Biomedical subjects
D Hannay
Publications and source records attributed to D Hannay.
Deprivation payments and workload.
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The discipline and literature of general practice.
In response to a review recently carried out by the Royal College of General Practitioners, the British Journal of General Practice is soon to be issued in a new and expanded format. While continuing to develop its primary role as a leading scientific journal of record, the journal will accommodate a monthly selection of integrated news, information and features. The editorial board welcomes the opportunities provided by these changes, but wishes to emphasize the continuing importance of general practice as a scientific discipline in its own right and to reaffirm its commitment to the publication of high-quality, peer-reviewed original research papers. It is hoped that the newlook journal will have a wide appeal. But, as the first-and still the foremost-journal of general practice in the world, it will continue to be a journal of record serving both its authors and the academic community worldwide.
Deprivation payments and workload.
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Career choices of trainees in general practice.
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Competence-based summative assessment of a student-directed course: involvement of key stakeholders.
The 5-week module in general practice for final-year students at the University of Sheffield is based on practice attachments and student-directed learning in small groups. This paper describes how the summative assessment process of the module was revised to incorporate the notion of competence-based assessment, and how general practitioner tutors, departmental tutors and students were involved in this revision. The question 'What are students expected to know and be able to do by the end of the module?' was answered in terms of a statement of the key purpose of the module and a list of intended learning outcomes. The question 'How can we find out if students have achieved these outcomes?' was addressed by developing check-lists of criteria for observed behaviours and for the written products of students' actions.
Heartsink patients: a study of their general practitioners.
BACKGROUND: A number of attempts have been made to investigate the heartsink, difficult, dysphoric or problem patient. Most studies have emphasized the role which the patient plays in evoking despair, anger and frustration in the doctor. However, one doctor's list of difficult patients may not necessarily be the same as another's. AIM: A study was undertaken to determine if the individual characteristics of general practitioners are associated with the number of heartsink patients they report on their patient lists. METHOD: Sixty out of 137 urban general practitioners drawn at random from the Sheffield Family Health Services Authority list were surveyed by structured interview and questionnaires in 1990. Outcome measures were interview data and scores on the 12-item general health questionnaire, Warr-Cook-Wall job satisfaction scale and the Bortner personality profile measure. RESULTS: Sixty per cent of the variance in the number of heartsink patients that general practitioners reported on their lists could be accounted for by the following four explanatory variables: greater perceived workload; lower job satisfaction; lack of training in counselling and/or communication skills; and lack of appropriate postgraduate qualifications. No other variables considered could account for the variance in the number of heartsink patients reported by general practitioners. CONCLUSION: The individual characteristics of doctors are associated with the number of heartsink patients reported by general practitioners. To reduce the number of such patients experienced, it may be necessary for general practitioners to reduce their workload and increase their job satisfaction and their level of relevant postgraduate training.
Workload of general practitioners before and after the new contract.
OBJECTIVE: To assess changes in general practitioners' workload associated with the new contract introduced in April 1990. DESIGN: Weekly workload diary completed during four weeks in February-March 1990 and during the same period in 1991. SETTING: Sheffield, United Kingdom. SUBJECTS: All 300 general practitioners on Sheffield Family Health Services Authority list as principals in 1990 and 1991. MAIN OUTCOME MEASURES: Mean number of hours worked per week, number of patients seen each week, and mean time spent per patient. RESULTS: 181 (60%) general practitioners responded in 1990 and 163 (54%) in 1991. Of these, 18 (10%) were not working in 1990 and 14 (7%) in 1991. General medical service work increased during a "normal working week" from a mean of 38.6 hours a week in 1990 to 40.6 hours in 1991, and non-general medical service work decreased from 5.4 hours a week to 4.5 hours. Hours spent on call were similar before and after the contract. For the 99 general practitioners who responded in both years, time spent on general medical service duties increased significantly (40.5 h in 1990 v 42.5 h [corrected] in 1991; p = 0.033), mainly due to more time being spent in clinics. Significantly more patients were being seen in clinics (9 v 14; p = 0.001); the average time spent per patient remained at about 8 1/2 minutes during surgeries and 16 minutes for a home visit, and rose from 13 to 14 minutes for patients seen in clinics. The time spent on practice administration fell but not significantly. CONCLUSION: Since the new contract there has been a significant increase in general medical services work, mainly due to more patients being seen in clinics, with no reduction in the time spent per patient.
Profile-based assessment of student project reports.
During their final year, medical students at Sheffield University are required to undertake a research or audit project. The students' project reports are assessed using a grid-style criterion-based profile. This is described, and the validity and reliability of this method of summative assessment are discussed.
Student-directed problem-based learning in general practice and public health medicine.
The development and implementation are described of a new 6-week course in general practice and public health medicine for final-year medical students. This course is based on the principles of student-directed problem-based learning in small groups and makes substantial use of student attachments to local general practices which act as learning resources. Student assessment is by profiles. Course evaluation is by qualitative feedback, and the results of this are presented. The course offers a flexible learning environment in which the aims of its designers and the goals of their students can be achieved.