Complaint-driven preferences & trust: patient’s views on consulting GP trainees

ABSTRACT

Background

Work-based learning depends on patients’ consent to have trainees involved in their care. However, patients can refuse trainees, which might lead to the loss of learning experiences. Improved understanding of patients’ views on consulting trainees may provide useful insights to further optimise learning for trainees.

Methods

We performed a qualitative study with 28 patients in The Netherlands. Participants were recruited from GP practices, and were purposively sampled on (un)willingness to consult GP trainees. In semi-structured interviews patients’ perspectives and willingness to consult a trainee were explored. Transcripts were thematically analysed using an inductive approach.

Results

Two themes explained patients’ views on consulting GP trainees: Presenting complaint-driven preferences and Trust in trainees’ capabilities. Patients select their doctor based on complaint-driven preferences and chose trainees if they fulfilled these preferences. For urgent, gender-specific and minor complaints, patients prefer timeliness, gender concordance or availability. Patients with more complex, long-term problems prefer to consult a trusted doctor with whom they have a longitudinal relationship. Through repeated visits and empathic behaviour trainees can become this doctor. Before patients consider consulting a trainee, they need to have trust in the trainee’s capabilities. This trust is related to the basic trust patients have in the education of the trainee, their knowledge about trainees’ capabilities and supervisory arrangements.

Conclusions

Patients’ decision to visit a trainee is fluid. Patients will visit a trainee when their complaint-driven preferences are satisfied. Influencing trainees’ fulfilment of these preferences and patients’ trust in trainees can make patients more willing to consult trainees.

KEYWORDS:

• Patients’ perspectives
• Attitudes
• Residency
• Medical Education
• General Practice

Acknowledgments

We would like to thank all participants who were willing to share their thoughts with us. Special thanks to the GP practices who helped us select and invite patients to participate.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical Review

The ethical review board of the Netherlands Association for Medical Education gave permission for the study (file number: 630).

Supplementary Material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by ZonMW under Grant number Netherlands Organisation for Health Research and Development 839130001.