Ramackers A, Van Leeuwen Y, Ponse K, Lammerts L. Care for the elderly in practice. Huisarts Wet 2012;55(8): 330-4.
Background Elderly care in general practice has changed, from focusing on the reason for the appointment to focusing on the patient’s overall functional status: reactive care has been replaced by anticipatory care. GP trainees need to learn this approach during specialization. In a pilot study, an educational intervention was tested in six training practices, during which GP trainees adopted and monitored elderly patients for 1 year. The educational intervention was flanked by qualitative research, to establish what the trainees learned and how they related this information to the intervention.
Method Semi-structured interviews were administered to GP trainees and their supervisors on three occasions. The interviews were verbally transcribed, and then three assessors independently coded and categorized the interview outcomes. Two assessors interpreted the outcomes.
Results Each GP trainee adopted 3-5 patients. Trainees reported that they got a better picture of their patients and of their problems as a whole, which enabled them to provide anticipatory care. They gained insight into their role in a network of care. They missed input from their supervisors and made limited use of the possibility to consult with specialists.
Conclusion Teaching practice interventions are warranted, as GP trainees want to learn on the job, but supervisors should provide more supervision than they currently do.