General practitioners as educators in adolescent health: a training evaluation.

BACKGROUND: General practitioners play an important role in the primary care of adolescents in both community and clinical settings. Yet studies show that GPs can lack confidence, skills and knowledge in adolescent health. This study evaluates the effectiveness of an innovative training intervention on medical participants' knowledge and confidence as adolescent health educators in a school setting. METHODS: 15 general practitioners, 12 general practice registrars and 18 medical students participated in an adolescent health education workshop followed by field experience in health education sessions in secondary schools. The mixed method design included a pre and post intervention survey and focus group interviews. RESULTS: Mean scores on the Confidence to Teach scale increased significantly (3.34 ± 0.51 to 4.09 ± 0.33) (p < .001) as did confidence to communicate with adolescents (3.64 ± 0.48 to 4.19 ± 0.33) (p < .001). Mean knowledge scores increased significantly (7.00 ± 1.22 to 8.98 ± 1.11) (p < .001). Participants highlighted the value of learning about adolescent health issues and generic teaching skills especially lesson planning and design, practicing experiential teaching strategies and finding the 'sweet spot' when communicating with adolescents. Some participants reported that these skills would transfer to the practice setting. CONCLUSION: An applied training intervention that uses evidence-based, experiential teaching strategies and focuses on developing knowledge and practical teaching skills appropriate for the health education of adolescents can enhance knowledge and confidence to engage in community-based adolescent health education.

Bilateral Hip Joint Hylan G-F 20 Granulomatous Synovitis due to Viscosupplementation Injections.

We present the diagnosis of bilateral granulomatous inflammation of the hip joints associated with Hylan G-F 20 viscosupplementation injections. Clinicians recommending therapeutic Hylan injections for the management of hip arthritis should maintain clinical awareness regarding this potential complication.

Evaluating a community-engaged vertically integrated teaching and learning pilot project.

OBJECTIVE: To evaluate a community engaged vertically integrated teaching and learning pilot project. METHOD: Thematic analysis of focus group interviews was used to examine 27 general practitioners' (GPs'), registrars' and medical students' perceptions of a vertically integrated workshop in adolescent health and subsequent small group health education sessions at two secondary schools. Pre- and postintervention surveys were used to measure changes to participants' knowledge, confidence, and attitudes towards registrars and students teaching in general practice. RESULTS: Knowledge scores (7.46 ± 1.17 vs 9.54 ± 1.17; t = -9.6, P <0.001), and scores on the Confidence to Teach (3.34 ± 0.51 vs 4.09 ± 0.33; t = -6.61, P <0.001), and Vertically Integrated Teaching (4.01 ± 0.40 vs 4.30 ± 0.42; t = -3.45, P <0.05) scales increased significantly following the intervention. Scale reliability ranged from 0.74 to 0.87. Participants enjoyed the collegiality of learning together in a vertically integrated model. The experience stimulated self-reflection on teaching skills and a desire for peer review of teaching. Suggestions for improving the intervention included building a clearer link between the facilitation skills learnt in the school setting and how to implement them in general practice, and providing more targeted support for GPs on facilitating sessions with multiple levels of learner involved. CONCLUSIONS: A community-engaged vertically integrated teaching and learning model has the potential to increase participants' confidence to teach in small groups, and create a more positive perception of registrars and students teaching in general practice. The concept would benefit from further longitudinal research with a wider sample.

Youth vouchers for GP services--a pilot project.

BACKGROUND: Identified barriers to young people accessing a general practitioner include cost, communication, confidentiality issues, and knowledge of Medicare. OBJECTIVE: This pilot project aimed to test the feasibility of reducing financial barriers for young people accessing GP services, examine if a professional assessment of being 'in need' influences GP billing, and promote communication between youth workers and GPs. METHOD: Youth workers were given vouchers to assist young people who needed to see a GP who were otherwise unable to do so for financial reasons. General practitioners accepted a voucher payment, bulk billed the young person and collected data about the consultation. RESULTS: Vouchers facilitated bulk billed consultations with GPs who otherwise would not have seen them. A voucher appeared to leverage acceptability by GPs of follow up bulk billed consultations. Financial factors, being identified as 'in need', and communication from youth workers were all important factors for GPs. DISCUSSION: Provision of vouchers for disadvantaged patients by health workers may improve access to GP services. Reasons are not just financial.