One of the first questions every new GP trainee asks is 'What do I need to learn to be a GP?' Many answers to this question exist, but very few are easy to apply in practice.
General practice is a very broad medical specialty and the curriculum is similarly broad. The first step every GP in training must do when planning their learning is to identify their most pressing learning needs in order to set some priorities.
One of the key benefits of the curriculum is that it identifies the core knowledge and skills that doctors need to acquire to become competent GPs. This makes it an ideal reference to use when identifying learning needs and planning learning activities.
Identifying learning needs
Contact with patients reveals many learning needs on a daily basis, particularly at the start of training. Simple topics can be recorded in a patient log, or in the eportfolio, and dealt with one by one.
Complex learning needs can be identified by more sophisticated methods, such as case analysis, consultation analysis (video surgeries) and shared surgeries.
How do GPs learn?
Some key principles can make learning more effective for GPs. GPs tend to learn from experience, through reflecting on events in daily practice, considering why they feel significant, addressing any learning needs that arise and formulating a new approach.
Most GPs like to direct their own learning. Learning based on the curriculum can feel particularly relevant to learning how to be a GP. GPs also need to learn how to solve problems. Patients rarely present with all their complaints neatly categorised.
Planning learning activities
The curriculum domains form a useful framework for planning learning activities, while ensuring you cover all aspects relevant to general practice.
For example, for curriculum statement 12, 'Care of people with cancer and palliative care', you can plan learning activities for each of the six core competencies described within the statement.
A contextual learning activity to prepare for the competence 'specific problem-solving skills' could be to meet with a district nurse and go over how to manage palliative care emergencies.
An attitudinal learning activity addressing the competence 'person-centred approach' could be to arrange a study group discussion on the issues around advanced directives and euthanasia.
A scientific learning activity addressing the competence 'holistic approach' could be to review a qualitative research study investigating the spiritual care needs of dying patients.
Approaches to learning
The Condensed Curriculum Guide contains information on useful approaches to learning in various situations, including learning independently, in tutorials and in groups, and offers advice on how to break down key competences and complex skills into their component parts to make them easier to learn (see box for example).
Teaching is a good way to learn general practice and GP registrars are encouraged to participate in providing seminars and presentations for their peers as part of their weekly release programme.
Dr Riley is a GP in Oxfordshire and RCGP curriculum development fellow and Dr Haynes is also a GP in Oxfordshire.
Competence and learning outcomes
To manage primary contact with patients, dealing with unselected problems.
- Knowledge of the epidemiology of problems presenting in primary care.
- Mastering an approach that allows easy access for patients with unselected problems.
- An organisational approach to the management of chronic conditions.
- Knowledge of conditions encountered in primary care and their treatment.
How the curriculum will make you an effective GP
- The curriculum identifies the core knowledge and skills a doctor needs to become a competent GP.
- Contact with patients generates simple and complex learning needs.
- Key adult learning principles make learning effective for GPs.
- The curriculum domains form a useful framework for you to plan learning activities on a topic.
- Teaching, through seminars and presentations to your peers, is an excellent way to learn general practice.
The Condensed Curriculum Guide, RCGP 2007 by Dr Ben Riley, Dr Jayne Haynes and Professor Steve Field
The Condensed Curriculum Guide is the official guidebook to the RCGP curriculum.
It is available from the RCGP Bookshop. Online: www.rcgp.org.uk/acatalog. Phone: (020) 7581 3232; fax: (020) 7581 8154. RCGP members and associates receive a 10 per cent discount when ordering this book.