GPs as medical educators--an Australian train-the-trainer program.

BACKGROUND: General practitioners undertake ongoing education in many areas. A train-the-trainer (TTT) approach may be an option for facilitation of continuing professional development (CPD) activities. METHODS: With the aim of training GPs to facilitate peer CPD activities, Monash University's Department of General Practice undertook a national TTT program on men's sexual and reproductive health. Over a 3 year period, 40 'GP trainers' were trained to facilitate education sessions on the topics of androgen deficiency, erectile dysfunction, prostate cancer and male infertility for 568 GPs from 33 Australian divisions of general practice. RESULTS: Evaluation of this program showed that GP trainers were a valuable resource for conducting training programs for GPs, being experienced role models who could provide relevant and practical training to their colleagues. DISCUSSION: While resource intensive, the TTT model provided an effective means of improving GP knowledge and clinical practice on men's sexual and reproductive health.

In-practice management versus quitline referral for enhancing smoking cessation in general practice: a cluster randomized trial.

BACKGROUND AND OBJECTIVE: GPs are an important source of smoking cessation advice. This research examined whether a model encouraging GP referral of patients who smoke to a specialist service would be acceptable and effective for increased smoking cessation when compared with a model of in-practice management. METHODS: The study design was cluster randomized controlled trial. Practices were randomized to one of two interventions, at a rate of 1:2: (i) standard in-practice GP management or (ii) referral to a quitline service. The main outcome measures were sustained abstinence of >or=1 month duration at 3-month follow-up and >or=10 months duration at 12 months, using intention to treat analysis. RESULTS: At 3-month follow-up, patients in the referral condition were twice as likely to report sustained abstinence than those in the in-practice condition [12.3% compared with 6.9%; odds ratio (OR) = 1.92 (95% confidence interval (CI) 1.17-3.13]. At 12-month follow-up, patients in the referral condition had nearly three times the odds of sustained abstinence [6.5% compared with 2.6%; OR = 2.86 (95% CI 0.94-8.71)]. The intervention effect was mediated by the amount of help received outside the practice. CONCLUSIONS: This research provided evidence that GPs referring smokers to an evidence-based quitline service results in increased cessation. The benefit is largely due to patients in the referral condition receiving more external help than patients in the in-practice condition, as they received equivalent practice-based help. Where suitable services exist, we recommend that referral become the normative strategy for management of smoking cessation in general practice to complement any practice-based help provided.

GP attitudes to male reproductive and sexual health education and promotion. A qualitative study.

BACKGROUND: Despite evidence that men believe the general practitioner is an appropriate person to assist with sexual health issues, few men actually access medical practitioners for such assistance. Raising community awareness of male sexual and reproductive health issues is expected to generate a clinical demand for men's health services. OBJECTIVE: The aim of this study was to determine GP perceptions of their own education needs and those of the community in the area of men's health. DISCUSSION: A total of 27 GPs from four Victorian divisions of general practice (three metropolitan and one rural) participated in three focus groups. Key themes from the data were identified after analysis of the data by three researchers. General practitioners indicated that a clinical demand for men's health services needed to be generated in order for GPs to be interested in professional development. They suggested community education providing general information to men about sexual and reproductive health issues and emphasising the importance of accessing their GP for health checks. However, due to a lack of information for GPs about some areas of male sexual and reproductive health, e.g., androgen deficiency and male infertility, a case based practical approach to GP education was recommended. General practitioners also requested concrete information, current specialist recommendations and details of locally available services working in men's health.