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General practice registrars' experiences of antenatal care: A cross-sectional analysis.

Abstract

BACKGROUND

General practitioners play an important role in diagnosis and ongoing management of pregnancies. Some GP registrars entering GP training may have had no post-graduate experience in obstetrics and gynaecology. GP registrars' involvement in antenatal care is under-researched.

AIMS

This study aimed to determine the prevalence and associations of Australian GP registrars' clinical consultations involving antenatal care.

MATERIALS AND METHODS

A cross-sectional analysis from the Registrar Clinical Encounters in Training (ReCEnT) cohort study. GP registrars record details of 60 consecutive consultations during each of three six-month training terms. Associations of managing pregnancy-related problems (compared to all other problems) were analysed using univariate and multivariable logistic regression. Independent variables included registrar, practice, patient, consultation and educational factors.

RESULTS

Antenatal care comprised 3277 (1.1%) of registrar problems/diagnoses. Consultations involving pregnancy-related problems were significantly associated with registrars being female, in term three, younger, and having post-graduate qualifications in obstetrics/gynaecology. Patients were significantly more likely to be from a non-English speaking background. Pregnancy-related problems/diagnoses were more likely to be seen in lower socioeconomic areas. Consultation factors significantly associated with a pregnancy-related problem/diagnosis included ordering imaging, ordering pathology, arranging referrals, and a longer duration of consultation. Registrars were less likely to prescribe medication or generate learning goals.

CONCLUSIONS

GP registrars see fewer antenatal problems compared to established GPs. Male registrars, especially, have significantly less exposure to antenatal care, suggesting potential limitation of opportunity to gain skills and experience in antenatal care.

Authors+Show Affiliations

Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia.School of Medicine and Public Health, University of Newcastle, Newcastle, Australia. NSW & ACT Research and Evaluation Unit, GP Synergy, Newcastle, Australia.School of Medicine and Public Health, University of Newcastle, Newcastle, Australia. NSW & ACT Research and Evaluation Unit, GP Synergy, Newcastle, Australia.School of Medicine and Public Health, University of Newcastle, Newcastle, Australia. NSW & ACT Research and Evaluation Unit, GP Synergy, Newcastle, Australia.School of Medicine and Public Health, University of Newcastle, Newcastle, Australia. Clinical Research Design, Information Technology and Statistical Support (CReDITSS) unit, Newcastle, Australia.Clinical Research Design, Information Technology and Statistical Support (CReDITSS) unit, Newcastle, Australia.Eastern Victoria GP Training (EVGPT), Melbourne, Australia. Department of General Practice, University of Melbourne, Melbourne, Australia.General Practice Training Tasmania (GPTT), Hobart, Australia.GP Synergy, Newcastle, Australia.Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31424574

Citation

Pappalardo, Emma, et al. "General Practice Registrars' Experiences of Antenatal Care: a Cross-sectional Analysis." The Australian & New Zealand Journal of Obstetrics & Gynaecology, 2019.
Pappalardo E, Magin P, Tapley A, et al. General practice registrars' experiences of antenatal care: A cross-sectional analysis. Aust N Z J Obstet Gynaecol. 2019.
Pappalardo, E., Magin, P., Tapley, A., Davey, A., Holliday, E. G., Ball, J., ... van Driel, M. L. (2019). General practice registrars' experiences of antenatal care: A cross-sectional analysis. The Australian & New Zealand Journal of Obstetrics & Gynaecology, doi:10.1111/ajo.13042.
Pappalardo E, et al. General Practice Registrars' Experiences of Antenatal Care: a Cross-sectional Analysis. Aust N Z J Obstet Gynaecol. 2019 Aug 19; PubMed PMID: 31424574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - General practice registrars' experiences of antenatal care: A cross-sectional analysis. AU - Pappalardo,Emma, AU - Magin,Parker, AU - Tapley,Amanda, AU - Davey,Andrew, AU - Holliday,Elizabeth G, AU - Ball,Jean, AU - Spike,Neil, AU - FitzGerald,Kristen, AU - Morgan,Simon, AU - van Driel,Mieke L, Y1 - 2019/08/19/ PY - 2019/01/31/received PY - 2019/06/25/accepted PY - 2019/8/20/entrez KW - cohort studies KW - general practice KW - inservice training KW - pregnancy KW - prenatal care JF - The Australian & New Zealand journal of obstetrics & gynaecology JO - Aust N Z J Obstet Gynaecol N2 - BACKGROUND: General practitioners play an important role in diagnosis and ongoing management of pregnancies. Some GP registrars entering GP training may have had no post-graduate experience in obstetrics and gynaecology. GP registrars' involvement in antenatal care is under-researched. AIMS: This study aimed to determine the prevalence and associations of Australian GP registrars' clinical consultations involving antenatal care. MATERIALS AND METHODS: A cross-sectional analysis from the Registrar Clinical Encounters in Training (ReCEnT) cohort study. GP registrars record details of 60 consecutive consultations during each of three six-month training terms. Associations of managing pregnancy-related problems (compared to all other problems) were analysed using univariate and multivariable logistic regression. Independent variables included registrar, practice, patient, consultation and educational factors. RESULTS: Antenatal care comprised 3277 (1.1%) of registrar problems/diagnoses. Consultations involving pregnancy-related problems were significantly associated with registrars being female, in term three, younger, and having post-graduate qualifications in obstetrics/gynaecology. Patients were significantly more likely to be from a non-English speaking background. Pregnancy-related problems/diagnoses were more likely to be seen in lower socioeconomic areas. Consultation factors significantly associated with a pregnancy-related problem/diagnosis included ordering imaging, ordering pathology, arranging referrals, and a longer duration of consultation. Registrars were less likely to prescribe medication or generate learning goals. CONCLUSIONS: GP registrars see fewer antenatal problems compared to established GPs. Male registrars, especially, have significantly less exposure to antenatal care, suggesting potential limitation of opportunity to gain skills and experience in antenatal care. SN - 1479-828X UR - https://www.unboundmedicine.com/medline/citation/31424574/General_practice_registrars'_experiences_of_antenatal_care:_A_cross-sectional_analysis L2 - https://doi.org/10.1111/ajo.13042 DB - PRIME DP - Unbound Medicine ER -