Improving the Quality of Tutorials in General Practice by Means of Instruction and Quality Assessment

Abstract

Dutch general practitioner (GP)-trainees spend the main parr of their vocational training in the practice of their GP-trainers. During this period, the GP-trainer teaches the trainee in daily sessions (tutorials) of approximately one hour. In 1994 the Vrije Universiteit of Amsterdam initiated a project to improve the teaching skills of twelve GP-trainers. The quality of their tutorials was assessed by analysing video-recording made before instructions were given, immediately afterwards, and three months later. For this analysis, a list often items was compiled, regarding the didactic method (4 items), the learning process (2 items) and the provision of a safe educational climate for the trainee (4 items). After instructions were given, slight improvements were measured, and were still measurable three months later. However, the overall scores tended to be rather low. The group of GP-trainers consisted of six new and six experienced trainers. The experienced trainers achieved higher scores on 'safe educational climate'; with regard to the other items (i. e. didactic method and learning process) there were no clear differences. It is therefore concluded that both new and experienced trainers can benefit from continuous and systematic training in teaching skills. Furthermore, instruction followed by feedback based on the assessment of video-recording might be an appropriate method to improve the quality of tutorials.