Jonathan. "Teaching doctors : the relationship between physicians' clinical and educational practice." Thesis, University of Exeter, 2013. http://hdl.handle.net/10871/8002.

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This thesis explores the relationship between physicians’ clinical and educational roles in the context of UK General Practice (GP) education by investigating the experiences of seven GP trainers through an ethnographic approach employing Activity Theory (AT). The Introduction considers the philosophy and structures of GP education and outlines the author’s professional biography to provide context. The Literature Review focusses on the development of medical education as a discrete field and identity formation in medical educators, concluding that: specialist medical educators are a relatively new group; and there is a paucity of knowledge regarding the impact on physicians of occupying dual clinical and educational roles. The thesis then focusses on three Research Questions (RQs), namely: 1. What is the impact of GP trainers’ clinical practice upon their educational work? 2. How does GP trainers’ educational practice influence their clinical work? 3. What are the social contexts for GP trainers’ clinical and educational practice? These questions are addressed within a pragmatic theoretical framework to build up an ethnographic description of the participants’ experiences. Data collection is through semi-structured interviews and observation of video-recorded teaching. Ethical issues associated with the study are discussed in detail, in particular the challenges of “insider” research. Four approaches are used for data analysis: global impressions; word cloud analysis; thematic analysis; and analysis shaped by AT. In answer to RQs 1 and 2, the study finds that GP trainers experience their dual roles as intimately linked, intuitively transferring their skills between their clinical and educational practice. The study also finds that GP trainers reconstruct their professional identities through teaching. With regard to RQ 3, engaging in teaching can lead to internal conflict for GP trainers and tensions with their colleagues, trainees and regulators. These findings are discussed in relation to medical education research methodology and the impact the study on the researcher is explored. The thesis closes by considering the conflicted position the participants occupy, concluding that teaching offers physicians the opportunity to reconstruct their professional identities so they can approach tensions in their practice with a sense of agency and optimism.
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20

Backlund, Lars. "General practitioners' decision-making on drug treatment of hypercholesterolaemia /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-672-3/.

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21

VOGEL, STEPHANIE LEAH. "THE EXTENT OF NUTRITION COUNSELING PROVIDED TO PATIENTS BY FAMILY PRACTICE PHYSICIANS." University of Cincinnati / OhioLINK, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1010171230.

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22

Schwarz, Imogen University of Ballarat. "(Re)creating spaces within rural general practice : women as agents of change at the organisational and practitioner levels." University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/12764.

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This thesis examines how women, as agents of change, contest the male-dominated structures at the organisational and practitioner levels of rural medicine in Australia. The premises for this study are that females now outnumber males as medical graduates and general practice trainees, yet women are significantly less likely than men to occupy rural and remote practice positions in Australia. Furthermore, the organisation of medicine remains strongly patriarchal. A feminist qualitative design underpins this empirical study involving: in-depth interviews with seventeen women activists and thirteen rural women general practitioners; grounded theory analysis of transcribed interviews; and interpretation of findings through a feminist poststructural lens. Findings uncover the gendered organisational and practitioner environment through which change is negotiated. At the organisational level, male exclusionary practices – played out through the ‘male as norm’ and the ‘problem is women’ discourses – position women in highly contradictory ways and marginalise their voices. Yet simultaneously, activists are challenging entrenched interests through individual and collective strategies of change which include: initiating gender-awareness projects; claiming legitimacy by using male-centred tactics and women-defined discourses; developing female-friendly initiatives; and mentoring of and building alliances between women. At the practitioner level, results reveal how women’s everyday lives as rural general practitioners are shaped by oppositional tensions. However, beyond the struggle of ‘fitting in’, women are altering rural medicine by (re)shaping meanings and (re)constructing work practices. Furthermore, their narratives suggest that rural spaces are integral to ways women carve out women-defined practice. A key innovation of this thesis is analysis of change at dual levels, both organisational and practitioner. This thesis marks a significant advancement upon the usual themes that attend only to the marginalisation of women and rural areas. It highlights the transformative process through which women (re)create the discursive spaces of rural general practice.
Doctor of Philosophy
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23

Schwarz, Imogen. "(Re)creating spaces within rural general practice : women as agents of change at the organisational and practitioner levels." University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/15386.

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This thesis examines how women, as agents of change, contest the male-dominated structures at the organisational and practitioner levels of rural medicine in Australia. The premises for this study are that females now outnumber males as medical graduates and general practice trainees, yet women are significantly less likely than men to occupy rural and remote practice positions in Australia. Furthermore, the organisation of medicine remains strongly patriarchal. A feminist qualitative design underpins this empirical study involving: in-depth interviews with seventeen women activists and thirteen rural women general practitioners; grounded theory analysis of transcribed interviews; and interpretation of findings through a feminist poststructural lens. Findings uncover the gendered organisational and practitioner environment through which change is negotiated. At the organisational level, male exclusionary practices – played out through the ‘male as norm’ and the ‘problem is women’ discourses – position women in highly contradictory ways and marginalise their voices. Yet simultaneously, activists are challenging entrenched interests through individual and collective strategies of change which include: initiating gender-awareness projects; claiming legitimacy by using male-centred tactics and women-defined discourses; developing female-friendly initiatives; and mentoring of and building alliances between women. At the practitioner level, results reveal how women’s everyday lives as rural general practitioners are shaped by oppositional tensions. However, beyond the struggle of ‘fitting in’, women are altering rural medicine by (re)shaping meanings and (re)constructing work practices. Furthermore, their narratives suggest that rural spaces are integral to ways women carve out women-defined practice. A key innovation of this thesis is analysis of change at dual levels, both organisational and practitioner. This thesis marks a significant advancement upon the usual themes that attend only to the marginalisation of women and rural areas. It highlights the transformative process through which women (re)create the discursive spaces of rural general practice.
Doctor of Philosophy
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24

Jacob, Thérèse. "The Tarasoff decisions and implications for practice /." Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=63994.

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25

Boer, Shaeema. "Challenges in the design of a smart phone (mobile) application for general practitioners: an interaction design approach." Thesis, Cape Peninsula University of Technology, 2014. http://hdl.handle.net/20.500.11838/1313.

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Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Design in the Faculty of Informatics and Design at the Cape Peninsula University of Technology 2014
If a patient arrives at a general practice whether with a scheduled appointment or at random during office hours, the general practitioner should be able to assist the patient’s with direct access to the patient folder which is stored at the office. What this research study focuses on is the accessing of patient information when the general practitioner is not at the office (usually after working hours). The research study takes place within the Durbanville suburb of Cape Town, South Africa. Interaction design is used as a framework to develop a solution by using smartphone technology.
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Furler, John. "Chronicity and character : patient centredness and health inequalities in general practice diabetes care /." Connect to thesis, 2006. http://repository.unimelb.edu.au/10187/52.

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This study explores the experiences of General Practitioners (GPs) and patients in the management of type 2 diabetes in contemporary Australia. I focus on the way the socioeconomic position of patients is a factor in that experience as my underlying interest is in exploring how health inequalities are understood, approached and handled in general practice. The study is thus a practical and grounded exploration of a widely debated theoretical issue in the study of social life, namely the relationship between the micro day-to-day interactions and events in the lives of individuals and the broad macro structure of society and the position of the individual within that. There is now wide acceptance and evidence that people’s social and economic circumstances impact on their health status and their experiences in the health system. However, there is considerable debate about the role played by primary medical care. Nevertheless, better theoretical understanding of the importance of psychosocial processes in generating social inequalities in health suggests medical care may well be important, as such processes are crucial in the care of chronic illnesses such as diabetes which are now such a large part of general practice work. I approach this study through an exploration of patient centred clinical practice. Patient centredness is a pragmatic, idealised prescriptive framework for clinical practice, particularly general practice. Patient centredness developed in part in response to critiques of biomedicine, and is premised on a notion of a more equal relationship between GP and patient, and one that places importance on the context of patients’ lives. It contains an implicit promise that it will help GP and patient engage with and confront social disadvantage.
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27

Weller, David P. "The pursuit of better health: what is the role of the general practitioner /." Title page, contents and synopsis only, 1990. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmw448.pdf.

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Thesis (M.P.H.)--University of Adelaide, Dept. of Community Medicine, 1991.
Result of a research project undertaken within the Department of Primary Health Care, Flinders Medical Centre ... part of a larger study which has been funded by the Research Into Drug and Alcohol Advisory Committee of the Commonwealth Department of Health. Typescript (Photocopy). Includes bibliographical references.
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28

Schembri, Sharon T. "Consumer understanding of professional service quality : a phenomenographic approach /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18920.pdf.

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29

Snyder, Jennifer A. "Investigation of Physician Assistants' Choice of Rural or Underserved Practice and Framing Methods of Recruitment and Retention." Thesis, Nova Southeastern University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3644022.

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Objective: This dissertation analyzed one state's physician assistant (PA) workforce focusing on recruitment and retention. The goal was to identify factors associated with Indiana PAs working in medically underserved, rural, and primary-care medicine. The study evaluated characteristics of PAs who chose initially to work in rural versus urban areas and who have continued to do so. From the literature and as a result of study outcomes, a framework was developed, upon which recommendations were made for effective methods of increasing and retaining the number of PAs in primary care within rural areas. Subjects: Data were obtained from applications for PA licensure submitted to the Indiana Professional Licensing Agency between the years 2000 and 2010. Additionally, PAs working in Indiana who graduated during this period were surveyed. Methods: Descriptive statistics quantitatively defined the Indiana PA workforce. Survey questions to this population focused on provider upbringing, education, and specialization interest, as well as recruitment and retention to rural, primary-care, or underserved areas. Chi Square tests and logistic regression were used, where appropriate, to examine the influence of independent variables on the choice of practicing in rural, primary-care, and medically underserved areas. Based on these responses, recommendations were developed for strategies to increase the supply of physician assistants in rural areas. Findings: Among applicants for PA licensure in Indiana from 2000 to 2010, there were more females (70%) than males (30%), and the median age of applicants was 35 years. Respondent PAs predominantly worked in counties that were designated by the United States Department of Agriculture as metropolitan (91.3%) and largely in areas designated as Code 1 according to Rural-Urban Continuum Codes, the highest level of urbanicity. Additionally, more PAs worked in a specialty area (79%) than in primary care (21%). Chi Square analyses revealed significant relationships (p < .05) between primary care and gender; educated outside of Indiana and working in an underserved area; and being born in a rural area and choosing to practice in a rural area. Binary logistic regression identified that female gender was predictive of the decision to practice in primary care, and birth in a rural area was predictive of current rural practice. In reflecting upon their first employment following training, 70 percent of respondents believed that the job offer was neither directly nor indirectly a result of having completed a clinical rotation at that particular site, or having worked with a particular preceptor, during their experiential training. A relationship was found between the respondents' initial job location being urban and living in a metro location at the time of high school graduation. Finally, educational debt influenced males' initial practice location and specialty but did not similarly affect choice of practice among females. Conclusions: There were several important characteristics of recently licensed PAs in Indiana that were identified in this study. Educational institutions, policymakers, and communities may increase recruitment and retention of PAs to rural and primary-care practice by actively identifying PAs who possess selected characteristics for the area of interest and providing incentives to reduce educational debt.

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TIEDEMANN, MARJORIE LORA. "EDUCATIONAL AND CURRICULAR FACTORS AFFECTING PHYSICIAN PRACTICE LOCATION." Diss., The University of Arizona, 1987. http://hdl.handle.net/10150/184120.

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The primary purpose of this study was to examine the relationship between educational and curricular factors and physician location decisions. As a background to the study, a literature search traced the history of medical education in the U.S., focusing on various influences on physician distribution. In the research on physician location decision, this study is unique in its use of the constant comparative method. This method is an inductive approach developed and refined by Glaser and Strauss, used in this study to generate theory regarding the role of educational factors in physician location decisions. In this research, two groups of physicians who completed training after 1965 were selected for study, based on their locations in distinctly different practice settings in Arizona: urban and rural. An open-ended interview format was developed, and each physician was interviewed, with data analysis beginning during the first interview and continuing through the entire period of data collection. Using the constant comparative method, similar groups (rural physicians) were compared to bring out basic properties of categories, and different groups (urban physicians) were then compared to establish boundaries of applicability of the theory. As the interviews proceeded a basic theoretical framework emerged, enabling development of a grounded theory of physician location decisions. The study presents strong empirical evidence in support of the proposition that educational factors are influential in the decision of a physician to enter practice in a rural area. Four primary influences were identified: faculty role modeling, participation in rural clerkships, preceptorships, or required family practice rotations, service activities related to health care for medically underserved populations, and education in a non-traditional setting, or residency training in a rural area. Curriculum content and requirements take on major significance when these influences are subsumed under the major influence of socialization. The extent to which these educational factors play a role in the practice locations of physicians varies according to educational opportunities available during the training period.
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Nilsson, Staffan. "From Higher Education To Professional Practice : A comparative study of physicians' and engineers' learning and competence use." Doctoral thesis, Linköping : Department of Behavioural Sciences and learning, Linköping University, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-10058.

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Duchatteau, Duco C. "Burnout among Dutch general practitioners: An empirical study of the determinants of physician burnout." Thesis, University of Bradford, 2016. http://hdl.handle.net/10454/17377.

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This study aims to examine to what extent Dutch GPs are at risk for burnout, and to identify personal, professional and practice related characteristics that are associated with high burn out scores. In the extant literature, physicians are identified as professionals who are high risk for burnout. In the past decade, working conditions for general practitioners (GPs) in the Netherlands have changed for the worse. There are no recent data on GP burnout in the Netherlands. Although much is known in the literature about factors that are associated with burnout and the role job demands and resources play in getting burned out, the extent to which these findings apply in the context of Dutch GPs is unknown. This study is designed as a quantitative, survey based, empirical study. An invitation to complete an online survey was sent to 4,000 GPs in the Netherlands, of whom close to 1,300 participated in this study (33% response rate). The data were analysed using IBM SPSS 22.0. The data analysis consisted of a descriptive analysis of the data with an emphasis on the outcome of burnout measurements, as well as an inferential analysis of the data with an emphasis on the association between respondents’ characteristics and burnout measurements. The results from this study indicate, that one in seven practicing Dutch GPs could be classified as burned out with fulltime working GPs reporting an average working week of 62 hours. According to the findings, the amount of hours worked per week is the most important determinant of emotional exhaustion. Variation in emotional exhaustion, depersonalisation and professional efficacy can to a large extent be explained by variation in demands (administrative burden, work-home conflict, psychological job demands) and resources (decision latitude, co-worker support and home support). Increased job demands are predominantly associated with emotional exhaustion, while a scarcity of resources predominantly leads to increased depersonalisation and reduced professional efficacy. The findings demonstrate, that a bigger job size, more hours worked and a more responsible position held, are associated with higher experienced demands, which is in turn associated with unfavourable burnout scores, particularly increased emotional exhaustion. Working in a group setting, being professionally active outside of one’s own practice and being in a relationship were found to be associated with increased resources, which is in turn associated with favourable burnout scores, particularly decreased depersonalisation and increased professional efficacy. Based on the findings of this study, three recommendations for government bodies, healthcare providers and other healthcare stakeholders were formulated: 1) Reduce the length of the working week, predominantly by reducing the number of allocated patients per GP. This recommendation implies an increase in the GP workforce; 2) Undertake a comprehensive analysis of the quantity, type and purpose of administrative duties currently performed by GPs and trim unnecessary paperwork and bureaucracy within the GP practice and 3) Increase co-worker support, either within the GP practice or by using the existing collegiate support infrastructure.
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Cooper, Carolyn Ellen May. "Death is something to be avoided the psychodynamics of end-of-life planning for the general practitioner /." [Hawthorn, Vic.] : Swinburne University of Technology, 2008. http://hdl.handle.net/1959.3/36677.

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Thesis (PhD) - Australian Graduate School of Entrepreneurship, Swinburne University of Technology - 2008.
Submitted as partial fulfilment of the requirements for the degree of Doctor of Philosophy, Australian Graduate School of Entrepreneurship, Swinburne University of Technology, 2008. Bibliography: p. 357-371.
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Mitchell, Geoffrey Keith. "The effect of case conferences between general practitioners and palliative care specialist teams on the quality of life of dying people /." [St. Lucia, Qld.], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18557.pdf.

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Tyler, Susan P. "Academic Physicians' Readiness to Change in their Professional Practices: A Qualitative Study." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1592170965675572.

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Penrose-Wall, Jonine Public Health &amp Community Medicine Faculty of Medicine UNSW. "Evaluating five models of dissemination of NHMRC 'Guideline depression in young people for GP's' through divisions of general practice." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2003. http://handle.unsw.edu.au/1959.4/20445.

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Background: Dissemination of evidence-based mental health clinical practice guidelines had not been studied in Australia prior to the National General Practice Guideline Implementation Program. This naturalistic research reports ten national interventions designed to disseminate the NHMRC 1997 Clinical Practice Guideline Depression in Young People for GPs (GDIYP-GP) through 123 Divisions of General Practice. The guideline covered depression and suicide in young people aged 13 to 20 years. Aim: To evaluate a 'coordinated link agent' and 'enhanced packaged approach' for disseminating a national guideline by engaging 20 Divisions in using 5 dissemination models and to measure Divisions' capacities in performing unfunded local dissemination to GPs. Method: An Implementation Kit was the main national intervention, housing the guidelines and 5 models: Education by the Division; Education by an external provider; 3) Clinical Audit; 4) Segmented Formats and 5) Appraisal. Five studies are reported: 1) an organisational census on guideline-related practices in all topics; 2) a Case Study Database of 3 consecutive interviews of 51 participating Divisions; 3) a Guideline Appraisal study of 9 cohorts of doctors; 4) a Clinical Audit study of 54 doctors involving 1200 patients; and 5) a 'Segmented Formats' documentary analysis of Division communications on GDIYP-GP. Results: Prior dissemination by most Divisions was administrative mail outs rather than planned programs. In all, 70 instead of the pilot 20 organisations participated (57% of the sector) using 10,000 guidelines: 45 participated by 7 weeks and 71 by 35 weeks and the majority used multiple active strategies showing fidelity to the Kit. Education by the Division, Segmented Formats and Appraisal were the most adopted models. GDIYP-GP was acceptable and relevant to the majority of Divisions and to 9 samples of doctors. Conclusion: Divisions are one appropriate system through which evidence-based mental health guidelines can be disseminated to general practitioners. Uptake can be rapid using a flexible enhanced package approach with link-agent support. 3-6 months is needed for organisations to begin effective interventions. Divisions reorient their approach with guidance toward evidence-based dissemination but Division and practice barriers
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Shrewsbury, Duncan Hooper. "Dyslexia and medicine : the experience and the impact of dyslexia on the education, training, and practice of doctors." Thesis, University of Exeter, 2018. http://hdl.handle.net/10871/32896.

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Introduction: Dyslexia is the most common specific learning difficulty, affecting of about 6% of the population. In medicine, the numbers of learners disclosing a diagnosis of dyslexia is rising. Small-scale studies have begun to venture into the effects of dyslexia on the education of medical students, and doctors in foundation year training and beyond. There is a call for research to develop a more nuanced understanding of how dyslexia affects doctors during their training and practice. Methodology: Using interpretative phenomenological analysis, this project aimed to develop a greater understanding of the ways in which dyslexia affects the training and practice of doctors. The data collection followed a three-phase approach, employing semi-structured interviews, a Self-Characterisation Sketch exercise, and Critical Incident Reflection audio-diaries. Analysis: In-depth, idiographic analysis of anonymised case studies for 10 doctors in training across a variety of specialties, from England and Wales was undertaken. The detail of the analysis cannot be adequately captured in a short summary but the overarching themes identified in the data included: Self; Belonging; and Coping. Each theme is supported by subthemes: good enough, chaos and power of the label; black sheep, conformity, and community; and difficulties and capabilities, agency and attribution, and strategies and risk, respectively. Notable ‘pearls’ within the data included the notion of partitioning, and that of brute failure. Discussion: The in-depth analysis of these doctors’ experience of their dyslexia, with reference to their education, training and practice, provides a unique insight into an unstudied aspect of lived experience of doctors. The analysis of the data from these doctors offers a unique understanding of self-concept, attribution and learned helplessness. These findings bear significance for engaging with, and seeking help from the team and wider structures in medical education. Synthesis of this analysis with wider literature would suggest a role for self-compassion and individual counselling approaches in medical education.
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Murray, Thomas Stuart. "Factors influencing the uptake of continuing medical education in general practice." Thesis, University of Glasgow, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.318636.

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Papanikitas, Andrew. "From the classroom to the clinic : ethics education and general practice." Thesis, King's College London (University of London), 2014. https://kclpure.kcl.ac.uk/portal/en/theses/from-the-classroom-to-the-clinic(3c03ba00-98b9-4e51-9b58-adcb134c24e4).html.

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This thesis is a qualitative study of ethics education as experienced by general practitioners in mainland Britain. It draws upon interviews and documents as well as observations and reflections from encounters in the field. Ethics is conceived of as a kind of knowledge and ethics education is seen as involving translational processes shaped by various social forces and tensions. The data analysis is organised according to three concepts outlined by Bernstein: curriculum, pedagogy and evaluation. These broadly map to academia, education and practice,and the purposive sample reflects participants with involvements in these three domains. Ethnographic, phenomenological, and grounded theories are key influences on the method for selecting and organising the empirical data. The findings chapters look at the determination and production of the broad curriculum (chapter 4); the ‘transmission’, or the delivery and reception of, the curriculum (chapter 5); the assessment of ethics education (chapter 6); the ways in which ethical issues are identified and negotiated in practice (chapter 7); and key substantive issues that arise in practice – confidentiality, abortion, payment for performance and resource allocation – which enables an exploration of the negotiation of ethical issues in practice (chapters 8 and 9). The concluding chapter pulls the threads together. Societal forces and tensions are present when curricula are conceived, when knowledge and skills are taught and when GPs attempt to integrate learning into their daily practice. Having understood these forces and tensions better we can conceive better of how to make improvements to ethics education and assessment. The overall aim is to improve the reflexivity of ethics education. Many of ethical shortcomings of doctors have historically been linked to hidden curricula, features of practice and the practice environment that have been unseen or ignored by teachers or learners. Knowing more about these features and about the translational processes, that shape the experiences and enactments of GP ethics, provides the potential ability to adjust for their influence.
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Garrison, Duncan Amber. "General Education in the 21st Century: Aspirational Goals and Institutional Practice." Thesis, University of Oregon, 2014. http://hdl.handle.net/1794/18484.

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The goal of general education is to provide students with an education that is broad and holistic, teaching transferable intellectual skills such as critical thinking, written and oral communication, problem solving and teamwork. General education courses are typically offered through the academic subjects of mathematics, science, English, and social science. Recent studies document concern that college graduates are not capable of demonstrating the intellectual skills expected. Through the use of content analysis, this study examined institutional practice to determine if the goals of general education are being met. A nationally representative sample of general education course syllabi and work products were analyzed for evidence of the intellectual skills expected of students and if those expectations were communicated. Findings indicate that learning expectations were not consistently provided and the goals of general education to deliver complex cognitive skills were not met. Implications provide insight for those responsible for general education reform.
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Linger, Barry Thomas. "What primary care physicians need to know about attention-deficit hyperactivity disorder a Delphi of experts and a content analysis /." Morgantown, W. Va. : [West Virginia University Libraries], 1998. http://157.182.199.25/etd/templates/showETD.cfm?recnum=279.

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Thesis (Ed. D.)--West Virginia University, 1998.
Title from document title page. Document formatted into pages; contains x, 126 p. Includes abstract. Includes bibliographical references (p. 81-87).
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Corrin, Anne. "Surviving and thriving in practice placements : a qualitative exploration of student nurses' practice placement learning experiences." Thesis, University of Essex, 2016. http://repository.essex.ac.uk/16833/.

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There are currently numerous concerns about the quality of pre-registration nurse training in the United Kingdom, particularly regarding the fifty per cent of that training spent in practice placement settings. If pre-registration nurse training is to be as effective as possible, it is essential to create practice placement learning environments where all student nurses are empowered to be caring, confident, competent and resilient, where students feel able to survive and thrive and, hence, where they can maximise their learning experiences. When undertaking nurse training in the United Kingdom every applicant has to decide which field of nursing they wish to enter – adult, mental health, child, or learning disability – the majority choosing adult nursing. The aim of this study was to gain a deeper understanding of the practice placement learning experiences’ of those students who had chosen the adult nursing field, with a view to improving those experiences. This qualitative study drew on interpretive description, narrative inquiry and used Framework as the basis for the data analysis and interpretation. The findings of this study suggest that in order to ensure that student nurses have the best possible practice placement learning experiences attention needs to be paid to the following areas: • The preparation of individual student nurses for their practice placements. • The selection and preparation of individual mentors for their mentorship role. • The design and development of humanistic and transformative pre-registration nursing and mentorship preparation curricula. • The development of effective practice placement learning environments, including consideration of how both students and mentors are supported and valued in those practice placement settings. This study proposes that if the practice placement learning experiences of student nurses are to be improved, changes are required at the professional and regulatory levels within nursing, at the practice placement-university level of nurse training and at the individual student nurse-mentor level. Such changes, however, must be underpinned by evidence and not based solely on expert opinion, political ideology, or economic expediency, as has so often been the case in the past.
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Bradley, Elizabeth Florence. "Taken-for-granted assumptions and professionalism in IAG practice." Thesis, Lancaster University, 2013. http://eprints.lancs.ac.uk/71466/.

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This thesis examines the role of reflection in Information, Advice and Guidance (IAG) practice, with particular reference to becoming aware of the role of taken-for-granted assumptions. It is grounded in the literature concerning taken-for-granted assumptions, personal knowledge and reflection in the context of professional practice. It is a qualitative study evolving through three iterative cycles, with an additional ‘pre-cycle’ exploring the origins of the research in the researcher’s own experience as an IAG professional working with ethnic minority women. The first main research cycle explored, in dialogue with a co-researcher, how we became aware of our own taken-for-granted assumptions. Subsequent cycles extend the data to responses from practitioners less close to me. Using the concept of researcher-as-bricoleur, a range of methodologies were employed. In the pre-cycle and first research cycle an auto-ethnograpahic approach captures the researcher’s voice and that of a co-researcher. In later cycles a heuristic approach enabled the researcher to focus on the self and engage with her own and other practitioners’ experiences of taken-for-granted assumptions. These cycles explored, through written capture sheets, conversational interviews and email exchanges, IAG practitioners’ understanding of and engagement with reflection and reflective practice. The research demonstrated different types and interpretations of reflection and reflective practice. Although practitioners described themselves as reflective and used self-reflection, this was insufficient to unearth taken-for-granted assumptions. The research ascertained that assumptions regarding whiteness were difficult to unearth, and were rarely acknowledged openly. Even less frequent was the sharing of unearthed assumptions with others. The research revealed that reflective practice has itself become taken-for-granted and does not achieve what it advocates. The need to coach and nurture the skill of reflective practice is emphasised, with one of the data analysis tools – the ‘I Poem’ – proposed as a reflective tool for enhancing self awareness and assisting practitioners to examine their reflective journals and reveal their taken-for-granted voice.
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André, Malin. "Rules of thumb and management of common infections in general practice /." Linköping : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5183.

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Boon, Johannes Marinus. "Procedures performed by family physicians in hospital practice in a developing country (South Africa) an evaluation of clinical anatomy competence /." Pretoria : [s.n.], 2009. http://upetd.up.ac.za/thesis/available/etd-07292009-093644/.

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Gallimore, Paul. "Practitioner learning styles and the professional education of chartered general practice surveyors." Thesis, Online version, 1990. http://ethos.bl.uk/OrderDetails.do?did=1&uin=uk.bl.ethos.293974.

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Thackara, Susan Tomchak. "Mobile Phone Use in a Pennsylvania Public High School| Does Policy Inform Practice?" Thesis, Wilkes University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3610219.

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Though many American educators embrace technology in classrooms, administrators can create policies that inhibit technology such as mobile phone use in classrooms or on district property. These policies range from restrictive with no mobile phone use permitted, to liberal in which unrestricted use of mobile phones is allowed. The purpose of this case study was to explore the divergent and convergent perceptions of mobile phone use and mobile phone policy across multiple groups of stakeholders in one northeastern Pennsylvania public high school. Focus groups of administrators, teachers, students, and parents were formed and group interviews were conducted to understand the perceptions of current mobile phone use, perceptions of the current mobile phone policy, and how the perceptions compare across stakeholder groups. The findings of this study uncovered three main themes: conflicting interpretations of the policy's purpose, inconsistent enforcement of the policy, and support for a more effective policy by bringing your own device to school. Stakeholders had a range of interpretations regarding Mountain Peak High School's mobile phone policy, which could be categorized into two main typologies: restrictive or liberal. The data from this study also showed that due to the range of policy interpretations, staff members at Mountain Peak High School were not enforcing the mobile phone policy consistently. During data collection, it was discovered that a pilot group of Mountain Peak teachers were allowed to have their students bring their own device to school. The findings of this study may help educational leaders evaluate and construct a more appropriate mobile phone policy for their respective school district.

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Liu, Chaojie. "Closing the gap between policy and reality : a study of community health services in Chengdu and Panzhihua /." Access full text, 2003. http://www.lib.latrobe.edu.au/thesis/public/adt-LTU20050303.102952/index.html.

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Lupton, Sarah. "Impact of a mental health training program for general practitioners on practice behaviour." Thesis, 2016. http://hdl.handle.net/1828/7633.

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Background: Accrual of continuing medical education credits is part of licensure in family medicine but opinions are mixed as to whether the training has an impact on clinical practice. Literature does suggest that practice change is most likely when training involves multiple interactive exposures, and when the benefit to patients is apparent. Aim: To determine whether an interactive peer-lead educational intervention for General Practitioners in British Columbia, the Practice Support Program Mental Health Module, resulted in measureable change in clinical practice of the Vancouver Island participants. Method: Administrative information from British Columbia Ministry of Health databases was obtained for analysis regarding physician billing and prescribing, and hospitalizations on Vancouver Island. Paired t-tests were used to compare physician-patient interactions among module participants before and after the training regarding a) initiation of antidepressants and anti-anxiety medication, and b) use of the mental health plan billing code, used to support patients who struggle with activities of daily living. In addition, mental health hospitalizations among participants' patients before and after training were used to measure its impact on patient outcomes. Results: One-hundred and ninety-seven General Practitioners on Vancouver Island completed the mental health module between 2008 and 2011. While no significant difference was found in the numbers of mental health patients seen during the pre- and post- periods (M=142.06, SD=97.45) and (M=144.44, SD=103.00); t(196)=-0.679, p=0.498, α=.05, the change in the proportion of new prescriptions between pre-period mean (M=0.0796, SD=.06527) and post-period means (M=.0530, SD=.03877); t(195)=6.668, p<0.001 was found to be significant and indicative of a relative decrease between 31.2 and 33.4%. The change in the proportion of mental health plans was also found to be significant between pre-period (M=0.1142, SD=.018598) and post-period means (M=.1674, SD=.23973); t(180)=-3.586, p<0.001. This indicated a relative increase between 42.0 and 46.6%. No significant change in patient hospitalizations was found between the pre- and post-period means: (M=0.039, SD=.0612) and (M=.0392, SD=.0978); t(192)=-0.055, p=0.956. Conclusion: This educational intervention appears to have resulted in significant changes in the practice patterns of the physician participants. Future research using better indicators may reveal more about the impact of physician training on patient outcomes.
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Jellie, Clara. "The impact of medico-legal issues on general practice care and policy initiatives." Master's thesis, 2001. http://hdl.handle.net/1885/147623.

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