An autumnal reflection

Climb the mountains and get their good tidings.

Nature’s peace will flow into you as sunshine flows

into trees. The winds will blow their own freshness

into you, and the storms their energy, while cares will

drop off like autumn leaves. [1]

As I write, the autumnal colours are truly beautiful. This brought to mind the above poem by John Muir in tools of the trade; the subject for this issue’s Green Review.[1] We offer a series of moving reflections on this small publication which has been most effective in highlighting the need to enable doctors to carry “humanity” in their pockets. We look forward to the next publication in the hope this will become more widely disseminated. At the WONCA Europe conference in Istanbul Amanda Howe, President Elect announced that “People, Politics and Poetry” would be the focus of her Presidency. Hopefully, we can work together to address one of the poorly developed areas of medical education, i.e. fostering and growing (not dampening as we seem to do now) the humanity students bring into the profession.

As primary care educators, we must remain person centred. This embraces, as Peter Cantillon highlights, nurturing the humanity and self awareness of the doctor as a person. This is crucial. We were therefore delighted to invite a more personal reflection from Roger Neighbour [2] on his powerful pioneering work on “housekeeping”, for this issue’s Three Papers section. This has given most valuable professional authenticity to the need to keep ourselves as doctors “in order”, as well as the patient.

So hopefully, as autumn heralds the transition of the journal from 2015 into the New Year, the winter winds will blow some freshness into education and drop, with the autumn leaves, some of the gloom which currently pervades. This issue highlights some important ways forward to foster more humanistic approaches to the doctor–patient interaction. We were very “taken by” the views of Peter Croft et al. on the need to look to the future and focus education on offering “prognosis” alongside “diagnosis”; a further move away from the “disease label”. We were delighted when he agreed to write a leading article [3] for us. Alison Sneddon and colleagues [4] argue cogently for a more person-centred approach to learning. Education for Primary Care would like to see some of the drawbacks of focusing on competency-based teaching overcome and to herald a much stronger research focus on what is actually learnt rather than taught. More challenging, maybe, but of increasing importance if we are to nurture the professional behaviours needed for the ever increasing complexity of health care. We will be on the lookout for papers offering higher levels of evidence for learning and health care outcomes. As Kieran Walsh [5] highlights we risk “missing the point” in the target- and competency-driven world.

How refreshing too that Eleanor Ragg et al. [6] have chosen to explore factors contributing to International Medical Graduates (IMGs) success in the RCGP Clinical Skills Assessment; a move from focusing on failure. The paper offers insight into the positive power of working supportively across cultural difference and of the importance of integrating IMGs into our Community of Practice. The importance of a doctor-centred focus also emerges once again, in the paper by Sharon Wiener-Olgivie,[7] which demonstrates the vital role we can play as GP educators in role modelling and attracting young doctors into primary person-centred care.

This issue heralds our thoughts for 2016. Across the year we plan to encourage articles and research into the thorny issue of recruitment into Primary Care. We have also commissioned a series of articles on Education for Patient Safety. Although both areas are problematically multifactorial, education undoubtedly does have an important role to play and its impact needs to be better understood. Lesley Pugsley has kindly agreed to support our plea for strong educational research on learning and outcomes by producing a “How to” series over the year on Medical Education Research.

The journal’s transfer from Radcliffe to Taylor Francis has fortunately not been stormy! Indeed, it has brought energy for change. We will be moving onto the Scholar One platform for submission and review. Avenues are now open for wider publishing and citing of articles on line ahead of hard copy. We are working with Taylor and Francis’s marketing to widen international links and enhance our partnership with WONCA. The May 2016 issue will be a special “WONCA Edition” with Professor Allyn Walsh, Chair of the WONCA Working Party Education as an invited Guest Editor. She will be supported by the expertise of our Deputy Editor, Ron MacVicar, and Luisa Pettigrew; both of whom have done so much to champion EPC as a forum for International publication.

It would be impossible to climb these mountains without immense support. Both Radcliffe, and now Taylor and Francis have provided invaluable assistance over the year. I am most grateful to both teams for their personal help and encouragement. This year we have met the Editorial Board’s objective for a quicker turnaround time to reach “first decisions” on papers. This has largely been due to tremendous work from the two Deputy Editors, Paul Sackin and Ron MacVicar. The Editorial Board too has been very much “on board” throughout the year; special thanks to Graham Easton and Peter Cantillon for their Three Paper series and Luisa Pettigrew for her support for the International series. I am also grateful to Lesley Pughsley and the Cardiff MSc in Medical Education for their ongoing production of the “How to” series.

Heartfelt thanks to our reviewers who are experiencing ever increasing workloads, yet provide such generous support. Your contributions are invaluable. Please continue to offer your expertise. At the same time we need to increase the pool. Nominations (self or peer) would be most welcome. Finally, we are most grateful to our readers: I am delighted that we now have a constant flow of letters to the Editor. Your feedback is so valuable to us.

Warmest best wishes to you all. I very much hope that the New Year “winds blow their own freshness into” the journal and that “Nature’s peace” will flow into you “as sunshine flows into trees.”

Val Wass
[email protected]