MétaCan
Menu
Back to cohort
Record W2790136083 · doi:10.1016/j.gaceta.2017.10.011

Exploring the training and scope of practice of GPs in England, Germany and Spain

2018· article· en· W2790136083 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

fundA Canadian funder is recorded on the work.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueGaceta Sanitaria · 2018
Typearticle
Languageen
FieldHealth Professions
TopicPrimary Care and Health Outcomes
Canadian institutionsnot available
FundersNational Institute of Child Health and Human DevelopmentNational Human Genome Research InstituteNational Institute of Mental HealthNational Heart, Lung, and Blood InstituteCanadian Institutes of Health ResearchNational Institute of Neurological Disorders and StrokeNational Institute for Health and Care ResearchGenome British ColumbiaCenter for Individualized Medicine, Mayo ClinicSeventh Framework ProgrammeMcGill UniversityKids Brain Health NetworkBC Children's HospitalNational Institutes of HealthChildren's Hospital FoundationEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentEuropean CommissionJohns Hopkins University
KeywordsGatekeepingSnowball samplingScope of practiceWorkforceNursingScope (computer science)Health careMedicineLegislationThematic analysisPopulation ageingAusterityGlobal Positioning SystemPublic relationsPopulationMedical educationQualitative researchPolitical scienceSociologyEnvironmental health

Abstract

fetched live from OpenAlex

To explore general practitioner (GP) training, continuing professional development, scope of practice, ethical issues and challenges in the working environment in three European countries. Qualitative study of 35 GPs from England, Germany and Spain working in urban primary care practices. Participants were recruited using convenience and snowball sampling techniques. Semi-structured interviews were recorded, transcribed and analysed by four independent researchers adopting a thematic approach. Entrance to and length of GP training differ between the three countries, while continuing professional development is required in all three, although with different characteristics. Key variations in the scope of practice include whether there is a gatekeeping role, whether GPs work in multidisciplinary teams or singlehandedly, the existence of appraisal processes, and the balance between administrative and clinical tasks. However, similar challenges, including the need to adapt to an ageing population, end-of-life care, ethical dilemmas, the impact of austerity measures, limited time for patients and gaps in coordination between primary and secondary care are experienced by GPs in all three countries. Primary health care variations have strong historical roots, derived from the different national experiences and the range of clinical services delivered by GPs. There is a need for an accessible source of information for GPs themselves and those responsible for safety and quality standards of the healthcare workforce. This paper maps out the current situation before Brexit is being implemented in the UK which could see many of the current EU arrangements and legislation to assure professional mobility between the UK and the rest of Europe dismantled. Analizar la formación, el desarrollo profesional continuado, el ámbito de práctica, las cuestiones éticas y los retos en el entorno laboral de los médicos de atención primaria en tres países europeos. Estudio cualitativo de 35 médicos de atención primaria de Inglaterra, Alemania y España que trabajan en centros urbanos de atención primaria. Se reclutó a los participantes utilizando técnicas de muestreo de oportunidad y con efecto multiplicador. Se registraron, transcribieron y analizaron entrevistas semiestructuradas realizadas por cuatro investigadores independientes, quienes adoptaron un enfoque temático. El acceso y la duración de la formación del médico de atención primaria difieren entre los tres países, mientras que se requiere desarrollo profesional continuado en los tres, aunque con características diferentes. Las variaciones clave en el ámbito de la práctica incluyen la existencia de un papel curativo, si el trabajo de médico de atención primaria se realiza en equipos multidisciplinarios o de manera individual, la existencia de procesos de valoración, y el equilibrio entre las tareas administrativas y clínicas. Sin embargo, los médicos de atención primaria en los tres países se enfrentan a retos similares, que incluyen la necesidad de adaptarse al envejecimiento de la población, la atención al final de la vida, el impacto de las medidas de austeridad, la limitación del tiempo de dedicación al paciente, y las brechas en cuanto a coordinación entre la atención primaria y secundaria. Las variaciones de la atención primaria tienen fuertes raíces históricas, que se derivan de las diferentes experiencias nacionales y el rango de los servicios clínicos proporcionados por los médicos de atención primaria. Existe una necesidad de fuentes de información accesibles para dichos médicos, y aquellos responsables de los estándares de seguridad y calidad del personal sanitario. Este trabajo esboza la situación actual que está siendo implementada en el Reino Unido con anterioridad al Brexit, que podría vislumbrar muchos de los acuerdos y legislaciones actuales de la UE para garantizar la movilidad profesional entre el Reino Unido y el resto de la Europa desmantelada.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.541
Threshold uncertainty score0.264

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.156
GPT teacher head0.407
Teacher spread0.251 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it