Master in General Practice

1. Master in General Practice • ICHO • Curriculum • Practical training • Seminars/Peer review & selfstudy • Masterthesis • Selection of the practice trainers • Selection of the group trainers • Assessment & Evaluation • Facts & Figures

2. L G A B 6 years undergraduate first year of education in General Practice Master in Family Medicine ICHO • Practical training in a GP’s practice (2 years) • Seminars/Peer review (min. 40 hrs a year) • Thematical training sessions - Selfstudy • Masterthesis

3. ICHO • Consortium founded in 1984 • Co-operation of the 4 Flemish universitary centres of GP (Louvain, Ghent, Antwerp, Brussels) • Primary goal: combine strength to liberate means and staff for the development of GP vocational training as a universitary degree (1995) • 01/10/2006: Master in General Practice

4. Curriculum • System of adult education • Global aim = task profile of the GP • Described in the “Final terms/Learning aims”-document • Personal learning agenda: trainees have to take up responsability and put together their own training program

5. Curriculum • Practical training in a GP’s practice • 24 months • Preferably in the practice of a GP trainer (max. 12 months in a hospital) • In selected training practices/appointed practice trainers • System of quality control & train the trainer • 90% of the trainees do 2 years in a GP’s practice

6. Curriculum • Peer review and individual guidance by the group trainer • Individual guidance • Intake discussion • Regular short meetings before or after a seminar • Yearly feedback and evaluation discussion • Yearly evaluation report taking into account the evaluation by the practice trainer • During the seminars, the trainer pays attention to the personal growth of every trainee • Coaching via electronic portfolio

7. Curriculum • Peer review and individual guidance by the group trainer • Peer review • Focus on critical reflection on concrete experiences • Variety of experiences and personalities; group support • Educational methods: case discussions, continuous registration of patient contacts, thematic registration, discussion of literature, role playing difficult consultations, etc. • Function of group trainer = crucial!

8. Curriculum Thematical training sessions & selfstudy In 2007-2008 20 topics are offered by ICHO Live training sessions of 0,5 > 2,5 days (Orthopaedic examination of the shoulder, knee, ...; Menopause; Social problems in general practice; Taping; The psychotic patient; Etc) Internet supported modules (Prevention of suicide; Spirometrics, Etc) Each session = evaluated by trainees / feedback to lecturer High satisfaction trainees

9. Curriculum • Thematical training sessions & selfstudy • Trainees choose topics (offered bij ICHO or other organisations) according to their personal learning agenda • Medical literature • Additional training: centres for family planning, centres for psychological care, etc.

10. Masterproof • a project • a portfolio

11. Masterproof • Project • A (quality improving) project • Steps: study of literature – definition of the research methodology – observation – analysis – conclusion – quality improving proposition – implementation - evaluation • Guidance by a promotor and the GP trainer

12. Masterproof • Learning portfolio • Documenting & archiving the most important learning activities • Critical reflections on the learning activities • Electronic support > exchanging information and experiences with other trainees and trainers • Guidance by the group trainer

13. Selection of the practice trainers • Minimum criteria: • 2 introduction days with ICHO • Being appointed as trainer by the Federal Public Service of Health • 7 years of experience as a GP • Variety of morbidity in the practice • Well-organised patientfilesystem • Practicing EBM • Developing a personal learning plan • Etc. • at least 2 educational sessions a year • Personal development plans and electronic portfolio

14. Selection of the practice trainers • 2 steps in the appointment & training by staff members of the universitary centres of GP • 1st appointment for 2 years • Training of teaching competencies & the use of a portfolio • Re-appointment (4 years) • Focus on personal learning plans & quality of portfolio

15. Selection of the group trainers • Appointed by ICHO • Introduction and specific agogic training • Special training sessions by staff members of the universitary centres of GP (yearly minimum 2 days training and/or workshops) • Peer-intervision

16. Assessment & Evaluation • Formative assessment based on learning agenda • A list of goals set by the trainee and/or his trainers • Regular assessment of the trainee by all trainers • summative evaluation • Year 1: evaluative discussion with trainers; written examination; interim report masterthesis; cases; video-analyses • Year 2: written knowledge test; oral examination; trainers report; OSCE’s; masterproof (manuscript-presentation-portfolio)

17. Final evaluation • Evaluation by trainer and coach • Written knowledge test • Oral examination • OSCE: 20 stimulation stations • Evaluation masterproof: • manuscript • presentation • (electronic) portfolio

18. Final evaluation • Reliability composite score = 0,92 • Reliability knowledge test: 0,90 (Cronbach’s alfa internal consistency)

19. Final evaluation • Written knowledge test • Based on a blueprint which indicates the frequence of the themes to be questioned (all domains of competence of GP are covered) • 160 multiple choice questions (extrended matching type) • Questions prepared each year by 5 GP’s and validated by staff members of the universitary centres of GP

20. Final evaluation • Oral examination • 1 hour with two jury’s of 2 GP’s from at least 2 different universities • To show his competenties • 5 cases from the trainees own practice • With relevant literature • Documentation on the handling of the problem • The jury’s chooses 2 cases: interrogation in depth (trainees critical reflection ability, professional maturity, trainees decisions based on sound evidence)

21. Final evaluation • Trainers report • Evaluation of the learning process (competencies, participation, personal development, progress) • Evaluation of the competence of the trainee as a GP • Group trainer’s report based on his own observations and on a report of the GP trainer

22. Final evaluation • OSCE’s (Objective Structured Clinical Examination) • 20 sequential stations with various primary health care problems • Given period of time (8 minutes/station) • Observation and scoring by GP’s

23. Final evaluation • Masterproof • Manuscript (55%) - Presentation (20%) – Portfolio (25%) • Evaluation based on “Dublin descriptors”, proven knowledge, used methodology, decision making, communication, attitude of life long learning, originality, etc.

24. Facts & Figures • 230 GP-trainees • 22 group trainers • 20 stafmembers • 350 GP-trainers (General Practices) • 28 pairs GP-trainers (Hospital Services)