Why an attachment to general practice is not an adequate substitute for a structured programme: a qualitative approach

Abstract

The Leeuwenhorst definition of the work of the general practitioner represents the gold standard for educational aims in general practice. The majority of educational programmes in Europe have developed from unstructured attachment, towards structured experiences in practice. The question arises as to what kind of educational aims students achieve by being attached to a general practitioner without a structured programme. A total of 166 reports from attachments in general practice were analysed in a qualitative way. The keywords describing the necessary skills of the general practitioner were used as a standard with which the reports were compared. All of the areas from the definition were identified by at least one student but overall clinical skills predominate, while communication and organizational skills were rarely identified. Attachment to general practice is not an adequate substitute for an organized family practice curriculum since students fail to recognize important skills necessary for the work of a general practitioner.