ABSTRACT
BACKGROUND: Procedural skills are an essential component of general practice vocational training. The aim of this study was to investigate the type, frequency and rural or urban associations of procedures performed by general practice registrars, and to establish levels of concordance of procedures performed with a core list of recommended procedural skills in general practice training. METHODS: A cross-sectional analysis of a cohort study of registrars' consultations between 2010 and 2016 was undertaken. Registrars record 60 consecutive consultations during each six-month training term. The outcome was any procedure performed. RESULTS: In 182,782 consultations, 19,411 procedures were performed. Procedures (except Papanicolaou [Pap] tests) were performed more often in rural than urban areas. Registrars commonly sought help from supervisors for more complex procedures. The majority of procedures recommended as essential in registrar training were infrequently performed. DISCUSSION: Registrars have low exposure to many relevant clinical procedures. There may be a need for greater use of laboratory-based training and/or to review the expectations of the scope of procedural skills in general practice.
Subject(s)
Clinical Competence/standards , General Practitioners/standards , Methods , Adult , Australia , Clinical Competence/statistics & numerical data , Cohort Studies , Cross-Sectional Studies , Education, Medical, Continuing/methods , Education, Medical, Continuing/statistics & numerical data , Education, Medical, Continuing/trends , Female , General Practice/education , General Practice/statistics & numerical data , General Practitioners/statistics & numerical data , Humans , Longitudinal Studies , Male , Middle AgedABSTRACT
Caffeine, a biologically active drug, is recognized as a contaminant of freshwater and marine systems. We quantified caffeine concentrations in Oregon's coastal ocean to determine whether levels correlated with proximity to caffeine pollution sources. Caffeine was analyzed at 14 coastal locations, stratified between populated areas with sources of caffeine pollution and sparsely populated areas with no major caffeine pollution sources. Caffeine concentrations were measured in major water bodies discharging near sampling locations. Caffeine in seawater ranged from below the reporting limit (8.5 ng/L) to 44.7 ng/L. Caffeine occurrence and concentrations in seawater did not correspond with pollution threats from population density and point and non-point sources, but did correspond with storm event occurrence. Caffeine concentrations in rivers and estuaries draining to the coast ranged from below the reporting limit to 152.2 ng/L. This study establishes the occurrence of caffeine in Oregon's coastal waters, yet relative importance of sources, seasonal variability, and processes affecting caffeine transport into the coastal ocean require further research.
