ABSTRACT
BACKGROUND: The pace of new medical evidence is rapidly increasing. A modern doctor needs skills to access high-quality and up-to-date information to provide healthcare. Information seeking is often done at the point of care due to time constraints and because most consultations are conducted with the doctor and patient in the same space. There are benefits to accessing information during the consultation, and navigating this successfully requires skill. OBJECTIVE: Based on interviews with patients, this article aims to provide an updated practical approach for clinicians accessing reputable and reliable information with patients during consultations. DISCUSSION: Accessing information at the point of care is now an important clinical skill for clinicians; however, patients view this as a communication skill. Successful access and use of information can build trust through communication, transparency and actively involving the patient.
Subject(s)
Information Seeking Behavior , Physicians , Humans , Referral and Consultation , Clinical CompetenceABSTRACT
BACKGROUND AND OBJECTIVES: Vaccine uptake in older Australians is suboptimal. This exploratory study aims to establish the associations of opportunistic older person immunisation in general practice registrars' practice. METHOD: This study was a cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. Univariate and multivariable regressions explored associations between vaccine recommendations and patient, registrar, practice and consultation factors. RESULTS: A total of 2839 registrars provided data on 74,436 consultations. Associations of lower odds of immunisation included Aboriginal and Torres Strait Islander peoples (odds ratio [OR] 0.69; 95% confidence interval [CI]: 0.50, 0.96), rural/remote practice location (OR 0.75; 95% CI: 0.58, 0.98, compared with major cities) and in areas of greater relative socioeconomic disadvantage (OR per decile 1.03; 95% CI: 1.01, 1.05). Patients new to the practice (OR 2.46; 95% CI: 2.06, 2.94), or to the registrar (2.02; 95% CI: 1.87, 2.18) had higher odds of receiving an immunisation. DISCUSSION: Our findings suggest that general practice registrars may be proactively facilitating immunisation in new patients, but that inequities in vaccination persist.
Subject(s)
COVID-19 , General Practice , Aged , Australia , Cross-Sectional Studies , General Practice/education , Humans , Immunization , Referral and Consultation , VaccinationABSTRACT
OBJECTIVE: To explore patient perceptions regarding doctors' information seeking during consultations. DESIGN AND SETTING: Qualitative interviews with participants from six general practice waiting rooms in South East Queensland, Australia. Participants were asked about their experiences and opinions, and to comment on short videos of simulated consultations in which a doctor sought information. The interviews were analysed through a process of iterative thematic analysis using the framework of Braun and Clarke. PARTICIPANTS: The 16 participants were purposively sampled including 5 men and 11 women from a diverse range of educational and age groups. RESULTS: How a doctor's need to look up information impacted patient impressions of competence and trust was an overarching theme. The four dominant themes include: the trust a patient has in the doctor before the consultation, whether the doctor is expected to know the answer to a question without searching, has the doctor added value to the consultation by searching and the consultation skills used in the process. CONCLUSIONS: Patient trust is fundamental to positive perceptions of general practitioners' information seeking at the point-of-care. Communication is key to building this trust. Understanding the patient's agenda, listening, assessing thoroughly and being honest and transparent about the need to seek information all contribute to a positive experience.
Subject(s)
Physician-Patient Relations , Physicians , Female , Humans , Information Seeking Behavior , Male , Point-of-Care Systems , Search EngineABSTRACT
BACKGROUND AND OBJECTIVES: Immunisation uptake in Australian older adults is suboptimal. General practice registrars are responsible for a significant proportion of immunisations in this age group and are also in the process of developing patterns of practice. Despite their role, little is known about general practice registrars' attitudes towards immunisation of older adults, the barriers faced, and the role supervisors play in developing adult immunisation skills. METHOD: This was a qualitative study involving semi-structured interviews with general practice registrars and supervisors purposively sampled from around Australia. Data were analysed using thematic analysis. RESULTS: The five key themes were grouped in terms of perceptions of registrars' role in immunisation of older adults, consultation barriers, health system barriers, managing vaccine hesitancy, and a team approach to vaccination. DISCUSSION: Vaccine positivity is an important attitude to cultivate within the general practice environment as it has an impact on registrar behaviour. Immunisation-skilled nurses could play a role in training general practice registrars in immunisation. Findings from the present study may be useful in improving vaccine uptake in the elderly in the context of the COVID-19 vaccine rollout.
