GP Training - Getting the most out of your GP trainer

Dr Prashini Naidoo and Dr Jemma Austin offer their respective views on trainer-trainee relationships.

Communicating learning needs and recognising your trainer's teaching style will help to maximise the gains you make from specialty training
Communicating learning needs and recognising your trainer's teaching style will help to maximise the gains you make from specialty training

A trainer's perspective by Dr Prashini Naidoo

The main aim of GP trainers is to help GP trainees become safe and independent GPs.

It is helpful to 'know your trainer' - to appreciate the trainer's perspective on teaching and to understand how they intend to organise your learning.

The GP trainer-trainee relationship is essentially a teaching relationship; to help someone learn. When trainers look at ePortfolio entries or discuss cases, they often ask trainees probing questions designed to stimulate new thinking. Trainees who want to be reassured that their management plans are good often do not understand why they are being challenged. Consequently, they may feel anxious, irritated or dissatisfied with the trainer.

Trainees who are open to new experiences and who understand the trainer's perspective are far more likely to have a more rewarding training experience.

Training is more effective if it is focused, structured and student-centred. Focus is an awareness of what will be learnt, how the learning will take place and why it is important to learn these things.

Hence, planning is essential. In my experience of talking to trainees about their learning needs, I find their eyes glaze over. However, this is a time when trainees should pay most attention. It is during planning that resources are allocated, particularly the time, courses and tutorials needed.

Different doctors have different learning styles and some find certain subjects easier to learn. If trainees fail to communicate how much time or help they require with certain aspects of their training, the resulting inadequate provision of resources will cause dissatisfaction.

Increasing complexity
Trainers expose trainees to increasingly complex learning situations as their experience grows. This is most often seen in out-of-hours care, home visits and debriefing on difficult cases.

Trainers give feedback on existing knowledge and skills, hoping trainees will transfer their learning beyond the immediate context to different situations.

Trainers often introduce complexity towards the latter half of the ST3 year, as trainees are preparing for exams. Trainees feel overloaded and complain of too little time to study. Trainers may feel trainees are unwilling or unable to appreciate the complexity of general practice. At least a quarter of clinical skills assessment cases involve complex issues, and it is difficult to confidently manage these if you encounter them for the first time in the exam.

Trainer types
Student-centred or self-directed learning means different things to different trainers, resulting in confused trainees. 'Traditionalist' trainers, who argue that trainees cannot determine their own learning because they do not know what they need to learn, often control and structure the learning. 'Humanist' trainers tend to relinquish control and simply make suggestions to help trainees.

Traditionalist trainers will expect you to spend more time seeing and discussing increasingly complex cases they have arranged. Humanist trainers may expect you to communicate, plan and feed back to them on your self-organised learning. Recognising the type of trainer you have will help you understand what is expected of you.

Ask for help and be clear about your expectations. If you are unlucky enough to have a trainer who does not support you, your course organiser and deanery will be able to provide advice.

A trainee's perspective by Dr Jemma Austin

After I completed my certificate of completion of training in August 2009, having worked in five different NHS and military practices, I realised trainers were a wondrous breed with many motivations, experiences and passions shaping their styles - just like every trainee.

My advice is to communicate openly and honestly; regular discussion is essential. Sometimes detailed planning is required. This can then be reviewed and tailored. Your trainers may have no idea that they are not matching your learning style and compromise is usually needed to ensure a healthier relationship for both.

Goal setting
Try to set your goals and timelines together. If things have to change, keep your trainer informed. The ePortfolio system is flexible but will only work if you communicate with your trainer. Do not worry about offending your trainer if there are experiences you want to achieve that do not include them. Working with other clinicians and specialist clinics is possible, if organised well.

For most trainers, you will not be their first trainee and they will have ways of ensuring you get the most out of your training. However, if you do have problems, discuss these with peers at your GP specialty training group to find out if they are serious matters. If you continue to have problems, your deanery can help, ensuring you become the best GP possible.

Learning points

1. Get to know your trainer and their teaching style. Find out how they intend to organise your learning.

2. Be aware that your trainer will introduce increasingly complex learning situations as you develop.

3. Remember to communicate openly and honestly with your trainer.

4. Set goals and timelines with your traine

Dr Naidoo is a GP trainer in Oxfordshire and Dr Austin is a military GP in Cyprus.

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